David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Jack Alan Reynolds
Learn more about PhilPapers
Journal of Medicine and Philosophy 36 (4):394-409 (2011)
This paper provides a brief overview and critique of the dominant objectivist understanding and use of illness narrative in Enlightenment (scientific) medicine and ethics, as well as several revisionist accounts, which reflect the evolution of this approach. In light of certain limitations and difficulties endemic in the objectivist understanding of illness narrative, an alternative phronesis approach to medical ethics influenced by Charles Taylor’s account of the interpretive nature of human agency and language is examined. To this end, the account of interpretive medical responsibility previously described by Schultz and Carnevale as "clinical phronesis" (based upon Taylor’s notion of "strong" or "radical evaluation") is reviewed and expanded. The thesis of this paper is that illness narrative has the ability to benefit patients as well as the potential to cause harm or iatrogenic effects. This benefit or harm is contingent upon how the story is told and understood. Consequently, these tales are not simply "nice stories," cathartic gestures, or mere supplements to scientific procedures and decision making, as suggested by the objectivist approach. Rather, they open the agent to meanings that provide a context for explanation and evaluation of illness episodes and therapeutic activities. This understanding provides indicators (guides) for right action. Hence, medical responsibility as clinical phronesis involves, first, the patient and provider’s coformulation and cointerpretation of what is going on in the patient’s illness narrative, and second, the patient and provider’s response to interpretation of the facts of illness and what they signify–not simply a response to the brute facts of illness, alone. The appeal to medical responsibility as clinical phronesis thus underscores the importance of getting the patient’s story of illness right. It is anticipated that further elaboration concerning the idea of clinical phronesis as interpretive illness narrative will provide a new foundation for medical ethics and decision making
|Keywords||No keywords specified (fix it)|
|Categories||categorize this paper)|
Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
|Through your library|
References found in this work BETA
No references found.
Citations of this work BETA
No citations found.
Similar books and articles
Dawson S. Schultz & Franco A. Carnevale (1996). Engagement and Suffering in Responsible Caregiving: On Overcoming Maleficience in Health Care. Theoretical Medicine and Bioethics 17 (3).
Daniel Hunt & Ronald Carter (2012). Seeing Through The Bell Jar: Investigating Linguistic Patterns of Psychological Disorder. [REVIEW] Journal of Medical Humanities 33 (1):27-39.
S. Kay Toombs (1988). Illness and the Paradigm of Lived Body. Theoretical Medicine and Bioethics 9 (2).
Kathryn Montgomery Hunter (1989). A Science of Individuals: Medicine and Casuistry. Journal of Medicine and Philosophy 14 (2):193-212.
S. Kay Toombs (1990). The Temporality of Illness: Four Levels of Experience. Theoretical Medicine and Bioethics 11 (3).
S. Kay Toombs (1987). The Meaning of Illness: A Phenomenological Approach to the Patient-Physician Relationship. Journal of Medicine and Philosophy 12 (3):219-240.
Ronald Schleifer & Jerry Vannatta (2006). The Logic of Diagnosis: Peirce, Literary Narrative, and the History of Present Illness. Journal of Medicine and Philosophy 31 (4):363 – 384.
Rita Charon & Martha Montello (eds.) (2002). Stories Matter: The Role of Narrative in Medical Ethics. Routledge.
Howard Kunin (1997). Ethical Issues in Pediatric Life-Threatening Illness: Dilemmas of Consent, Assent, and Communication. Ethics and Behavior 7 (1):43 – 57.
Drew Leder (1990). Clinical Interpretation: The Hermeneutics of Medicine. Theoretical Medicine and Bioethics 11 (1).
Richard J. Baron (1981). Bridging Clinical Distance: An Empathic Rediscovery of the Known. Journal of Medicine and Philosophy 6 (1):5-24.
Richard M. Zaner (1990). Medicine and Dialogue. Journal of Medicine and Philosophy 15 (3):303-325.
Roberto Mordacci (1998). The Desire for Health and the Promises of Medicine. Medicine, Healthcare and Philosophy 1 (1):21-30.
H. Carel (2012). Phenomenology as a Resource for Patients. Journal of Medicine and Philosophy 37 (2):96-113.
Ian James Kidd (2012). Can Illness Be Edifying? Inquiry 55 (5):496-520.
Added to index2011-09-08
Total downloads14 ( #120,382 of 1,101,815 )
Recent downloads (6 months)4 ( #91,766 of 1,101,815 )
How can I increase my downloads?