Abstract
Philosophical anthropologies that emphasise the role of the emotions can be used to expand existing notions of moral agency and learning in situations of great moral complexity. In this article we tell the story of one patient facing the tough decision of whether to be tested for Huntington’s disease or not. We then interpret her story from two different but compatible philosophical entry points: Aristotle’s conception of Greek tragedy and Karl Jaspers’ notion of Grenzsituationen (boundary situations). We continue by indicating some ways in which these two positions may be used for reflecting upon different perspectives involved in clinical decision-making, those of patients, clinicians and bioethicists. We conclude that the ideas we introduce can be used as hermeneutic tools for situating learning and dialogue within a broader cultural field in which literature and art may also play important roles.
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Notes
These paper draws on data and methodology from the Swiss study “Time as an contextual element in ethical decision-making in the field of genetic diagnosis” (Swiss National Science Foundation 1114-64956.01, 101311–103606): Jackie Leach Scully, Rouven Porz and Christoph Rehmann-Sutter (2002–2005).
Interviews were conducted and transcribed in German, English translation of the quotes by the authors.
In modern medical nomenclature, the term metabasis is sometimes used to refer to a change in the symptoms during the course of a disease. As will also be pointed out in a later section, dealing with the concept of catharsis, the medical references and metaphors are present in many parts of the Poetics.
Salamun (1988) translates the concept as “boundary situation”, “limiting situation”, “borderline situation” or “ultimate situation”. In what follows we continue to refer to the concept as Grenzsituationen.
English translation of the German Jaspers’ quotes by the authors.
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Acknowledgements
The authors thank Jackie Leach Scully and Christoph Rehmann-Sutter for their support in this work and the two anonymous reviewers for their helpful comments. The study ‘Time as a contextual element in ethical decision-making in the field of genetic diagnosis’ was funded by the Swiss National Science Foundation, SNSF. We are grateful to Monica Buckland Hofstetter for linguistic assistance. Parts of this paper were presented at the conference “New Pathways for European Bioethics”, organised by the European Association of Centres of Medical Ethics (EACME), September 2007 in Leuven, Belgium.
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Rommetveit, K., Porz, R. Tragedy and Grenzsituationen in genetic prediction. Med Health Care and Philos 12, 9–16 (2009). https://doi.org/10.1007/s11019-008-9139-x
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DOI: https://doi.org/10.1007/s11019-008-9139-x