Summary Care and cure have been described as different kinds of ethical approaches to clinical situations. Female concerns in nursing care have been contrasted with masculine, cure orientated physician's attitudes. Ethics in such different voices may have sociologic determinants, but they do not represent intrinsic distinctions. Medicine has shown a divergent development, on the one hand stressing cure in a deterministic and instrumental way, on the other hand being aware that disease is as much a pathographic as a biographic, care‐requiring (...) existential situation. Disease is a breakdown of the living organism, to be cured by therapeutic efforts, but it is also the distressing failure of the lived body, requiring concern and care. Based on Lévinas’ ethics of encounter, it is suggested that any interpersonal relatedness is based on concern for the other, being grounded on an essentially ethical interaction. The clinical encounter is a paradigm of such ethics‐based relationships, which necessarily builds on awareness of the other qua other, and is concerned with fulfilling the therapeutic mandate. Caring for the other means doing one's best to help her/him, so that care and cure are inextricably interwoven, although care is the more fundamental form of human relatedness. Thus, neither gender nor professional tasks can allow for a caring attitude to develop without curing concerns, just as trying to cure without caring is unthinkable. (shrink)

The past 10 years have seen considerable developments in the use of narrative in medicine, primarily through the emergence of the so-called narrative medicine. In this article, I question narrative medicine’s self-understanding and contend that one of the most prominent issues is its lack of a clear epistemological framework. Drawing from Gadamer’s work on hermeneutics, I first show that narrative medicine is deeply linked with the hermeneutical field of knowledge. Then I try to identify which claims can be legitimately expected (...) from narrative medicine, and which ones cannot be. I scrutinize in particular whether narrative medicine can legitimately grasp the patient’s lived experience of his or her illness. In the last section of this article, I begin to explore the potential usefulness of this epistemological clarification. This analysis allows for a further understanding of what is really at stake with narrative medicine, and thus to identify when it may be convenient, and when it may not. Furthermore, this clarification opens up promising new possibilities of dialogue with critics of the field. I conclude that narrative medicine finds its proper place as a possible tool available to mediate dialogue, which is at the heart of the clinical encounter in medical practice. (shrink)

Wir stellen ein präzises Modell der wissenschaftlichen Begriffs-theorie vor, in dem die Beschreibungs-, die Wirklichkeits- und die mengentheoretische Ebene verknüpft werden. Einerseits wird ein allgemeiner Rahmen für die Gesamtheit der Begriffe, andererseits die „lokale” Struktur eines Begriffs beschrieben. Wir spezialisieren diesen Rahmen auf wissenschaftliche Begriffe, wissenschaftliche Theorien, und auf die zugehörigen strukturalistischen, wissenschaftstheoretischen Konstruktionen. We introduce a precise model for the theory of concepts in philosophy of science. In this model we connect the level of description, the level of reality (...) and the level of set theoretic systems. On the one hand we describe a general frame for the collection of concepts, and on the other hand the „local” structure of a concept. We specialize this frame to scientific concepts, scientific theories, and to the appertaining structuralist constructions from philosophy of science. (shrink)