Philosophy is commonly criticized for being too abstract and detached from practical spheres. Upon chronicling how philosophy has gained this reputation, the authors explore the philosophical fields of phenomenology and hermeneutics that have explicitly attempted to merge philosophy with everyday life contexts. In recent decades, phenomenology and hermeneutics have been applied to healthcare. In the realm of nursing, Patricia Benner's nursing theory is especially informed by phenomenology, which is briefly explored through her relationship with one of her mentors, the philosopher (...) Hubert Dreyfus. The authors then turn their attention to Hans-Georg Gadamer's philosophy in an attempt to mine concepts relevant to the practice of nursing. Gadamer juxtaposed the human sciences from the natural sciences and thought that both needed different approaches: whereas natural sciences are guided by episteme, that is, universal knowledge, human sciences are guided by phronesis, that is, practical wisdom. Gadamer's philosophy is especially helpful in understanding how to cultivate phronesis in nursing wherein a nurse relies upon one's clinical experience to masterfully navigate each unique patient relationship. Nurses must serve as authorities in the realm of healthcare but also be open to the authority of their patients, who ultimately choose their course of treatment in our contemporary era of patient autonomy. Gadamer's philosophy can help us understand why phronesis requires not only practice but also reflection on that practice to be appropriately cultivated. The authors apply this to the realm of nursing in showing how both practice—clinically and via simulation—and reflection—through journaling or dialogue—are necessary for phronesis to emerge. (shrink)

Journal of Social Philosophy, EarlyView.

The significance of critical phenomenology for psychiatric praxis has yet to be expounded. In this paper, I argue that the adoption of a critical phenomenological stance can remedy localised instances of hermeneutical injustice, which may arise in the encounter between clinicians and patients with psychosis. In this context, what is communicated is often deemed to lack meaning or to be difficult to understand. While a degree of un-shareability is inherent to subjective life, I argue that issues of unintelligibility can be (...) addressed by shifting from individualistic conceptions of understanding to an interactionist view. This takes into account the contextual, historical and relational background within which meaning is co-constituted. I conclude by providing a corrective for hermeneutical injustice, which entails a specific attentiveness towards the person’s subjectivity, a careful sensitivity to contingent meaning-generating structures, and a degree of hermeneutical flexibility as an attitude of openness towards alternative horizons of possibility. (shrink)

The article presents a doctor–patient relationship model based on the assumptions of a holistic approach to the patient. The author draws attention to selected patients’ needs, ones taken into account in this model. These are the right to autonomy and an individualised approach to the patient. These issues, considered in relation to philosophy, show a conflict between patients’ values and aspirations and doctors’ values and their experience. Nowadays, patients’ needs are protected by consumer rights as well as being strengthened by (...) postmodern philosophy, which shapes society’s awareness of various definitions of health and underlines the right of the individual to self‐determination. This situation creates an incredible challenge for doctors because attempts to assist is, according to medical knowledge, associated with an inevitable collision with the subjective perception of a patient’s health. Because of this issue, the author considers it necessary to enquire about the needs and aspirations of not so much patients as doctors themselves. It is assumed that the definition of what is currently important for this group determines the scope of any possible admission or intentional ignorance of patients’ needs. (shrink)

Recent editions of diagnostic manuals in psychiatry have focused on providing quick and efficient operationalized criteria. Notwithstanding the genuine value of these classifications, many psychiatrists have argued that the operationalization approach does not sufficiently accommodate the rich and complex domain of patients’ experiences that is crucial for clinical reasoning in psychiatry. How can we increase the role of phenomenology in the process of diagnostic reasoning in psychiatry? I argue that this could be done by adopting a clinical staging approach in (...) diagnostic reasoning in psychiatry. The approach has the resources to include the progressive nature of patients’ experiences to a much greater degree than is currently practiced. It can address the recent plea for increasing the role of phenomenology in psychiatric diagnosis by offering a model for clinical reasoning that goes beyond the operationalized, static criteria of diagnostic manuals, without depriving us of their benefits. (shrink)

