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)|
References found in this work BETA
No references found.
Citations of this work BETA
Heidegger, Ontological Death, and the Healing Professions.Kevin A. Aho - 2016 - Medicine, Health Care and Philosophy 19 (1):55-63.
Similar books and articles
Engagement and Suffering in Responsible Caregiving: On Overcoming Maleficience in Health Care.Dawson S. Schultz & Franco A. Carnevale - 1996 - Theoretical Medicine and Bioethics 17 (3).
Seeing Through The Bell Jar: Investigating Linguistic Patterns of Psychological Disorder. [REVIEW]Daniel Hunt & Ronald Carter - 2012 - Journal of Medical Humanities 33 (1):27-39.
Illness and the Paradigm of Lived Body.S. Kay Toombs - 1988 - Theoretical Medicine and Bioethics 9 (2).
A Science of Individuals: Medicine and Casuistry.Kathryn Montgomery Hunter - 1989 - Journal of Medicine and Philosophy 14 (2):193-212.
The Temporality of Illness: Four Levels of Experience.S. Kay Toombs - 1990 - Theoretical Medicine and Bioethics 11 (3).
The Meaning of Illness: A Phenomenological Approach to the Patient-Physician Relationship.S. Kay Toombs - 1987 - Journal of Medicine and Philosophy 12 (3):219-240.
The Logic of Diagnosis: Peirce, Literary Narrative, and the History of Present Illness.Ronald Schleifer & Jerry Vannatta - 2006 - Journal of Medicine and Philosophy 31 (4):363 – 384.
Stories Matter: The Role of Narrative in Medical Ethics.Rita Charon & Martha Montello (eds.) - 2002 - Routledge.
Ethical Issues in Pediatric Life-Threatening Illness: Dilemmas of Consent, Assent, and Communication.Howard Kunin - 1997 - Ethics and Behavior 7 (1):43 – 57.
Clinical Interpretation: The Hermeneutics of Medicine.Drew Leder - 1990 - Theoretical Medicine and Bioethics 11 (1).
Bridging Clinical Distance: An Empathic Rediscovery of the Known.Richard J. Baron - 1981 - Journal of Medicine and Philosophy 6 (1):5-24.
The Desire for Health and the Promises of Medicine.Roberto Mordacci - 1998 - Medicine, Healthcare and Philosophy 1 (1):21-30.
Phenomenology as a Resource for Patients.H. Carel - 2012 - Journal of Medicine and Philosophy 37 (2):96-113.
Added to index2011-09-08
Total downloads22 ( #230,091 of 2,178,148 )
Recent downloads (6 months)1 ( #316,504 of 2,178,148 )
How can I increase my downloads?