The Twofold Yes to Life: Integrating Medicine and Redemptive Suffering

The Twofold Yes to Life: Integrating Medicine and Redemptive Suffering – Why Scientific Medicine Needs Redemptive Suffering.

The topic of suffering often perplexes us. It is painful, difficult to comprehend, and our first instinct is to ask why or what is the reason for suffering? As Dostoevsky famously reflects in The Brothers Karamazov, “Why do children suffer?”¹ Suffering provokes such a strong response in the human person that it can be difficult even to confront. This paper does not directly address the question of why suffering exists. Rather, it begins with the acknowledgment that suffering is an inherent part of the human condition, an experience inseparable from being human.² From this starting point, the paper will analyze different approaches to understanding and responding to suffering.

1. Suffering – an Inquiry

Eric Cassel’s 1982 landmark paper – The Nature of Suffering and the Goals of Medicine provides an excellent foundational approach to understanding suffering. Cassel sees suffering as “the state of severe distress associated with events that threaten the intactness of the person.”³ The focus is on the distress that suffering causes, whether by disease, trauma, or mental health conditions, and how that distress affects the intactness of the person. For Cassel, the person is at the center of suffering.⁴ What this inquiry offers about suffering is a shift from suffering as merely bodily or physical, to suffering as it relates to the whole human person. Suffering is not just about physical pain, but also about how it relates to the human person. Cassell gives the example that not all pain is suffering, describing the pain of childbirth not as suffering, but a pain of joy.⁵ However, as Cassel rightly points out, it is not only physical pain that influences suffering; our memories, prior experiences, culture, and background all play a role in how each person experiences suffering.⁶ As Cassel asks, if suffering is more than just pain, “Why are we not suffering all the time?”⁷ According to Cassel, this is because a person’s experience of suffering depends on many different factors.

Cassel indeed gives us an in-depth analysis of suffering as person-centered, not just physical. Emphasizing the person as the center of suffering and his experience of suffering raises the question of whether suffering is merely subjective. However, Cassel’s shift was necessary to move from suffering being merely physical to relating it to the human person. As with all scientific inquiry, a conclusion allows a theory to advance: suffering begins with the human person and their experience, yet it also possesses an objective aspect.

Suffering thus begins with an external manifestation or phenomenon that results in severe distress affecting the human person. For Cassel, the emphasis may have been on the “distress” & “the intactness of the person.”⁸ The disease, the symptoms, and the psychological trauma all focus on the distress, which in turn affects the intactness of the Person. However, focusing on distress, whether intentionally or unintentionally, can lead to a mere subjectivist approach to suffering. The suffering, as Cassel rightly points out, is not determined solely by pain but by the person’s narrative. But an emphasis on the person’s narrative – their experience, background, and so on - also has drawbacks, making it a purely subjective experience.

2. Suffering as a Loss of Sense of Self

The human person has a sense of self, meaning human beings can be the object of their own actions.⁹ Tyler Tate and Robert Pearlman illustrate, how our sense of self is always in relation to relationships, roles, and narratives.¹⁰ For example, the question of who you are, for a Christian, is often described in terms of being a beloved in God’s eyes, based on the person’s relationship with God. Often, the question of who you are is presented as “I am a professor,” or the roles one assumes, or the question of who you are is answered through a narrative: “I grew up in such and such town.” What Tate and Pearlman try to point out is that a loss of sense of self defines suffering.¹¹ When a person goes through the death of a loved one, there is a loss of a relationship, which can result in a loss of sense of self, which is identified as suffering. This suffering manifests emotions, symptoms, grief, and can change how we go about life.

Fredrick Svenaeus illustrates that suffering is also accompanied by alienating moods that affect the person, leading them to struggle to find meaning and purpose in the face of this loss.¹² He describes the painful experience associated with suffering as involving negative feelings and mood, but it has implications for a person’s entire life.¹³ Thus, a loss of sense of self can be an objective measurement of human suffering along with its associated affectivity. Suffering, therefore, begins with the human experience as Cassel rightly describes, but becomes measured in terms of its loss of sense of self and its associated affectivity.

