Neonatal pediatric suffering: limits of the phenomenology of suffering?

• Ramos-dos-Reis, Róbson ^[1]
  1. [1] Universidade Federal de Santa Maria

     Universidade Federal de Santa Maria

     Brasil

     
• Localización: Estudios de Filosofía, ISSN-e 2256-358X, ISSN 0121-3628, Nº. 70, 2024 (Ejemplar dedicado a: july-december 2024 (Disease, illness, sickness: philosophical perspectives)), págs. 160-179
• Idioma: inglés
• DOI: 10.17533/udea.ef.355671
• Títulos paralelos:
  • Sufrimiento pediátrico neonatal: ¿límites de la fenomenología del sufrimiento?
• Enlaces
  • Texto completo
• Dialnet Métricas: 1 Cita
• Resumen
  • español

    El sufrimiento neonatal ha sido el foco de debates recientes en bioética pediátrica y teoría del sufrimiento. ¿Cómo debemos acceder y conceptualizar el sufrimiento que se puede atribuir a los recién nacidos? ¿Cómo podemos discernir el sufrimiento de los recién nacidos que no son neurotípicos y pueden tener vidas cortas y discapacidades neurocognitivas graves, además de ser totalmente dependientes de las personas o de las tecnologías que les sustentan la vida? La fenomenología ha proporcionado herramientas valiosas para analizar las experiencias humanas del sufrimiento, pero su aplicación al sufrimiento neonatal plantea desafíos fundamentales. En este artículo, se consideran contribuciones recientes para dilucidar el fenómeno del sufrimiento neonatal, especialmente aquellas en el campo de las teorías no experienciales del sufrimiento. A partir de esta revisión, se examina un enfoque fenomenológico reciente del sufrimiento. Dirigido explícitamente a personas narrativas, ese enfoque parece ser inherentemente limitado a la hora de dilucidar el fenómeno del sufrimiento pediátrico neonatal. Se ofrece una sugerencia para elaborar parcialmente los fundamentos teóricos de una teoría fenomenológica del sufrimiento neonatal. Esta sugerencia apunta hacia un programa para una fenomenología de los sentimientos existenciales de los recién nacidos.

  • English

    Neonatal suffering has been the focus of recent debates in pediatric bioethics and suffering theory. How can we access and conceptualize the suffering that can be attributed to newborns? How are we to discern the suffering of newborns who are non-neurotypical and may have short lives and severe neurocognitive disabilities, in addition to being entirely dependent on people or life-sustaining technologies? Phenomenology has provided valuable tools for analyzing the human experiences of suffering, but its application to neonatal suffering comes with fundamental challenges. In this paper, I consider recent contributions for elucidating the phenomenon of neonatal suffering, especially those in the field of non-experiential theories of suffering. Based on this review, a recent phenomenological approach to suffering is examined. Explicitly directed toward narrative persons, that approach appears to be inherently limited in elucidating the phenomenon of neonatal pediatric suffering. A suggestion is offered for partially elaborating the theoretical foundations of a phenomenological theory of neonatal suffering. This suggestion points towards a program for a phenomenology of the existential feelings of newborns.