The philosophy of medicine is an area that has experienced significant growth and change in the last decade or so. While usually thought to be distinct from bioethics, the philosophy of medicine addresses a wide range of questions having to do with epistemology, metaphysics, and values. In this survey, I use the concept of the reference class to draw connections between a number of questions of longstanding and of more recent concern in the philosophy of medicine. By focusing on the (...) way in which the reference class plays a role in questions and approaches that sometimes seem to be at odds with one another, I hope to illustrate the ways in which these oppositions are less complete than they might at first appear, and to show how the connections between different problems are being redrawn. (shrink)

This paper uses an ongoing ethnography of childhood rehabilitation to rethink the Heideggerian phenomenology of death. We argue that Heidegger’s threefold perishing/death/dying framework offers a fruitful way to chart how young people, their parents, and practitioners address mortality in the routine management of muscular dystrophies. Heidegger’s almost exclusive focus on being-towards-death as an individualizing existential structure, rather than the social life with and around death, is at odds with the clinical experience we explore in this paper. After looking to the (...) basic structures of Heidegger’s philosophy of death, we point to recent work by Leder, Svenaeus, Aho, and Carel, bringing health and the spaces of healthcare into our purview. Turning to ethnographic data, we argue that a revised phenomenology of death gives a nuanced account of how health care practitioners address death, dying, and perishing, and outline some steps toward a more ontologically sensitive clinical space. These revisions are in line with recent work in disability studies, that see disability as more than a death sentence. We advocate adjusting phenomenological reflections on disability, to be framed as a way of life, rather than as a deficient or especially deadly mode of human existence. (shrink)

There is no systematic knowledge about how individuals with Locked-in Syndrome experience their situation. A phenomenology of LIS, in the sense of a description of subjective experience as lived by the ill persons themselves, does not yet exist as an organized endeavor. The present article takes a step in that direction by reviewing various materials and making some suggestions. First-person narratives provide the most important sources, but very few have been discussed. LIS barely appears in bioethics and neuroethics. Research on (...) Quality of Life provides relevant information, one questionnaire study explores the sense of personal continuity in LIS patients, and LIS has been used as a test case of theories in “embodied cognition” and to explore issues in the phenomenology of illness and communication. A systematic phenomenology of LIS would draw on these different areas: while some deal directly with subjective experience, others throw light on its psychological, sociocultural and materials conditions. Such an undertaking can contribute to the improvement of care and QOL, and help inform philosophical questions, such as those concerning the properties that define persons, the conditions of their identity and continuity, or the dynamics of embodiment and intersubjectivity. (shrink)

Although by no means mainstream, phenomenological approaches to bioethics and philosophy of medicine are no longer novel. Such approaches take the lived body —as opposed to the body understood as a material, biological object —as their point of departure to offer a more robust understanding of a plurality of experiences that go far beyond those surrounding disease...

In some quarters within philosophy of medicine, more particularly in the phenomenological approaches, naturalism is looked upon with suspicion. This paper argues, first, that it is necessary to distinguish between two expressions of this attitude towards naturalism: phenomenological approaches to illness disagree with naturalism regarding various theoretical claims and they disapprove of naturalism on an ethical level. Second, this paper argues that both the disagreement with and the disapproval of naturalism are to a large extent confused. It then offers some (...) proposals to set up an agenda for future collaboration. (shrink)

Phenomenology in medicine’s main contribution is to present a first-person narrative of illness, in an effort to aid medicine in reaching an accurate disease diagnosis and establishing a personal relationship with patients whose lived experience changes dramatically when severe disease and disabling condition is confirmed. Once disease is diagnosed, the lived experience of illness is reconstructed into a living-with-disease narrative that medicine’s biological approach has widely neglected. Key concepts like health, sickness, illness, disease and the clinical encounter are being diversely (...) and ambiguously used, leading to distortions in socio-medical practices such as medicalization, pharmaceuticalization, emphasis on surveillance medicine. Current definitions of these concepts as employed in phenomenology of medicine are revised, concluding that more stringent semantics ought to reinforce an empirical phenomenological or postphenomenological approach. (shrink)