A person with cancer undergoing treatment experiences suffering based on their own narrative, story, and the physical pain often associated with such treatment. The many physical symptoms of cancer & chemotherapy cause distress and have a negative affectivity. The cancer and its treatment result in the person no longer being able to take long walks, spend time playing with their grandchildren, or eat what they like. It results in a negative affectivity that makes him ask questions about meaning and purpose, life after death, and so on. His role, relationships, narrative, and affectivity are changed by the suffering caused by cancer and treatment. Suffering is more than a physical phenomenon; it is more than a subjective experience—it involves the human person, his body and soul.

3. The Scientific Approach to Suffering.

The development of medicine as a science over the past two or three centuries has led to the advancement of evidence-based clinical medicine. In doing so, questions related to suffering were also aimed at being treated scientifically.¹⁴ Michel Foucault famously captures the spirit of the times and its approach to medicine; the physician must distance himself from the disease to learn the pathological truth.¹⁵ Suffering, pain, and disease were to be observed, studied, carefully examined, and measured. In doing so, we have made numerous advances in medicine. The development of antibiotics, vaccines, and innumerable treatments for diseases can all be attributed to careful observation, study, and the scientific method. Louis Pasteur’s careful quantitative methods and the necessity of quantitative studies in the 19th century are prime examples of the spirit of scientific medicine that led to the development of germ theory.¹⁶ It was Pasteur and others, such as Robert Koch, Joseph Lister, and Edward Jenner, among many others, through their careful observations, meticulous scientific methods, and measurement of outcomes, who led us to understand the origins of many diseases caused by microorganisms and, in doing so, their cures.¹⁷ In recent years, the development of immunotherapy, Chimeric Antigen Receptor T-Cell therapy (CAR-T cell), and stem cell transplantation has all been guided by careful scientific methods. It has positively impacted numerous people, enabling them to live better lives. Books could be written to summarize the advantages of the scientific method in approaching medicine as a science and the lives it has affected.

At the same time, was there a cost to focusing on the body - what is measurable, what can be seen and observed? How does one approach the question of suffering through a scientific lens? The scientific method reaches its limits when it attempts to understand suffering purely through observation and detachment. It must either confine its inquiry to the body and its symptoms or deny suffering as a fundamental human experience.

Charles Taylor describes one of the hallmarks of the secular world as an “immanent framework.”¹⁸ In an immanent framework, “a constructed social order that reconfigures space, time, rationality, and nature all in immanent terms—a full-blown human social system aimed toward a human flourishing that contains no necessary contingency on the reality of transcendence undergirding human flourishing.”¹⁹ What the scientific method has done for medicine is to try and answer all questions about human suffering through the lens of science. In doing so, we have reduced suffering to bodily disease; thus, alleviating suffering means alleviating disease. The physician is seen as one who can eliminate disease, not a healer of the human person. The physician tends to the person’s pain, not to his suffering. What can be measured, observed, and proven is what the human person is reduced to.

Our understanding of suffering involves the whole human person- body, soul, and acknowledges both the experience of pain and the loss of self that suffering can bring. In this light, medicine can be seen as affirming life within the biological limits of human existence. Medicine, as a scientific and evidence-based approach, supports reducing suffering associated with pain and the biological functions of the body, promotes recovery, health, and flourishing, and extends our lives. If we are to see medicine as a science through this perspective-that the body is part of the human person and what affects the body impacts the soul (without creating a dichotomy, but recognizing the integrated human being)²⁰--then we can avoid rejecting the scientific method and the many advances it has contributed to alleviating human suffering, while affirming a commitment to life.

