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June 4, 1997

The Paradox of Technology: Learning to Share Control With the Patient

JAMA. 1997;277(21):1681. doi:10.1001/jama.1997.03540450037027

To the Editor.  —Dr Suchman and colleagues1 offered an interesting model of verbal communication behaviors, including empathic and praise opportunities and terminators. They reported that emotional clues for opportunities went unacknowledged and were left unexplored by most physicians. Instead, physicians continued with the biomedical assessment, and patients perceived this as uncaring because their needs were not met as human beings. Although Suchman et al analyzed various factors contributing to this situation, there are other important factors such as suffering, perception, and psychosocial skills.Understanding suffering is a prerequisite to empathic connection and compassion.2 Sick persons bring to physicians not merely their symptoms, but also their stories of suffering. Suffering is of a physical, emotional, social, and spiritual nature. Because of this, to understand suffering and healing, we need to expand our medical model to a biopsychosocial and spiritual one.2,3 Suffering is the inner experience of sickness, and it is related