Document Type


Degree Name

Doctor of Philosophy (PhD)


Social Work


Lyle S. Hallman Faculty of Social Work

First Advisor

Dr. Cheryl-Anne Cait

Advisor Role

Dissertation Advisor


While one of the primary aims of palliative care is to prevent and relieve suffering, both physical and non-physical, research to date has been very limited re: clinicians’ experiences with patients’ non-physical suffering (e.g., suffering that may be psychological, emotional, social, spiritual and/or existential in nature); both how clinicians work with/respond to this kind of suffering in their day-to-day work, and the effect of this aspect of their work on clinicians themselves. No research to date has considered the impact of palliative care’s dominant non-physical suffering discourse — which presents the relief of non-physical suffering as falling along a binary spectrum of suffering’s transcendence via meaning-making on one end of the spectrum, and palliative sedation and/or a medically assisted death on the other end — on how clinicians work with patients’ non-physical suffering. This study aims to help fill these research gaps. Using discourse analysis as the methodology, and poststructuralism as the overarching theoretical framework, this project has several research aims: (1) To identify what discourses exist within palliative care clinicians’ experiences with patients’ non-physical suffering; (2) To identify whether and how these discourses may affect palliative care clinicians and impact clinical care; and (3) To identify whether clinicians’ experiences with patients’ non-physical suffering fall within and/or outside the dominant discourse. Over a three month period in summer/fall 2020, 24 palliative care clinicians (social workers, physicians, nurses, music therapists, and an occupational therapist) from across Canada participated in this study. The majority of study participants identified as white, female, spiritual, practiced full-time in a combination of palliative care practice settings, and had between 10-19 years of palliative care practice experience. Four discourses are visible within how participants talked about their experiences with adult patients’ non-physical suffering: 1) Expectations of Palliative Care; 2) Unexpressed Non-Physical Suffering; 3) Medical Assistance in Dying (MAiD); and 4) The Professional in the Personal/The Personal in the Professional. Study findings demonstrate both the negative effects of the dominant discourse on clinicians and how they work with patients’ non-physical suffering, as well as how clinicians resist the dominant discourse. Findings have implications for palliative care practice, clinician training, education and support, and future research. It is anticipated/hoped that this study’s findings will ultimately help to disrupt and expand palliative care’s non-physical suffering discourse, to make it more inclusive of the on-the-ground realities of clinicians’ experiences navigating non-physical suffering on the front-lines of palliative care provision.

Convocation Year


Convocation Season


Available for download on Saturday, November 29, 2025