4. Religion’s Approach to Suffering.

In a 2021 study by the Pew Research Center, half of adults endorsed the idea that suffering is part of God’s larger plan.²¹ Suffering, from a purely religious point of view, aims to embody the answer that either everything happens for a reason or is part of a larger plan. Suffering in religion seeks meaning. In doing so, it can create a certain resignation to suffering. The human person sees suffering as part of God’s larger plan; therefore, his only option is to accept it, resign to it, and find meaning. The meaning happens through different manifestations, either as part of a larger plan, or that something good will come out of it. For a Christian, the approach would be to identify with Christ on the cross and say this is meant to happen to me, just as it did to Christ. In undertaking this, the Christian can easily enter into a kind of victimization. All these may have elements of truth in them, but what religion does, through this approach, is undermine the human experience of suffering. The body and what it goes through, the loss of sense of self, is bypassed, and religion aims to blindly equate suffering with “God’s plan.” What is here in this world, what you are going through, your experience of pain, your loss of self, is lost in an absolutization of a religious view of suffering. One could view the purely religious perspective as a reaction to the scientific method and the harmful anthropology of reducing the human person to mere body, without a call to transcendence. Still, a purely transcendental view of suffering, a purely religious view of suffering without acknowledging the human body, also carries harm in itself – it makes suffering disembodied.

5. Redemptive Suffering & Scientific Medicine

I was not at my mother’s death, I was not at my brother’s death, I was not at my father’s death…At twenty, I had already lost all the people I loved.²²

John Paul II, a philosopher, a phenomenologist, and a person who himself went through immense suffering (apart from the loss of loved ones, he was shot and also suffered from Parkinson’s disease in his later years), providentially wrote an apostolic letter on suffering – Salvifici Doloris (Salvific suffering) in 1984.

Even though Paul, in the Letter to the Romans, wrote that ‘the whole creation has been groaning in travail together until now,’even though man knows and is close to the sufferings of the animal world, nevertheless, what we express by the word “suffering” seems to be particularly essential to the nature of man. It is as deep as man himself, precisely because it manifests in its own way that depth, which is proper to man, and in its own way surpasses it. Suffering seems to belong to man’s transcendence: it is one of those points in which man is in a certain sense “destined” to go beyond himself, and he is called to this in a mysterious way.²³

In Salvifici Doloris, St. John Paul II acknowledges that suffering is, in fact, a human condition. However, for a Christian, suffering assumes a deeper meaning; it becomes a means of participating in the saving work that Jesus accomplished for humanity. Suffering, for John Paul II finds its heart in transcendence. Transcendence does not deny the body, the physical, or the sense of self, but takes it all into account and brings it into all transcendence. Our suffering becomes redemptive. But this is not just another blind generalization of how to find meaning in suffering. As John Paul II writes, “In the cross of Christ not only is the redemption accomplished through suffering, but also human suffering itself has been redeemed.”²⁴ The heart of redemptive suffering is the fact that Christ, who is the second person of the Trinity, God himself, comes as a human and willingly, by his free choice, enters into suffering. By willingly entering into human suffering – of experiencing abandonment (“My God, my God why have you forsaken me?”), of experiencing deep anguish and fear (“Father, if you are willing, remove this cup from me; yet, not my will but yours be done”), of physical pain of being flogged and crucified ²⁵- Christ takes in all this and transforms the suffering.²⁶ He transforms the suffering into what? into the mystery of love, the mystery of the heart of redemption, the mystery of the heart of the Father.²⁷ Our suffering is transformed into a saving power for ourselves and for others. It is a yes to life – acknowledging the limits of our physical body, while saying yes to life that transcends those limits – the two-fold yes to life.

For a patient facing the diagnosis of terminal cancer, experiencing pain and suffering, being hospitalized, or struggling with addiction, Christ enters into that suffering and transforms it. It is not just a simple act of solidarity that occurs when one invites Christ into suffering, but a transformation of suffering into love. It is not merely identifying with the cross of Christ or believing that everything happens for a reason, but a transformation that occurs because Christ first entered into human suffering to experience the love of the Father.

What redemptive suffering offers to the scientific method is a yes to life when the limits of scientific function have been reached. Redemptive suffering acknowledges the experience of the human person —the suffering that occurs, the pain, the anguish of a severe diagnosis, and the physical symptoms that come with it. The science of medicine says yes to life within biological boundaries. Still, redemptive suffering says yes to life that transcends those limits, affirming life even when biological function fails and medical intervention is exhausted.