This article analyses the phenomenon of epistemic injustice within contemporary healthcare. We begin by detailing the persistent complaints patients make about their testimonial frustration and hermeneutical marginalization, and the negative impact this has on their care. We offer an epistemic analysis of this problem using Miranda Fricker's account of epistemic injustice. We detail two types of epistemic injustice, testimonial and hermeneutical, and identify the negative stereotypes and structural features of modern healthcare practices that generate them. We claim that these stereotypes (...) and structural features render ill persons especially vulnerable to these two types of epistemic injustice. We end by proposing five avenues for further work on epistemic injustice in healthcare. (shrink)

During recent decades various researchers from health and social sciences have been debating what it means for a person to be disabled. A rather overlooked approach has developed alongside this debate, primarily inspired by the philosophical tradition called phenomenology. This paper develops a phenomenological model of disability by arguing for a different methodological and conceptual framework from that used by the existing phenomenological approach. The existing approach is developed from the phenomenology of illness, but the paper illustrates how the case (...) of congenital disabilities, looking at the congenital disorder called cerebral palsy (CP), presents a fundamental problem for the approach. In order to understand such congenital cases as CP, the experience of disability is described as being gradually different from, rather than a disruption of, the experience of being abled, and it is argued that the experience of disability is complex and dynamically influenced by both intrinsic and extrinsic factors. Different experiential aspects of disability— pre-reflective, attuned and reflective aspects—are described, demonstrating that the experience of disability comes in different degrees. Overall, this paper contributes to the debates about disability by further describing the personal aspects and experience of persons living with disabilities. (shrink)

In this article, I propose that illness is philosophically revealing and can be used to explore human experience. I suggest that illness is a limit case of embodied experience. By pushing embodied experience to its limit, illness sheds light on normal experience, revealing its ordinary and thus overlooked structure. Illness produces a distancing effect, which allows us to observe normal human behavior and cognition via their pathological counterpart. I suggest that these characteristics warrant illness a philosophical role that has not (...) been articulated. Illness can be used as a philosophical tool for the study of normally tacit aspects of human existence. I argue that illness itself can be integral to philosophical method, insofar as it facilitates a distancing from everyday practices. This method relies on pathological or limit cases to illuminate normally overlooked aspects of human perception and action. I offer Merleau-Ponty’s analysis of the case of Schneider as an example of this method. (shrink)

In this chapter, I consider three ‘promises’ of bringing phenomenology into dialogue with networked learning. First, a ‘conceptual promise’, which draws attention to conceptual resources in phenomenology that can inspire and inform how we understand, conceive of, and uncover experiences of participants in networked learning activities and environments. Second, a ‘methodological promise’, which outlines a variety of ways that phenomenological methodologies and concepts can be put to use in empirical research in networked learning. And third, a ‘critical promise’, which suggests (...) how work done in the realm of critical phenomenology is complementary to and useful for exploring the social justice and emancipatory aims of networked learning researchers. Through this framework, I reflect upon multiple ways in which phenomenology has and might continue to fruitfully inform and shape networked learning research. In doing so, I emphasise that deploying phenomenology in the context of networked learning not only enriches our understanding of networked learning but that phenomenology itself is enriched through testing, finetuning, and expanding its methods, concepts, and understanding, as well as unveiling its own limitations and constraints. (shrink)