• Referencias bibliográficas
  • Anand, K. J.; Hickey, P. R. (1987). Pain and its effects in the human neonate and fetus. The New England Journal of Medicine, 317(21), 1321–1329....
  • Brady, M. (2018). Suffering and Virtue. Oxford University Press.
  • Brancatisano, S. (2021). Suffering and end-of-life decision making. Journal of Paediatrics and Child Health, 57(5), 766. https://doi.org/10.1111/jpc.15461.
  • Campelia, G.; Kett, J; Wightman, A. (2020). Relational suffering and the moral authority of love and care. Theoretical Medicine and Bioethics,...
  • Carel, H.; Feder, G.; Gyorffy, G. (2019). Children and health. En A. Gheaus; G. Calder; J. Wispelaere (Eds.), The Routledge Handbook of the...
  • Carel, H.; Kidd, I. (2020). Suffering and transformative experience. En D. Bain; M. Brady; J. Corns, J. (eds.), Philosophy of Suffering: Metaphysics,...
  • Cassel E. (1991). The Nature of Suffering and the Goals of Medicine. Oxford University Press.
  • Clément de Cléty, S.; Friedel, M.; Verhagen, A. A.; Lantos, J. D.; Carter, B. S. (2016). Please do whatever it takes to end our daughter’s...
  • Corns, J. (2021). Suffering as significantly disrupted agency. Philosophy and Phenomenological Research, 10 (3), 706–729. https://doi.org/10.1111/phpr.12841.
  • de Weerd, W.; van Tol, D.; Albers, M.; Sauer, P.; Verkerk, M. (2015). Suffering in children: Opinions from parents and health-care professionals....
  • Fitzgerald M. (2015). What do we really know about newborn infant pain? Experimental Physiology, 100(12), 1451–1457. https://doi.org/10.1113/EP085134.
  • Friedrich, A. B.; Dempsey, K. M.; Salter, E. (2019). The use of suffering in pediatric bioethics and clinical literature: a qualitative content...
  • Green, J.; Darbyshire, P.; Adams, A.; Jackson, D. (2016). It’s agony for us as well: Neonatal nurses reflect on iatrogenic pain. Nursing Ethics,...
  • Hanson S. S. (2016). Pediatric euthanasia and palliative care can work together. The American Journal of Hospice & Palliative Care, 33(5),...
  • Isaacs, D.; Preisz, A. (2021). Suffering and end-of-life decision-making. Journal of Paediatrics and Child Health, 57(9), 1356–1359. https://doi.org/10.1111/jpc.15380.
  • Kauppinen, A. (2020). The world according to suffering. En D. Bain; M. Brady; J. Corns (eds.), Philosophy of Suffering: Metaphysics, Value,...
  • Kious B. (2022). Three kinds of suffering and their relative moral significance. Bioethics, 36(6), 621–627. https://doi.org/10.1111/bioe.13021.
  • Kious B. (2023). Suffering and the dilemmas of pediatric care: a response to Tyler Tate. Theoretical Medicine and Bioethics, 44(3), 249–258....
  • Klinke, M.; Fernandez, A. (2022). Taking phenomenology beyond the first-person perspective: conceptual grounding in the collection and analysis...
  • Lagercrantz, H.; Changeux, J. P. (2009). The emergence of human consciousness: from fetal to neonatal life. Pediatric Research, 65(3), 255–260....
  • Leder, D. (1990). The Absent Body. University of Chicago Press.
  • Massie J. (2021). Suffering and the end of life. Journal of Paediatrics and Child Health, 57(7), 979–980. https://doi.org/10.1111/jpc.15566.
  • Mayerfeld, J. (1999). Suffering and Moral Responsibility. Oxford University Press.
  • McClelland, T. (2020). The disruption model of suffering. En D. Bain; M. Brady; J. Corns (eds.), Philosophy of Suffering: Metaphysics, Value,...
  • Phillips, W. R.; Uygur, J. M.; Egnew, T. R. (2023). A comprehensive clinical model of suffering. Journal of the American Board of Family Medicine,...
  • Ratcliffe, M. (2008). Feelings of Being. Phenomenology, Psychiatry, and the Sense of Reality. Oxford University Press. https://doi.org/10.1093/med/9780199206469.001.0001
  • Ratcliffe, M. (2015). Experiences of Depression. A Study in Phenomenology. Oxford University Press.
  • Ratcliffe, M. (2020). Existential feelings. En T. Szanto; H. Landweer, (eds.). The Routledge Handbook of Phenomenology of Emotion (pp. 250-261)....
  • Ratcliffe, M. (2023). The underlying unity of hope and trust. The Monist, 106, 1–11. https://doi.org/10.1093/monist/onac018.
  • Ratcliffe, M. (unpublished). Scaffolding regulation and the social world: A perspective on human emotional experience. Available at https://www.academia.edu/92412177/.
  • Ratcliffe, M.; Broome, M. (2022). Beyond “salience” and “affordance”: Understanding anomalous experiences of significant possibilities (50–69)....
  • Ratcliffe, M.; Ruddell, M.; Smith, B. (2014). What is a “sense of foreshortened future?” A phenomenological study of trauma, trust, and time....
  • Reis, R. (2020). Fenomenologia hermenêutica e psicologia experimental do desenvolvimento. Ekstasis. Revista de Hermenêutica e Fenomenologia,...
  • Rochat, P. (2011). What is it like to be a newborn? En S. Gallagher (ed.). The Oxford Handbook of the Self (pp. 57–79). Oxford University...
  • Salter, E. K. (2020). The new futility? The rhetoric and role of “suffering” in pediatric decision-making. Nursing Ethics, 27(1), 16–27. https://doi.org/10.1177/0969733019840745.
  • Svenaeus, F. (2014). The phenomenology of suffering in medicine and bioethics. Theoretical Medicine and Bioethics, 35(6), 407–420. https://doi.org/10.1007/s11017-014-9315-3.
  • Svenaeus, F. (2018). Phenomenological Bioethics: Medical Technologies, Human Suffering, and the Meaning of Being Alive. Routledge.
  • Svenaeus, F. (2020). To die well: The phenomenology of suffering and end of life ethics. Medicine, Health Care and Philosophy, 23(3), 335–342....
  • Svenaeus F. (2022). Health and illness as enacted phenomena. Topoi: An International Review of Philosophy, 41(2), 373–382. https://doi.org/10.1007/s11245-021-09747-0.
  • Tate T. (2020a). Pediatric suffering and the burden of proof. Pediatrics, 146(1), S70–S74. https://doi.org/10.1542/peds.2020-0818N.
  • Tate T. (2020b). Philosophical investigations into the essence of pediatric suffering. Theoretical Medicine and Bioethics, 41(4), 137–142....
  • Tate, Tyler (2020c). What we talk about when we talk about pediatric suffering. Theoretical Medicine and Bioethics, 41(4), 143–163. https://doi.org/10.1007/s11017-020-09535-8.
  • Tate, T.; Pearlman, R. (2019). What we mean when we talk about suffering—and why Eric Cassell should not have the last word. Perspectives...
  • Tobin, B. (2021). Suffering and end-of-life decision-making. Journal of Paediatrics and Child Health, 57(9), 1360–1361. https://doi.org/10.1111/jpc.15437.
  • van Hooft, S. (1998). Suffering and the goals of medicine. Medicine, Health Care and Philosophy, 1(2), 25–131. https://doi.org/10.1023/A:1009923104175.
  • van Manen, M. (2019). Phenomenology of the Newborn: Life from Womb to World. Routledge.
  • Vincini, S.; Gallagher, S. (2021). Developmental phenomenology: Examples from social cognition. Continental Philosophy Review, 54, 183–199....
  • Verhagen, E.; Sauer, P. J. (2005). The Groningen Protocol—Euthanasia in severely ill newborns. The New England Journal of Medicine, 352(10),...
  • Walsh, J. (2022). Into that darkness: A Heideggerian phenomenology of pain and suffering. Journal of Phenomenological Psychology, 53(1), 82–102....
  • Zayegh A. M. (2022). Addressing suffering in infants and young children using the concept of suffering pluralism. Journal of Bioethical Inquiry,...