The healthcare worker’s healing touch and the patient’s embrace of suffering are not in conflict but are analogous expressions of the same affirmation of life. This reconciles the apparent contradiction between medicine’s pursuit of healing and Christianity’s embrace of suffering. Medicine operates in temporal participation in divine healing; redemptive suffering operates in eternal participation in divine love. The most integrated response pursues medicine vigorously, while viewing its limits not as failure, but as thresholds to a more profound truth. The cancer patient who fights for a cure while embracing suffering as redemptive is not inconsistent, but affirms life on both levels. Medicine and redemptive suffering are not only compatible but mutually illuminating. Medicine shows what we affirm; redemptive suffering reveals why that affirmation is ultimately unconditional.

6. Witnesses of the Two-Fold Yes to Life – The Early Church

In the early Church, around AD 200, there were two remarkable witnesses, St. Perpetua and St. Felicity. Perpetua, a mother of an infant, and her companion Felicity are persecuted for their Christian faith under the rule of Roman Emperor Septimus Severus.²⁸ They were taken from the prison into the amphitheater. As they are taken into the amphitheater, they describe their procession into the amphitheater to be martyred ;“it was with joy, not with fear.”²⁹ A moment in the lives of these two women, who are unwillingly and forcibly led to their deaths by brutal and inhuman means, is transformed into a moment of joy. The mystery of redemption replaces fear through their acceptance of Christ, who transforms their suffering. Perpetua and Felicity are ultimately fed to a wild beast. Although Perpetua survives this ordeal and is eventually executed by the sword, Felicity is killed by the wild beast. A poignant moment in their martyrdom occurs when Perpetua shares a kiss of peace with her companions facing death—a symbol of forgiveness, unity, and strength. This is what redemptive transformation looks like. It transforms the worst of human situations into moments of grace, love, and joy. This transformation comes from participating in the redemptive suffering of Christ.

The account of the martyrdom of Saints Perpetua and Felicity is not for the faint of heart. It does not shy away from the suffering of the saints, nor does it lack vivid, descriptive imagery. The fear and anguish that Perpetua endures, the rejection and abandonment by her family, the shame of being naked before a large crowd, and the graphic imagery of blood being poured out and trampled by beasts are all described in detail.³⁰ The martyrs experience a loss of self in many ways—physically and mentally. Yet, through all this, the early church martyrs teach us that when we recognize the limits of our biological bodies and physical pain, we can affirm a life that goes beyond those limits, embracing life on all levels.

The two-fold ‘yes’ to life requires us to accept our bodily suffering and limitations, and to do everything we can to alleviate them. At the same time, the two-fold yes to life recognizes those limitations and allows us to say yes to life beyond them, affirming eternal life and unconditional love-that does not end with our time on earth but sustains our love as eternal and unconditional. St. John Vianney writes regarding suffering:

Whether we will or not, we must suffer. There are some who suffer like the good thief, and others like the bad thief. They both suffered equally. But one knew how to make his sufferings meritorious, he accepted them in the spirit of reparation, and turning towards Jesus crucified, he received from His mouth these beautiful words: ‘This day thou shalt be with Me in Paradise.’ The other, on the contrary, cried out, uttered imprecations and blasphemies, and expired in the most frightful despair. There are two ways of suffering - to suffer with love, and to suffer without love.³¹

St. John Vianney captures beautifully the two-fold ‘yes’ to life, acknowledging first and foremost that suffering is an inherent part of the human condition. The Christian call is then to suffer with love, so that our suffering may be transformed and ultimately be redemptive.

7. The Ethical Implications of the Two-Fold Yes to Life

A two-fold ‘yes’ to life offers a perspective that allows us to acknowledge the dignity of the human person. The human person, a composite of body and soul, regains their dignity through a two-fold ‘yes’ to life. A purely scientific or purely religious view does harm to the human person. As ethicist Jeffrey Bishop writes,

Medicine has grounded its metaphysics in efficient causation. They cannot be returned to a socially productive function, and yet, they continue to require medical care. They are confronting—and force us all to confront—metaphysical questions of the meaning and purpose of life. And yet, for medicine, these questions are irrelevant. From the perspective of efficient causation, the only thing left for these patients to confront is the non-functioning of their corporeal machine.³²

As we have observed, one of the main consequences of rejecting a two-fold yes to life is our view of human life. If we consider suffering only through the lens of medicine, there is no room for questions about love in suffering, because science cannot answer them. Science is the wrong tool for exploring questions of love in suffering. An overly rigid religious perspective on suffering would deny many benefits and even fail to challenge the boundaries of the scientific method and evidence-based medicine.