Aims and Objectives. This article uses the concept of embodiment to demonstrate a conceptual approach to applied phenomenology. -/- Background. Traditionally, qualitative researchers and healthcare professionals have been taught phenomenological methods, such as the epoché, reduction, or bracketing. These methods are typically construed as a way of avoiding biases so that one may attend to the phenomena in an open and unprejudiced way. However, it has also been argued that qualitative researchers and healthcare professionals can benefit from phenomenology’s well-articulated theoretical (...) framework, which consists of core concepts, such as selfhood, empathy, temporality, spatiality, affectivity, and embodiment. -/- Design. This is a discursive article that demonstrates a conceptual approach to applied phenomenology. -/- Method. To outline and explain this approach to applied phenomenology, the Discussion section walks the reader through four stages of phenomenology, which progress incrementally from the most theoretical to the most practical. -/- Discussion. Part one introduces the philosophical concept of embodiment, which can be applied broadly to any human subject. Part two shows how philosophically trained phenomenologists use the concept of embodiment to describe general features of illness and disability. Part three illustrates how the phenomenological concept of embodiment can inform empirical qualitative studies and reflects on the challenges of integrating philosophy and qualitative research. Part four turns to phenomenology’s application in clinical practice and outlines a workshop model that guides clinicians through the process of using phenomenological concepts to better understand patient experience. -/- Conclusion and Relevance to Clinical Practice. A conceptual approach to applied phenomenology provides a valuable alternative to traditional methodological approaches. Phenomenological concepts provide a foundation for better understanding patient experience in both qualitative health research and clinical practice, and therefore provide resources for enhancing patient care. (shrink)

RESUMEN El trabajo ofrece un análisis crítico a la noción de cuerpo propio en M. Merleau-Ponty, como superación del dualismo cuerpo-mente. Se amplía dicha noción para integrar las experiencias del cuerpo físico y posibilitar el diálogo entre fenomenología y medicina, al proponer una fenomenología del organismo doliente. ABSTRACT The article provides a critical analysis of the notion oflived body in M. Merleau-Ponty, as the overcoming of the body-mind dualism. It expands that notion in order to integrate the experiences of the (...) physical body and make possible the dialogue between phenomenology and medicine by proposing a phenomenology of the ailing body. (shrink)

El trabajo ofrece un análisis crítico a la noción de cuerpo propio (Leib) en M. Merleau-Ponty, como superación del dualismo cuerpo-mente. Se amplía dicha noción para integrar las experiencias del cuerpo físico (Körper) y posibilitar el diálogo entre fe-nomenología y medicina, al proponer una fenomenología del organismo doliente.

Phenomenology provides a method for disability theorists to describe embodied subjectivity lacking within the social model of disability. Within the literature on body integrity identity disorder (BIID), dominant narratives of disability are influential, individual bodies are considered in isolation, and experiences of disabled people are omitted. Research on BIID tends to incorporate an individualist ontology. In this article, I argue that Merleau-Ponty's conceptualization of “being in the world,” which recognizes subjectivity as embodied and intersubjective, provides a better starting point for (...) research describing the experiences of those with BIID and amputees. (shrink)

According to recent approaches in the philosophy of medicine, biomedicine should be replaced or complemented by a humanistic medical model. Two humanistic approaches, narrative medicine and the phenomenology of medicine, have grown particularly popular in recent decades. This paper first suggests that these humanistic criticisms of biomedicine are insufficient. A central problem is that both approaches seem to offer a straw man definition of biomedicine. It then argues that the subsequent definition of humanism found in these approaches is problematically reduced (...) to a compassionate or psychological understanding. My main claims are that humanism cannot be sought in the patient–physician relationship alone and that a broad definition of medicine should help to revisit humanism. With this end in view, I defend what I call an outcomes-oriented approach to humanistic medicine, where humanism is set upon the capacity for a health system to produce good health outcomes. (shrink)

Naturalistic theories of disease appeal to concepts of biological function, and use the notion of dysfunction as the basis of their definitions. Debates in the philosophy of biology demonstrate how attributing functions in organisms and establishing the function-dysfunction distinction is by no means straightforward. This problematization of functional ascription has undermined naturalistic theories and led some authors to abandon the concept of dysfunction, favoring instead definitions based in normative criteria or phenomenological approaches. Although this work has enhanced our understanding of (...) disease and illness, we need not necessarily abandon naturalistic concepts of function and dysfunction in the disease debate. This article attempts to move towards a new naturalistic theory of disease that overcomes the limitations of previous definitions and offers advantages in the clinical setting. Our approach involves a re-evaluation of concepts of biological function employed by naturalistic theories. Drawing on recent insights from the philosophy of biology, we develop a contextual and evaluative account of function that is better suited to clinical medicine and remains consistent with contemporary naturalism. We also show how an updated naturalistic view shares important affinities with normativist and phenomenological positions, suggesting a possibility for consilience in the disease debate. (shrink)

