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Hermeneutics and Experiences of the Body. The Case of Low Back Pain

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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.

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REFERENCES

  1. Gillon R, ed. Principles of Health Care Ethics, Chicester etc.: John Wiley, 1994.

  2. Merlaeu-Ponty M. Phenomenology of Perception. London and New York: Routledge, 1962: xix.

    Google Scholar 

  3. Ricoeur P. The task of hermeneutics. Philosophy Today 1973; 17: 112–128.

    Google Scholar 

  4. Thomasma DC. Clinical ethics as medical hermeneutics. Theor Med 1994; 15: 93–111.

    Google Scholar 

  5. Spiegelberg H. The Phenomenological Movement. A Historical Introduction. 3rd revised and enlarged edition. The Hague etc: Martinus Nijhoff Publishers, 1982: 104–105.

    Google Scholar 

  6. Thomasma 1994 (see note 4): 95–96.

    Google Scholar 

  7. Tongeren P van. Moral philosophy as a hermeneutics of moral experience. Int Philos Quarterly 1994; 34: 199–214; Tongeren P van. The relation of narrativity and hermeneutics to an adequate practical ethic. Ethical Perspectives 1994; 1: 57–70.

    Google Scholar 

  8. Thomasma 1994 (see note 4); Carson RA. Interpretive bioethics: The way of discernment. Theor Med 1990; 11: 51–59.

  9. Have HAMJ ten. The hyperreality of clinical ethics: A unitary theory and hermeneutics. Theor Med 1994; 15: 113–131.

    Google Scholar 

  10. Daniel SL. Hermeneutical clinical ethics: A commentary. Theor Med 1994; 15: 133–139; see p. 136.

    Google Scholar 

  11. Daniel SL. The patient as a text: a model of clinical hermeneutics. Theor Med 1986; 7: 195–210.

    Google Scholar 

  12. Potter RL. The hermeneutical process and clinical ethics. J Clin Ethics 1995; 6: 88–91.

    Google Scholar 

  13. Have HAMJ ten. The anthropological tradition in the philosophy of medicine. Theor Med 1995; 16: 3–14; Dekkers WJM. F.J.J. Buytendijk's concept of an anthropological physiology. Theor Med 1995; 16: 15–39.

    Google Scholar 

  14. Leder D. Clinical interpretation: The hermeneutics of medicine. Theor Med 1990; 11: 9–24.

    Google Scholar 

  15. Have HAMJ ten 1994 (see note 13): 120.

    Google Scholar 

  16. Leder 1990 Clinical interpretation: The hermeneutics of medicine. Theor Med 1990; 11: (see note): 14.

    Google Scholar 

  17. Ibid: 14.

    Google Scholar 

  18. Ibid: 12.

    Google Scholar 

  19. Nijhof G. Towards a sociological hypothesis on the accounting for chronicity. Int J Health Sciences 1992; 3: 3–11.

    Google Scholar 

  20. Quotations in Nijhof 1992 (see note 19): 6.

    Google Scholar 

  21. Pellegrino ED, Thomasma DC. For The Patient's Good: The Restoration of Benificence in Health Care. New York etc.: Oxford University Press, 1988.

    Google Scholar 

  22. Engelhardt HT Jr. Introduction. In: Peset JL, Gracia D, eds. The Ethics of Diagnosis. Dordrecht etc: Kluwer Academic Publishers, 1992: 1–9.

    Google Scholar 

  23. Nelson JB. Body Theology. Louisville, Kentucky: Westminster/John Knox press, 1992.

    Google Scholar 

  24. Ibid: 42.

  25. Quotations by van Tongeren, Moral Philosophy (see note 7): 203.

  26. Ricoeur P. Time and Narrative. Volume I. Chicago and London: The University of Chicago Press, 1984: 31.

    Google Scholar 

  27. Hunter KM. Doctors' Stories. The Narrative Structure of Medical Knowledge. Princeton, New Jersey: Princeton University Press, 1991.

    Google Scholar 

  28. Toombs SK. The Meaning of Illness. The Phenomenological Account of the Different Perspectives of Physician and Patient. Dordrecht etc.: Kluwer Academic Publishers, 1992: 10.

    Google Scholar 

  29. Tsouyopoulos N. Postmodernist theory and the physician-patient relationship. Theor Med 1994; 15: 267–275.

    Google Scholar 

  30. Leder 1990 (see note 14): 17.

    Google Scholar 

  31. Welie JVM. In the Face of Suffering. Prolegomena to a Philosophical Foundation of Clinical Ethics [Diss]. Nijmegen: Catholic University, 1994.

    Google Scholar 

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Authors and Affiliations

  1. Department of Ethics, Philosophy and History of Medicine, Faculty of Medical Sciences and Center for Ethics, University of Nijmegen, PO Box 9101, 6500 HB, Nijmegen, The Netherlands

    Wim Dekkers

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  1. Wim Dekkers
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Dekkers, W. Hermeneutics and Experiences of the Body. The Case of Low Back Pain. Theor Med Bioeth 19, 277–293 (1998). https://doi.org/10.1023/A:1009922217656

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