TY - JOUR T1 - The nature of suffering and its relief: a proposal for a redefinition JF - BMJ Supportive & Palliative Care JO - BMJ Support Palliat Care SP - e1 LP - e1 DO - 10.1136/bmjspcare-2019-001796 VL - 10 IS - 1 AU - Paul Muleli Kioko AU - Pablo Requena Meana Y1 - 2020/03/01 UR - http://spcare.bmj.com/content/10/1/e1.abstract N2 - Recent advances in our understanding of the nature of suffering and its different dimensions have exposed certain deficits in the current definition of suffering. These shortcomings have impacted negatively on the appropriate formulation of precise treatment objectives for each dimension of suffering within the overall framework of the goals of medicine. Existential suffering offers a clear example where the lack of a universally accepted definition has led to confusion regarding what should constitute appropriate relief for this particular dimension of suffering. In this thought piece, we propose a redefinition of suffering based on three elements: first, suffering refers to a specific state of a person (the essence of suffering); second, this state is characterised by a specific psychosomatic anguish reaction (the manifestation of suffering) and third, this reaction is in response to a perceived threat to the integrity of the person (the cause of suffering). The proposed definition allows for an important and clear distinction to be made between the primary and symptomatic relief of suffering and the role of medicine in each form of relief. The terms of the proposed definition and the distinction between primary and symptomatic relief provide useful tools for further research regarding the different dimensions of suffering and its relief. ER -