In this paper we argue that ill persons are particularly vulnerable to epistemic injustice in the sense articulated by Fricker. Ill persons are vulnerable to testimonial injustice through the presumptive attribution of characteristics like cognitive unreliability and emotional instability that downgrade the credibility of their testimonies. Ill persons are also vulnerable to hermeneutical injustice because many aspects of the experience of illness are difficult to understand and communicate and this often owes to gaps in collective hermeneutical resources. We then argue (...) that epistemic injustice arises in part owing to the epistemic privilege enjoyed by the practitioners and institutions of contemporary healthcare services—the former owing to their training, expertise, and third-person psychology, and the latter owing to their implicit privileging of certain styles of articulating and evidencing testimonies in ways that marginalise ill persons. We suggest that a phenomenological toolkit may be part of an effort to ameliorate epistemic injustice. (shrink)

This article examines the philosophical role of illness. It briefly surveys the philosophical role accorded to illness in the history of philosophy and explains why illness merits such a role. It suggests that illness modifies, and thus sheds light on, normal experience, revealing its ordinary and therefore overlooked structure. Illness also provides an opportunity for reflection by performing a kind of suspension (epoché) of previously held beliefs, including tacit beliefs. The article argues that these characteristics warrant a philosophical role for (...) illness. While the performance of most philosophical procedures is volitional and theoretical, however, illness is uninvited and threatening, throwing the ill person into anxiety and uncertainty. As such it can be viewed as a radical philosophical motivation that can profoundly alter our outlook. The article suggests that illness can change the ways in which we philosophise: it may shape philosophical methods and concerns and change one's sense of salience and conception of philosophy. (shrink)

This paper explores the phenomenon of vulnerabilisation in relation to the experiences of persons with chronic illnesses. We distinguish a range of kinds of vulnerability, including epistemic vulnerabilities related to epistemic injustices, and describe various interpersonal and institutional processes which can create, exacerbate, and intensify those vulnerabilities. The dynamics of vulnerablisation are related to individual vices and institutional failings, the the pervasive pathophobia of many societies, and various contingent life-events. We conclude that susceptibility to varieties of vulnerabilisation is ultimately reflective (...) of the fragility that is definitive of the human condition. (shrink)

Invalidation from healthcare practitioners is an experience shared by many patients, especially those marginalized or living with contested conditions (e.g., chronic pain, fibromyalgia, etc.). Invalidation can include not taking someone’s testimony seriously, imposing one’s thoughts, discrediting someone’s emotions, or not perceiving someone’s testimony as equal and competent. Epistemic injustices, that is, the disqualification of a person as a knower, are a form of invalidation. Epistemic injustices have been used as a theoretical framework to understand invalidation that occurs in the patient-healthcare (...) provider relationship. However, to date, the different recommendations to achieve epistemic justice have not been listed, analyzed, nor compared yet. This paper aims at better understanding the state of the literature and to critically review possible avenues to achieve epistemic justice in healthcare. A systematic and critical review of the existing literature on epistemic justice was conducted. The search in four databases identified 629 articles, from which 35 were included in the review. Strategies to promote epistemic justice that can be applied to healthcare are mapped in the literature and sorted in six different approaches to epistemic justice, including virtuous, structural, narrative, cognitive, and partnership approaches, as well as resistance strategies. These strategies are critically appraised. A patient partnership approach based on the Montreal Model, implemented at all levels of healthcare systems, seems promising to promote epistemic justice in healthcare. (shrink)

The phenomenological method has been fruitfully used to study the experience of illness in recent years. However, the role of illness is not merely that of a passive object for phenomenological scrutiny. I propose that illness, and pathology more generally, can be developed into a phenomenological method in their own right. I claim that studying cases of pathology, breakdown, and illness offer illumination not only of these experiences, but also of normal function and the tacit background that underpins it. In (...) particular, I claim that the study of embodiment can be greatly enhanced, and indeed would be incomplete, without attending to bodily breakdown and what I term bodily doubt. I offer an analogy between illness and Husserl’s epoché, suggesting that both are a source of distancing, and therefore motivate a reflective stance. (shrink)

