Online research in philosophy

In this paper I present and compare the ideas behind naturalistic theories of health on the one hand and phenomenological theories of health on the other. The basic difference between the two sets of theories is no doubt that whereas naturalistic theories claim to rest on value neutral concepts, such as normal biological function, the phenomenological suggestions for theories of health take their starting point in what is often named intentionality: meaningful stances taken by the embodied person in experiencing and (...) understanding her situation and taking action in the world. (shrink)

Heidegger’s thoughts on modern technology have received much attention in many disciplines and fields, but, with a few exceptions, the influence has been sparse in biomedical ethics. The reason for this might be that Heidegger’s position has been misinterpreted as being generally hostile towards modern science and technology, and the fact that Heidegger himself never subjected medical technologies to scrutiny but was concerned rather with industrial technology and information technology. In this paper, Heidegger’s philosophy of modern technology is introduced and (...) then brought to bear on medical technology. Its main relevance for biomedical ethics is found to be that the field needs to focus upon epistemological and ontological questions in the philosophy of medicine related to the structure and goal of medical practice. Heidegger’s philosophy can help us to see how the scientific attitude in medicine must always be balanced by and integrated into a phenomenological way of understanding the life-world concerns of patients. The difference between the scientific and the phenomenological method in medicine is articulated by Heidegger as two different ways of studying the human body: as biological organism and as lived body. Medicine needs to acknowledge the priority of the lived body in addressing health as a way of being-in-the-world and not as the absence of disease only. A critical development of Heidegger’s position can provide us with a criterion for distinguishing the uses of medical technologies that are compatible with such an endeavor from the technological projects that are not. (shrink)

Three metaphors appear to guide contemporary thinking about organ transplantation. Although the gift is the sanctioned metaphor for donating organs, the underlying perspective from the side of the state, authorities and the medical establishment often seems to be that the body shall rather be understood as a resource . The acute scarcity of organs, which generates a desperate demand in relation to a group of potential suppliers who are desperate to an equal extent, leads easily to the gift’s becoming, in (...) reality, not only a resource, but also a commodity . In this paper, the claim is made that a successful explication of the gift metaphor in the case of organ transplantation and a complementary defence of the ethical primacy of the giving of organs need to be grounded in a philosophical anthropology which considers the implications of embodiment in a different and more substantial way than is generally the case in contemporary bioethics. I show that Heidegger’s phenomenology offers such an alternative, with the help of which we can understand why body parts could and, indeed, under certain circumstances, should be given to others in need, but yet are neither resources nor properties to be sold. The phenomenological exploration in question is tied to fundamental questions about what kind of relationship we have to our own bodies, as well as about what kind of relationship we have to each other as human beings sharing the same being-in-the-world as embodied creatures. (shrink)

This paper investigates the question of what an organ is from a phenomenological perspective. Proceeding from the phenomenology of being-in-the-world developed by Heidegger in Being and Time and subsequent works, it compares the being of the organ with the being of the tool. It attempts to display similarities and differences between the embodied nature of the organs and the way tools of the world are handled. It explicates the way tools belong to the totalities of things of the world that (...) are ready to use and the way organs belong to the totality of a bodily being able to be in this very world. In so doing, the paper argues that while the organ is in some respects similar to a bodily tool, this tool is nonetheless different from the tools of the world in being tied to the organism as a whole, which offers the founding ground of the being of the person. However, from a phenomenological point of view, the line between organs and tools cannot simply be drawn by determining what is inside and outside the physiological borders of the organism. We have, from the beginning of history, integrated technological devices (tools) in our being-in-the-world in ways that make them parts of ourselves rather than parts of the world (more organ- than tool-like), and also, more recently, have started to make our organs more tool-like by visualising, moving, manipulating, and controlling them through medical technology. In this paper, Heidegger’s analysis of organ, tool, and world-making is confronted with this development brought about by contemporary medical technology. It is argued that this development has, to a large extent, changed the phenomenology of the organ in making our bodies more similar to machines with parts that have certain functions and that can be exchanged. This development harbours the threat of instrumentalising our bodily being but also the possibility of curing or alleviating suffering brought about by diseases which disturb and destroy the normal functioning of our organs. (shrink)

In this paper I develop a phenomenology of falling ill by presenting, interpreting and developing the basic model we find in Jean-Paul Sartre’s Being and Nothingness ( 1956 ). The three steps identified by Sartre in this process are analysed, developed further and brought to a five-step model: (1) pre-reflective experience of discomfort, (2) lived, bodily discomfort, (3) suffered illness, (4) disease pondering, and (5) disease state. To fall ill is to fall victim to a gradual process of alienation, and (...) with each step this alienating process is taken to a new qualitative level. Consequently, the five steps of falling ill have not only a contingent chronological order but also a kind of logical order, in that they typically presuppose each other. I adopt Sartre’s focus on embodiment as the core ground of the alienation process, but point out that the alienation of the body in illness is not only the experience of a psychic object, but an experience of the independent life of one’s own body. This facticity of the body is the result neither of the gaze of the other person, nor of a reflection adopting the outer perspective of the other in an indirect way, but is a result of the very otherness of one’s own body, which addresses and plagues us when we fall ill. I use examples of falling ill and being a patient to show how a phenomenology of falling ill can be helpful in educating health-care personnel (and perhaps also patients) about the ways of the lived body. (shrink)

