Abstract
This paper takes a phenomenological hermeneutic orientation to explicate and explore the notion of the grey zone of health and illness and seeks to develop the concept through an examination of the case of alcohol consumption. The grey zone is an interpretive area referring to the irremediable zone of ambiguity that haunts even the most apparently resolute discourse. This idea points to an ontological indeterminacy, in the face of which decisions have to be made with regard to the health of a person (e.g., an alcoholic), a system (e.g., the health system), or a society. The fundamental character of this notion will be developed in relation to the discourse on health and the limitations of different disciplinary practices. The case of alcohol consumption will be used to tease out the grey zone embedded in the different kinds of knowledge made available through the disciplinary traditions of medical science, with its emphasis on somatic well-being, and anthropology, with its focus on communal well-being. This tension or grey zone embedded in different knowledge outcomes will be shown to have a discursive parallel with the dialogue between the Athenian, the Spartan, and the Cretan in Plato’s Laws. Making use of the dialogical approach as described by Gadamer, the Athenian’s particular resolution of the tension will be explored as a case study to demonstrate the necessarily particular analysis involved in a grey zone resolution.
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Notes
This paper is part of a 5-year, $1.5 million research project on “City Life and Well-Being: The Grey Zone of Health and Illness” funded by the Canadian Institute for Health Research. The project is funded from 2006 to 2011 and seeks to add to our knowledge of the grey zone between health and illness through the study of five areas: death and dying, midwifery, prosthetics, alcohol consumption, and media representation.
Cf. Gadamer’s definition here with Arendt’s description of great bodily pain as “the most intense feeling we know of, intense to the point of blotting out all other experiences” [12, p. 50].
I thank Ryan Devitt for his research in this area.
In terms of drinking categories, although there is no agreement on standardized measures, there is a high degree of consensus that “light drinking” means 1.2, “moderate drinking” means 2.2, and “heavy drinking” means 3.5 drinks per day [25]. “Abusive drinking” is further defined, on average, as 5.4 drinks per day.
On the other hand, Edwards states that many epidemiological “studies from many…countries and relating to many different time periods have confirmed that population drinking and population cirrhosis mortality are likely to go hand in hand” [14, p. 202].
Using the projected figures of the American Medical Association (1973), approximately 10% of the people who drink do so to the point of interfering with their lives, while 1% come to be labeled as chronic alcoholics” [30, p. 14].
As Gadamer says, the question of what “illness tells the one who is ill” is becoming increasingly irrelevant given “contemporary medicine’s virtuosic capacity to ‘eliminate pain,’ the source of pain, the symptom and sometimes even more than this…. In the case of transient illnesses and ‘eliminable pain’ we have learnt to regard them as not longer important. Consequently modern medicine has principally seen itself confronted by chronic illnesses and the different challenges they make” [13, p. 76].
The main protagonist in the Hollywood movie Leaving Las Vegas, who literally drinks himself to death, could be taken up as an example of such an orientation.
One does put one who does not have control over their sexual impulses in charge of one’s daughters, yet it can be an expensive lesson to discover that.
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Acknowledgments
I would like to thank Roisin Bonner, Carolyn Dirks, and Margaret O’Shea Bonner who in different ways helped me with this paper. In particular, I would like to thank Ryan Devitt for his research relating to the medical science literature on alcohol consumption. Versions of it were presented at a Grey Zone workshop at the Culture of Cities Centre in Toronto and at invited Sociology Seminars at Edinburgh University and University College Cork, in Ireland. I thank Stanley Raffel and Kieran Keohane for the invitations and responses to my presentation. I also thank the reviewers and editor of the journal for their helpful criticisms.
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Bonner, K. A dialogical exploration of the grey zone of health and illness: medical science, anthropology, and Plato on alcohol consumption. Theor Med Bioeth 30, 81–103 (2009). https://doi.org/10.1007/s11017-009-9098-0
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DOI: https://doi.org/10.1007/s11017-009-9098-0