When elderly people are ideating on manners to end their lives, because they feel life is over and no longer worth living, it is important to understand their lived experiences, thoughts and behaviour in order to appropriately align care, support and policy to the needs of these people. In the literature, the wish to die in elderly people is often understood from a medical, psychopathological paradigm, referred to as cognitive impairment, depressive disorder, pathological bereavement, and suicidality. In this paper, we (...) evaluate this dominant paradigm by considering three serious limitations, namely: (1) the risk of epistemic transformation; (2) the risk of reduction; and (3) the risk of obscuring the social and cultural embeddedness. Drawing on insights from our empirical–phenomenological research on the issue of elderly and the self-chosen death, this paper argues for a phenomenological perspective to counteract the medicalisation of death wishes in elderly people. (shrink)

Several philosophers have recently argued that phenomenology is well-suited to help understand the concepts of health, disease, and illness. The general claim is that by better analysing how illness appears to or is experienced by ill individuals—incorporating the first-person perspective—some limitations of what is seen as the currently dominant third-person or ‘naturalistic’ approaches to understand health and disease can be overcome. In this article, after discussing some of the main insights and benefits of the phenomenological approach, I develop three general (...) critiques of it. First, I show that what is often referred to as naturalism tends to be misunderstood and/or misrepresented, resulting in straw-man arguments. Second, the concept of normality is often problematically employed such that some aspects of naturalism are actually presupposed by many phenomenologists of medicine. Third, several of the key phenomenological insights and concepts, e.g. having vs. being a body, the alienation of illness, the epistemic role of the first-person perspective, and the idea of health within illness, each bring with them new problems that limit their utility. While acknowledging the possible contributions of phenomenology, these criticisms point to some severe limitations of bringing phenomenological insights to bear on the problems facing philosophy of medicine that should be addressed if phenomenology is to add anything substantially new to its debates. (shrink)

Even though it is not a methodology on the level of principlism or casuistry, narrative bioethics nonetheless contributes to and guides decision-making in the field of biomedical ethics. However, unlike other methodologies, the narrative approach lacks a set of specific patterns and formal rules for doing so. This deficiency leaves this approach more vulnerable to the influence of historical factors; in fact, the vital history of a person is made up of thousands of scenes, which one must select and group (...) under different norms. Yet the historicity of narrative does not destroy its normative value; rather, it gives rise to a confluence of stories that contradict one another on the basis of their practical consequences. This problem is less severe in traditional cultures, where some stories take precedence over others according to the normative value conferred through the supposed authority of their sources. But it manifests in an intense manner within current multicultural societies. It is imperative to find the thread that leads outside the labyrinth of subjectivity. This paper shows that the end of this thread lies, paradoxically, not in actions but in the subject-actors that perform them—specifically when such subjects are conceived as dramaturgical characters in narrative. (shrink)

This contribution intends to explore patients’ lived experience, with a focus on the temporal dimension. On the basis of a qualitative study that led me to interview persons with Parkinson’s disease (PD), caregivers, and medical professionals, I develop an empirical and philosophical investigation of the temporalities surrounding the implementation of deep brain stimulation (DBS) in Greece. I raise the issue of access to DBS medical care, and show how distinct temporalities are implied when the patients face such a matter: that (...) of linear time, linked with the medical discourse, the bureaucratic time linked to administrative and financial hurdles in the implementation and maintenance of DBS, and the technological time of the body/technology fusion. I consider initially the impact of technology and health care settings on the lived experience of patients and the enactment of multiple bodies which are interrelated with the social world. I then expand my analysis in order to show that this experience cannot be a solipsistic one, or specific to one physician/patient relationship. It is fully socially shaped. (shrink)

