David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Ezio Di Nucci
Jack Alan Reynolds
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Theoretical Medicine and Bioethics 11 (1) (1990)
I argue that clinical medicine can best be understood not as a purified science but as a hermeneutical enterprise: that is, as involved with the interpretation of texts. The literary critic reading a novel, the judge asked to apply a law, must arrive at a coherent reading of their respective texts. Similarly, the physician interprets the text of the ill person: clinical signs and symptoms are read to ferret out their meaning, the underlying disease. However, I suggest that the hermeneutics of medicine is rendered uniquely complex by its wide variety of textual forms. I discuss four in turn: the experiential text of illness as lived out by the patient; the narrative text constituted during history-taking; the physical text of the patient's body as objectively examined; the instrumental text constructed by diagnostic technologies. I further suggest that certain flaws in modern medicine arise from its refusal of a hermeneutic self-understanding. In seeking to escape all interpretive subjectivity, medicine has threatened to expunge its primary subject — the living, experiencing patient.
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Kirsti Malterud (2002). Reflexivity and Metapositions: Strategies for Appraisal of Clinical Evidence. Journal of Evaluation in Clinical Practice 8 (2):121-126.
Havi Carel (2009). A Reply to 'Towards an Understanding of Nursing as a Response to Human Vulnerability' by Derek Sellman: Vulnerability and Illness. Nursing Philosophy 10 (3):214-219.
Mark H. Waymack (2009). Yearning for Certainty and the Critique of Medicine as “Science”. Theoretical Medicine and Bioethics 30 (3):215-229.
Michael H. Kottow (2001). Between Caring and Curing. Nursing Philosophy 2 (1):53-61.
Diego Gracia (1995). Hard Times, Hard Choices: Founding Bioethics Today. Bioethics 9 (3):192–206.
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