Debates about the legitimacy of embryonic stem-cell research have largely focused on the type of ethical value that should be accorded to the human embryo in␣vitro. In this paper, I try to show that, to broaden the scope of these debates, one needs to articulate an ontology that does not limit itself to biological accounts, but that instead focuses on the embryo’s place in a totality of relevance surrounding and guiding a human practice. Instead of attempting to substantiate the ethical (...) value of the embryo exclusively by pointing out that it has potentiality for personhood, one should examine the types of practices in which the embryo occurs and focus on the ends inherent to these practices. With this emphasis on context, it becomes apparent that the embryo’s ethical significance can only be understood by elucidating the attitudes that are established towards it in the course of specific activities. The distinction between fertilized embryos and cloned embryos proves to be important in this contextual analysis, since, from the point of view of practice, the two types of embryos appear to belong to different human practices: (assisted) procreation and medical research, respectively. In my arguments, I highlight the concepts of practice, technology, and nature, as they have been analyzed in the phenomenological tradition, particularly by Martin Heidegger. I come to the conclusion that therapeutic cloning should be allowed, provided that it turns out to be a project that benefits medical science in its aim to battle diseases. Important precautions have to be taken, however, in order to safeguard the practice of procreation from becoming perverted by the aims and attitudes of medical science when the two practices intersect. The threat in question needs to be taken seriously, since it concerns the structure and goal of practices which are central to our very self understanding as human beings. (shrink)

The relevance of the Aristotelian concept ofphronesis – practical wisdom – for medicine and medical ethics has been much debated during the last two decades. This paper attempts to show how Aristotle’s practical philosophy was of central importance toHans-Georg Gadamer and to the development of his philosophical hermeneutics, and how,accordingly, the concept of phronesiswill be central to a Gadamerian hermeneutics of medicine. If medical practice is conceived of as an interpretative meeting between doctor and patient with the aim of restoring (...) the health of the latter, then phronesis is the mark of the good physician, who through interpretation comes to know the best thing todo for this particular patient at this particular time. The potential fruitfulness of this hermeneutical appropriation of phronesis for the field of medical ethics is also discussed. The concept can be (and has been) used in critiques of the conceptualization of bioethics as the application of principle-based theory to clinical situations, since Aristotle’s point is exactly that problems of praxis cannot be approached in this way. It can also point theway for alternative forms of medical ethics, such as virtue ethics or a phenomenological andhermeneutical ethics. The latter alternative would have to address the phenomena of healthand the good life as issues for medical practice. It would also have to map out in detail the terrain of the medical meeting and the acts of interpretation through which phronesis is exercised. (shrink)

In this article I aim at developing a phenomenology ofillness through a critical interpretation of the worksof Sigmund Freud and Martin Heidegger. The phenomenonof ``Unheimlichkeit'' – uncanniness and unhomelikeness– is demonstrated not only to play a key role in thetheories of Freud and Heidegger, but also toconstitute the essence of the experience of illness.Two different modes of unhomelikeness – ``The minduncanny'' and ``The world uncanny'' – are in thisconnection explored as constitutive parts of thephenomenon of illness. The consequence I draw (...) fromthis analysis is that the mission of health careprofessionals must be not only to cure diseases, butactually, through devoting attention to thebeing-in-the-world of the patient, also to open uppossible paths back to homelikeness. This mission canonly be carried out if medicine acknowledges the basicimportance of the meaning-realm of the patient's life– his or her life-world characteristics. (shrink)

This article is an attempt to analyse the experience of embodiment in illness. Drawing upon Heidegger' sphenomenology and the suggestion that illness can be understood as unhomelike being-in-the-world, I try to show how the way we live our own bodies in illness is experienced precisely as unhomelike. The body is alien, yet, at the same time, myself. It involves biological processes beyond my control, but these processes still belong to me as lived by me. This a priori otherness of the (...) body presents itself in illness in an uncanny and merciless way. The unhomelike breakdown of our everyday being-in-the-world suffered in illness is explored through Heidegger's notion of the world being a totality of relevance , a pattern of meaning played out between different tools . The lived body is compared to a broken tool that alters and obstruct sour way of being thrown and projecting ourselves in the meaning patterns of the world through feelings,thoughts and actions. The similarities and differences between this unhomelikeness of illness and the specific unhomelikeness of authentic understanding,reached according to Heidegger in existential anxiety,are discussed. In order to illustrate how the lived body can present itself as broken and other to its owner, and in what way this unhomelike experience calls for help from health-care professionals, I make use of a clinical example of a severe and common disease: stroke. (shrink)

Fredrik Svenaeus' book is a delight to read. Not only does he exhibit keen understanding of a wide range of topics and figures in both medicine and philosophy, but he manages to bring them together in an innovative manner that convincingly demonstrates how deeply these two significant fields can be and, in the end, must be mutually enlightening. Medicine, Svenaeus suggests, reveals deep but rarely explicit themes whose proper comprehension invites a careful phenomenological and hermeneutical explication. Certain philosophical approaches, on (...) the other hand - specifically, Heidegger's phenomenology and Gadamer's hermeneutics - are shown to have a hitherto unrealized potential for making sense of those themes long buried within Western medicine. Richard M. Zaner, Ann Geddes Stahlman Professor of Medical Ethics, Vanderbilt University. (shrink)