Victims of disaster suffer, not only at the very moment of the disaster, but also years after the disaster has taken place, they are still in an emotional journey. While many moral perspectives focus on the moment of the disaster itself, a lot of work is to be done years after the disaster. How do people go through their suffering and how can we take care of them? Research on human suffering after a major catastrophe, using an ethics of care (...) perspective, is scarce. People suffering from disasters are often called to be in distress and their emotional difficulties ‘medicalised’. This brings them often into a situation of long term use of medication, and one can wonder if medication is of help to them in the long run. In our paper, we will explore another moral perspective, focusing on the importance of the victims’ narrative and their lived experiences. We will use Paul Ricoeur’s phenomenological reflections from ‘Suffering is not the same as pain’ for conceptualizing human suffering and how to apply it to victims of disaster. Ricoeur suggests that suffering is not a quantity that can be measured, but a characteristic that should be studied qualitatively in interpersonal and narrative contexts. Above all, the perspective of care and listening could offer an opportunity to reconcile people from their loss and suffering. (shrink)

_Phenomenological insights into health issues relating to bodily self-experience, normality and deviance, self-alienation, and objectification._.

This paper demonstrates how the problematic kinds of epistemic power that physicians have can diminish the epistemic privilege that pregnant women have over their bodies and can put them in a state of epistemic powerlessness. This result, I argue, constitutes an epistemic injustice for many pregnant women. A reconsideration of how we understand and care for pregnant women and of the physician–patient relationship can provide us with a valuable context and starting point for helping to alleviate the knowledge/power problems that (...) are symptomatic of the current system and structure of medicine. I suggest that we can begin to confront this kind of injustice if medicine adopts a more phenomenological understanding of bodies and if physicians and patients—in this case, pregnant women—become what I call “epistemic peers.”. (shrink)

This article adopts Husserl’s transcendental phenomenology to explore the complex relationship between patients and physicians. It delves into the coexistence of two distinct voices in the realm of medicine and health: the “voice of medicine” and the “voice of life-world.” Divided into three sections, the article emphasizes the importance of shifting from a scientific-medical attitude to a more personalistic approach in physician–patient interactions. This shift aims to prevent depersonalization and desubjectification. Additionally, it highlights the equal and irreducible nature of patients (...) while acknowledging the vital role physicians hold in the realm of illness. The article stresses the need for a balanced and equitable relationship between both parties, rooted in the shared life-world. Moreover, empathy is underscored as a crucial element in fostering meaningful dialogue, wherein understanding diverse perspectives and attitudes towards illness is paramount. The article argues that differences between patients and physicians are necessary for empathy, while shared similarities form its foundation. Ultimately, a harmonious relationship facilitates empathy and enables the constitution of a new sense of life for both patients and physicians. (shrink)

The general aim of this paper is to provide insight into the relevance of critical phenomenology for the study of the patient-provider relationship in health care systems in U.S. jails, prisons, and detention facilities. In particular, I utilize tools from the work of scholars studying phenomenological approaches to health care and structural forms of oppression to analyze several harms that arise from the provision of medical care under the punitive constraints of carceral facilities.

Metaphysics often has an important role in deciding ethical questions. Specifically, in the realm of bioethics, metaphysical questions such as the nature of persons, diseases, and properties in general can be crucial to determining what is right or wrong. In this article, I tie together various metaphysical themes that recur throughout the rest of the issue: rationality as an element of human nature, ontological classifications, and kinds of action. I will explain that each has ethical implications. Actions that contravene reason (...) will be morally problematic, whereas our classification of illnesses will have important implications for how we ought to respond to ill persons. Metaphysical questions appear, or are at least suggested, in each article, pointing to the need for metaphysics in answering bioethical questions. (shrink)

Clinically significant delusion is a symptom of a number of mental illnesses. We rely on what a person says and how she behaves in order to identify if she has this symptom and it is clear from the literature that delusions are heterogeneous and extremely difficult to define. People with active delusions were interviewed to explore what it is like to develop and experience delusion. The transcribed interview data was analysed to identify themes and narrative trajectories that help to explain (...) the phenomenon. Results showed that delusions can sometimes provide pragmatic benefits and that the genesis of some delusions can be characterised in terms of the enactivist notion of affective framing. Affective framing is a term that captures the background emotions that enable know-how in terms of goal directed action and cognition. If a person’s affective frame alters the world is no longer understood and know-how is lost. The way in which a person relates to her environment can be highly anomalous thus requiring her to find an extraordinary explanation. I argue that delusions arise as a result of a breakdown in affective framing and offer a conceptualisation of delusion supported by empirical findings. (shrink)