Our care for the terminally ill and dying is based on the understanding that, in their suffering, they participate in Christ’s redemptive salvation. When medical science reaches its limits, their relief from suffering comes through their participation in Christ’s redemptive suffering. This is why, at the end of life, we aim to alleviate all physical symptoms but do not choose to end their lives. The double affirmation of life demonstrates that human dignity goes beyond mere functionality. When medicine is based on the metaphysics of efficient causation, it risks dismissing the non-functional patient as insignificant. Embracing redemptive suffering affirms that value endures even when utility ends. The debates on euthanasia, disability, and chronic illness are often linked to questions of autonomy and capacity, but redemptive suffering helps us see suffering beyond the limits of human autonomy and functionality. Redemptive suffering allows us to see that every person, no matter the extent of their suffering, participates in the redemptive work of humanity.

Every person in front of us is unique, each with an inherent dignity. At the heart of the human condition is suffering. Suffering brings with it questions that challenge the very core of human existence. Should we not then give suffering the reverence it’s due? Medicine, at its core, is at the service of the human person who suffers. The call for medicine is to reclaim it as a human endeavor, aiming to serve the healing of the entire person—body and soul—without separating the two. Embracing scientific medicine and integrating redemptive suffering into the core of the mystery of suffering offers an approach that seeks to reverence the mystery of the human person and his suffering.

Acknowledgements

I want to express my sincere gratitude to Dr. Caitlin Gilson (St. Vincent de Paul Regional Seminary, Florida) for her assistance in providing additional references that greatly enriched this work. I am also thankful to Mary and Lily Gilson for their valuable editorial comments and suggestions. My appreciation extends to Fr. Jose Lopez (St. Vincent de Paul Regional Seminary, Florida) for his insightful guidance regarding the section on early Church martyrs and Dr.Troy A. Stefano (St.Vincent de Paul Regional Seminary) for the helping with the overall framework and outline.

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1. Fyodor Dostoyevsky, The Brothers Karamazov, trans. David McDuff (Penguin Classics, 2003), bks. 5, Chapter 4.. It’s not worth the tears of that one tortured child who beat itself on the breast with its little fist and prayed in its stinking outhouse, with its unexpiated tears to ‘dear, kind God!’ It’s not worth it, because those tears are unatoned for. They must be atoned for, or there can be no harmony. But how? How are you going to atone for them? Is it possible? By their being avenged? But what do I care for avenging them? What do I care for a Hell for oppressors? What good can Hell do, since those children have already been tortured? And what becomes of harmony, if there is Hell? I want to forgive. I want to embrace. I don’t want more suffering. And if the sufferings of children go to swell the sum of sufferings which was necessary to pay for truth, then I protest that the truth is not worth such a price.” ↩

2. BMJ, “Suffering and the Human Condition,” Journal of Medical Ethics Blog, January 6, 2012, https://blogs.bmj.com/medical-ethics/2012/01/06/suffering-and-the-human-condition/. ↩

3. Eric J. Cassel, “The Nature of Suffering and the Goals of Medicine,” research-article, The New England Journal of Medicine, Massachusetts Medical Society, March 18, 1982, world, https://doi.org/10.1056/NEJM198203183061104. ↩

4. Cassel, “The Nature of Suffering and the Goals of Medicine.” ↩

5. Cassel, “The Nature of Suffering and the Goals of Medicine.” ↩

6. Cassel, “The Nature of Suffering and the Goals of Medicine.” ↩

7. Eric J. Cassel, “The Nature of Suffering and the Goals of Medicine,” research-article, The New England Journal of Medicine, Massachusetts Medical Society, March 18, 1982, world, https://doi.org/10.1056/NEJM198203183061104. ↩

8. Cassel, “The Nature of Suffering and the Goals of Medicine.” ↩

9. Tyler Tate and Robert Pearlman, “What We Mean When We Talk About Suffering—and Why Eric Cassell Should Not Have the Last Word,” Perspectives in Biology and Medicine 62, no. 1 (2019): 95–110. ↩

