The philosophical, psychological and physical effects of suffering.
Why does it take the imminent end-of-life for people to ask important life questions?
The phone call came from the aged care facility to say after finishing her evening meal, Nan had quietly died. At 101 years old, everyone says she has had a good life, but had she?
What does a good life look like?
How can we know that our life was good?
People who are facing end-of-life begin a quest to find meaning in and for their existence. They often begin asking questions about the role they have played in life, the relationships forged and efforts made towards living a meaningful life. As a result of asking these questions, they often develop a ‘greater appreciation for life and changed sense of priorities; warmer, more intimate relationships with others; a greater sense of personal strength; recognition of new possibilities or paths for one’s life and spiritual development’ (Varelius 2019). These ideas, which are considered to be an aspect of philosophical suffering, can bring a level of comfort at end-of-life for the patient and family.
Suffering is most often associated with the physical symptoms of pain or trauma felt by a patient. In most instances, medical staff can treat pain associated with disease or illness through administering pain relief. ‘Pain is often the cause of physical suffering, but pain and suffering are not necessarily synonymous.’ (O'Connor 2020) Physical suffering is only one aspect care-givers should consider when supporting end-of-life patients. Suffering or theodicy as it is known from a religious perspective, considers a physical, philosophical (theological) and psychological view-point, in this instance, towards end-of-life.
The psychological view considers the emotional perspective towards ‘the awareness of the imminence of death, the knowledge that they will soon permanently lose whatever they consider valuable in life and that life will shortly be over for good.’ (Varelius 2019) Considerations towards these ideas can bring up emotional responses, which for some people be can uncomfortable and even foreign. In some instances there may be a crossover of psychological and philosophical suffering, with some experts referencing psychological and spiritual pain as the same (O’Connor 2020). I believe there is a difference between emotions felt at the time of a loss and the questions around belief and values that may arise. I often use the idea of the head and the heart to disseminate between the thoughts and feelings experienced.
Philosophical suffering or the intellectual perception of end-of-life, may include theoretical question of ‘why me?’ as patients seek a rational explanation for their suffering. For Christians, the theological or ‘the intellectual problem of suffering is about how to give a rational explanation for the existence of God and the suffering in the world’ (Kuwornu-Adjaottor 2019). Philosophical viewpoints can evolve from key theological or intellectual questions such as What is God really like? or Why has God allowed this to happen? Additionally there are further religious views which can be expressed through the philosophical lens which O’Connor (2021) talks about and include meaning making, accepting change, the potential to learn and grow and a changed view of the world.
These (new) perspectives offer not only patients, but care-givers, the opportunity to re-evaluate life. They offer opportunities for conversations to be had, decisions to be made and the potential of growth to occur which may add greater value to life and relationships.
Bron Gowty is an education consultant, kinesiologist and spiritual carer who has been working with children for more than 20 years in schools and with children and adults in a clinic setting for 6 years.