Hermeneutics and experiences of the body. The case of low back pain

Theoretical Medicine and Bioethics 19 (3):277-293 (1998)
Abstract
The purpose of this paper is to elaborate on the notion of clinical medicine as a hermeneutical enterprise and to bridge the gap between the general perspectives of hermeneutics and the particularities of medical practice. The case of a patient with low back pain is analyzed. The discussion centers around the metaphor of the patient as a text and a model of five social discourses about low back pain. The problems addressed are: (1) the nature of a moral experience, (2) the variety of available texts, (3) the difference between the doctor's and patient's narratives, and (4) the patient's and doctor's responsibility regarding the existential, biographical meaning of an illness. Although many problems are left unsolved, it is argued that from a philosophical point of view the notion of medicine as a hermeneutical enterprise opens up the possibility of gaining insight in the foundations of the clinical encounter.
Keywords the body as a text  clinical judgment  hermeneutics  interpretation  low back pain  medical ethics  moral experience  narrativity  patient-physician relationship
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