10. Tate and Pearlman, “What We Mean When We Talk About Suffering—and Why Eric Cassell Should Not Have the Last Word.” ↩

11. Tate and Pearlman, “What We Mean When We Talk About Suffering—and Why Eric Cassell Should Not Have the Last Word.” ↩

12. Fredrik Svenaeus, “The Phenomenology of Suffering in Medicine and Bioethics,” Theoretical Medicine and Bioethics 35, no. 6 (2014): 407–20, https://doi.org/10.1007/s11017-014-9315-3. ↩

13. Svenaeus, “The Phenomenology of Suffering in Medicine and Bioethics.” ↩

14. “Los sentidos del sufrimiento [The Senses of Suffering],” in Alivio De Las Situaciones Difíciles Y Del Sufrimiento En La Terminalidad, ed. Wilson A Astudillo et al. (Sociedad Vasca de Cuidados Paliativos, 2005), https://paliativossinfronteras.org/wp-content/uploads/libroAlivio.pdf. ↩

15. Michel Foucault, Naissance de la clinique [The Birth of the Clinic], vol. 23 (Presses Universitaires de France, 1997). ↩

16. Kendall A. Smith, “Louis Pasteur, the Father of Immunology?,” Frontiers in Immunology 3 (April 2012): 68, https://doi.org/10.3389/fimmu.2012.00068. ↩

17. Smith, “Louis Pasteur, the Father of Immunology?” ↩

18. Charles Taylor, A Secular Age, First Harvard University Press paperback edition (The Belknap Press of Harvard University Press, 2018). ↩

19. Taylor, A Secular Age. ↩

20. For example: the debilitating arthritis is a physical pain, it is simultaneously a psychological one, it stretches and changes relationships, alters views of myself, it dilates the spiritual relation, pulling me towards my mortality and the questions of end. ↩

21. Travis Mitchell, “Views on Human Suffering and God’s Role in It,” Pew Research Center, November 23, 2021, https://www.pewresearch.org/religion/2021/11/23/views-on-human-suffering-and-gods-role-in-it/. ↩

22. Michael Howard, “Uncommon Love Was a Common Virtue for Pope St John Paul II,” The Catholic Leader, October 22, 2024, https://catholicleader.com.au/life/faith/uncommon-love-was-a-common-virtue-for-pope-st-john-paul-ii/. ↩

23. John Paul II, “Salvifici Doloris (Salvific Suffering) - Apostolic Letter,” Libreria Editrice Vaticana, February 11, 1984, para. 2, http://www.vatican.va/content/john-paul-ii/en/apost_letters/1984/documents/hf_jp-ii_apl_11021984_salvifici-doloris.html. ↩

24. John Paul II, “Salvifici Doloris (Salvific Suffering) - Apostolic Letter,” para. 19. ↩

25. Holy Bible: NRSV, New Revised Standard Version, Catholic Edition, Anglicized Text, XL Catholic ed.; 1st ed (Harper Catholic Bibles, 2007). Matthew 27:46,Luke 22:42. ↩

26. Hans Urs Von Balthasar, To the Heart of the Mystery of Redemption, 1st ed, with Adrienne Von Speyr (Ignatius Press, 2010), chap. 8. ↩

27. Von Balthasar, To the Heart of the Mystery of Redemption, chap. 8. ↩

28. “Church Fathers: Passion of Perpetua and Felicity,” accessed October 26, 2025, https://www.newadvent.org/fathers/0324.htm?utm_source=chatgpt.com. ↩

29. “Church Fathers: Passion of Perpetua and Felicity.” ↩

30. “Church Fathers: Passion of Perpetua and Felicity.” ↩

31. Vianney, The Little Catechism of the Curé of Ars, chap. 18. ↩

32. Harold Braswell, “Jeffrey P. Bishop, The Anticipatory Corpse (Notre Dame, IN: University of Notre Dame Press, 2011), ISBN: 978-0268022273,” Foucault Studies, September 17, 2012, 196–200, https://doi.org/10.22439/fs.v0i14.3899. ↩