Biomedicine is a global enterprise constructed upon the belief in the universality of scientific truths. However, despite huge scientific advances over recent decades it has not been able to formulate a specific and universal definition of death: In fact, in its attempt to redefine death, the concept of death appears to have become immersed in ever increasing vagueness and ambiguity. Even more worrisome is that bioethics, in the form of principlism, is also endeavouring to become a global enterprise by claiming (...) neutrality. It appears that the discourse within both disciplines have similarly manipulated the boundaries of death to include the “dying”. This paper argues that the redefinition of death debate in biomedicine reveals a concept of personhood which is profoundly western in origin and which is in accordance to the concept adhered to within principlism. Biomedicine and bioethics do not appear to acknowledge the limitations of their own world view and hence lack an understanding of their applicability and appropriateness in diverse social and cultural contexts; a situation which adds credence to claims as to the hegemonic and imperialistic nature of all such global enterprises. (shrink)

The focus is on the intersubjective, narrative and dialogic aspects of the clinical phenomenon of insight in psychosis. By introducing a socio-dialogic model for the clinical production of insight, it can be learned how insight, as a form of self-knowledge , is a product of the clinical interview, namely the dialogic relation between patient and clinical interviewer. Drawing upon the philosophy of Emmanuel Levinas, expressly his notion of the ethical encounter, the production of insight in the clinical interview is elucidated (...) as both a synchronic and diachronic phenomenon—a provisional form of self-knowledge based on historically-produced frames of meaning which are recalled and narrated, i.e., produced at a specific moment in time. The production of insight, based on auto-biographical memory, is ultimately a processual and transactional phenomenon which arises out of the narrative construction of experience and the dialogic negotiation of the individual's "authored" experience. This process may be understood as a synergistic dynamic between intersubjective micro-processes and symbolic macro-processes , which may, when crystallized at the individual level, precipitate a subjectively insightful account of the prodromal illness experience. (shrink)