Rethinking suffering: a triadic model of suffering for use in evaluating the ethical permissibility of medically assisted dying

<p dir="ltr">Theories of ‘suffering’ and assumptions about its nature have significantly influenced debates about the permissibility and practice of medically assisted dying (MAD). In all jurisdictions where the law permits MAD, suffering is a condition for accessing MAD. The permissibility of MAD on the grounds suffering often relies on theoretical assumptions about its nature and source. In the philosophical literature theories of suffering conceptualise suffering as either an inherently subjective experience or an objectively identifiable phenomenon. This thesis argues that purely subjective or objective approaches to conceptualising suffering are insufficient for guiding ethical judgments concerning the permissibility of MAD. This results in incomplete assessments of suffering that fail to capture important cases and their ethical implications. In response, to the deficiencies identified in monistic theories of suffering I develops a triadic model of suffering which encompasses the <i>medical</i>, <i>personal</i>, and <i>social </i>aspects of suffering by drawing on Andrew Twaddle’s triadic model of malady. I apply the triadic model of suffering to a hypothetical case of Alzheimer’s Disease to demonstrate its epistemic and normative utility. Finally, I consider the value of the triadic model of suffering for assessing individual choice, collective dimensions of suffering and socially sanctioned MAD.</p>