"In pain waiting to die": everyday understandings of suffering.

OBJECTIVE: The notion of "suffering" is understood in very different ways in a variety of contexts. In palliative care, the relief and prevention of suffering is considered to be a fundamental goal (Pastrana et al., 2008). However, the avoidance of suffering has also been used as an argument by those campaigning for the legalization of euthanasia and assisted suicide (Finlay, 2009). In reflecting upon suffering in these two contexts, we were intrigued by Finlay's (2009) contention that to laypeople, the phrase "'unbearable suffering' conjures up images of patients on their deathbeds wracked with uncontrolled pain" (p. 1841). METHOD: This article explores how suffering is used and understood in an "everyday" discourse, by analyzing comments posted to a website debating assisted suicide in the context of the Canadian case of Sue Rodriguez. RESULTS: Using a broad social approach to discourse analysis (Tonkiss, 2004), three themes emerged in our analysis: (1) when people suffer, (2) how people are understood to suffer, and (3) how suffering should be dealt with. We also examined what was not said in this discussion: there was little consideration of the more holistic goals of palliative care and how suffering might be understood and managed in ways other than within the frame of assisted suicide. SIGNIFICANCE OF RESULTS: Paying attention to the everyday discourse of suffering is important because, as members of society, we all play a role in negotiating the meaning of suffering. Such meaning has a significant impact upon patients and palliative care professionals alike.

Coping in the time of COVID-19: Insights from university students with intellectual disabilities.

Background: For almost two decades, students with intellectual, developmental and multiple disabilities have attended undergraduate classes at the University of Manitoba, in Winnipeg, Canada as part-time auditing students. They are supported by the Campus Life program. Campus Life employs graduate and undergraduate university students as academic tutors and social role models because they too are immersed in university life. Methods: We chose collaborative autoethnography as a research method because we believe in researching and writing with individuals with disabilities, rather than about them. Three student tutor dyads elected to participate in this study. In the context of the pandemic and the switch from on-campus in-person learning to off-campus online learning, we were interested in learning about the changes, challenges or unanticipated benefits they experienced. Each dyad engaged in tutor-led conversations, guided by open-ended questions, and wrote their story. Findings: The stories from the three dyads were received and analysed. We found three emergent themes. The first was centred on worries about the health risks of COVID-19, the difficulties they experienced in adapting to online learning and their development of better skills in listening and communicating. The second theme was about the dramatic reduction in their opportunities for social engagement. With respect to the third emergent theme, they recounted some advantages of online learning, noting that it was more accessible, more convenient and safer during a pandemic. Conclusion: For the study participants the shift to online classes and tutoring sessions was surprisingly successful. They became more independent and improved their online communication, time-management and organisational skills. Social engagement was sorely missed, especially studying and socializing with classmates at university and participating in extracurricular activities. The students also noted some advantages to online learning such as accessibility, convenience, feeling comfortable at home, avoiding transportation to the university and learning to use new tech tools. The tutors began sharing and learning from each other. This was facilitated by online tutoring roundtables. Our first insight from this study is the realisation that we now have a new medium for tutoring Campus Life students. A second is the need to better understand student social engagement in the online world.

End-of-life ethics and disability: differing perspectives on case-based teaching.

The way in which medical professionals engage in bioethical issues ultimately reflects the type of care such patients are likely to receive. It is therefore critical for doctors and other health care professionals to have a broad understanding of disability. Our purpose in this paper is to explore ways of teaching bioethical issues to first year medical students by integrating alternative approaches. Such approaches include (a) the use of the narrative format, (b) the inclusion of a disability perspective, and (c) the presentation and facilitation of classes by people with disabilities. We consider how these new kinds of presentations are evaluated by students, faculty, people with disabilities and professional ethicists. We hope new knowledge may provide health care professionals with a greater understanding of the perspectives of patients with disabilities, who are confronted by conflicting ethical values and frameworks for decision-making in their interaction with such professionals.

Nursing educators' perspectives of students with disabilities: a grounded theory study.

The purpose of this grounded theory study was to increase understanding of nursing educators' perspectives of students with disabilities. Seventeen educators from four nursing education programs in western Canada participated. The theory emerging from this data was "producing competent graduates". The central category was supporting students to become competent graduates. This paper focuses on the nursing educators' perspectives of students with disabilities, which influenced their efforts to support students with disabilities on that path.