Suffering, defined as a state of undergoing pain, distress or hardship, is a multidimensional concept; it can entail physical, psychological and spiritual distress that prompts the sufferer to seek medical attention. As a construct originating from and unique to each patient, no patient’s suffering is equal to another’s or completely reducible to any generalizable frame of understanding. As it happens in a common medical encounter, the suffering patient requires an anamnesis provided by attentive and comprehensive listening to both the said (...) and unsaid parts of his or her discourse interpreted through the hermeneutical skills of the physician. Suffering can then be decoded into a complex construct, which can guide the formulation of a strategy to help patient coping by attempting to find meaning in it. To help this search for meaning, one may employ philosophic therapy, bibliotherapy and counseling, among other approaches. Suffering-based medicine (SBM) thus circumvents the limitations of the reductionistic Allopathic medical frame of understanding of disease. Such an attitude should be a common goal for all scientific medicine practitioners, as it complements and does not conflict with any of its therapeutic modalities. Furthermore, medical education should include humanistic disciplines to empower physicians to better understand their patients’ experience of suffering. (shrink)

The vulnerability of a patient gives rise to special obligations to provide aid, but the extent of our obligations to those vulnerable is not always clear. How far we are obligated to provide aid raises profound questions over the balance of liberty, equality, utility, and other core values for which we ought to strive in modern society. This essay helps illustrate how such a balance must be worked out in relation to rich contexts and be responsive to continually evolving epistemic (...) and social configurations. (shrink)

In this article, I introduce engaged phenomenology as an approach through which phenomenologists can more explicitly and critically consider the generative conditions and implications of their rese...

This article discusses how existential phenomenology may serve as a frame in a mixed‐methods study of changes in weight and body composition among women in adjuvant treatment for breast cancer. In accordance with ontologically and epistemologically fundamental assumptions in nursing, we link mixed‐methods and existential phenomenology from the perspective of the French philosopher Maurice Merleau‐Ponty and his notion of a unified body subject. Letting this perspective permeate our philosophy, methodology and issues at the method level in mixed‐method research undermines the (...) distinction between first‐ and third‐person perspective when applying and integrating different data sources in a mixed‐methods study. Applying Merleau‐Ponty's third way, the women's bodily experiences appear as gestalt; a ‘figure’ against a ground of existential threats that are grasped through insight from data integrating in joint displays, which revealed the women's experiences on a deep existential level. Existential phenomenology as a frame in mixed‐method studies can speak not only to nurses but also to a multidisciplinary audience in a shared attempt to deepen the understanding of a patient's healthcare problem. (shrink)

The number of people who survive critical illness is increasing. In parallel, a growing body of literature reveals a broad range of side-effects following intensive care treatment. Today, more attention is needed to improve the quality of survival. Based on nine individual stories of illness experiences given by participants in two focus groups and one individual interview, this paper elaborates how former critically ill patients craft and recraft their personal stories throughout their illness trajectory. The analysis was conducted from a (...) phenomenological perspective and led to the meaning structure; a quest to find oneself after critical illness. In this structure, illness represented a breakdown of the participants’ lives, forcing them to develop a new understanding of themselves. Despite acute illness, they felt safe in hospital. Coming home, however, meant a constant balancing between health and illness, and being either in or out of control. To gain a deeper understanding of the participants’ narratives of survival, the meaning structure was developed from a phenomenological life world perspective, Heidegger’s concept of homelikeness and Arthur Frank’s typologies of illness narratives. In conclusion listening to and acknowledging the patients’ lived experiences of critical illness may support the patient efforts to establish the newly defined self and hence be vital for recovery. Phenomenology is one approach facilitating care tailored to the patients’ lived experience of critical illness and its aftermaths. (shrink)