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Using Cognitive Capacity, Experiential Capacity, and Domains of Suffering to Inform Assessment of Suffering in Children

Certo, Michael Vincent (2022) Using Cognitive Capacity, Experiential Capacity, and Domains of Suffering to Inform Assessment of Suffering in Children. Master's Thesis, University of Pittsburgh. (Unpublished)

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Medical decision-making for children across the spectra of age and development may involve consideration of suffering by parents, caregivers, and medical personnel. Assessment of suffering in children is challenging, because typical child development entails a state of near constant change with respect to how children experience the world, and how they process that experience. Given this considerable variability in cognitive development across the spectrum of childhood, ethical consideration of suffering in medical decision-making for children requires that healthcare providers have robust frameworks by which to assess whether a child is capable of suffering, and if so, whether they are suffering now. This paper presents a framework in which a child’s cognitive capacity and experiential capacity—the degree to which a child has access to certain aspects of physical, psychological, and existential experiences—are factors in determining their access to certain domains of suffering. Work by psychologist Phillippe Rochat is salient to the concept of experiential capacity as it relates to pediatric suffering because it provides a way to better understand a given individual’s ability to engage in a certain experience at a certain time as a function of their cognitive capacity and cognitive development. Expanding on Rochat’s work, and incorporating elements of accounts suggested by Eric Cassel, Erica Salter, Steven Edwards, and Noelia Bueno-Gómez, I offer a new characterization of pediatric suffering that incorporates cognitive capacity, experiential capacity, and domains of suffering. A more informed conceptualization of suffering in children provides a clear and justifiable framework for determining whether and how patients are suffering, reduces the risk of inaccurate or unsupported secondhand claims of suffering, helps clinicians identify the needs and means to ameliorate suffering, and reduces the risk that inaccurate attributions of suffering are used to defend premature or unjustified decisions regarding treatment. I close by presenting several clinical case examples demonstrating the utility of this model.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Certo, Michael Vincentmvc31@pitt.edumvc31
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Thesis AdvisorWicclair, Mark
Committee MemberParker, Lisa
Committee MemberSilverman, Ethan
Date: 13 October 2022
Date Type: Publication
Defense Date: 9 March 2022
Approval Date: 13 October 2022
Submission Date: 26 July 2022
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 76
Institution: University of Pittsburgh
Schools and Programs: Dietrich School of Arts and Sciences > Bioethics
Degree: MA - Master of Arts
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: Bioethics, ethics, children, pediatrics, suffering, capacity
Date Deposited: 13 Oct 2022 16:00
Last Modified: 13 Oct 2022 16:00


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