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. (shrink)

Schleiermacher's Soliloquies not only represent a pivotal work in this classically modern theologian's development as a moral philosopher. They are also arguably the principal moral writing of the early German romantic movement and therefore a significant, if widely overlooked, contribution to the history of ethics in the West. This essay provides a comprehensive interpretation and modest retrieval of this unusual and difficult work by bringing Schleiermacher's early “ethics of individuality” into conversation with Charles Taylor's conception of “expressivist” understandings of human (...) selfhood. It argues that the Monologen are a signal instance of what Taylor has subtly characterized as romanticism's expressivist impulse. (shrink)

Zusammenfassung Schleiermachers Theorie der Erbsünde wird gewöhnlich als Abkehr von Augustinus verstanden. Diese Behauptung ist unhaltbar. Eine genauere Untersuchung wird zeigen, dass Schleiermachers Kritik an Augustinus darauf abzielt, Augustins Lehre von der Erbsünde logisch kohärent und widerspruchsfrei zu machen und die Gefahr eines manichäischen Dualismus so weit wie möglich zu umgehen. Darüber hinaus wird gezeigt, dass Schleiermachers Lehre von der Erbsünde in hohem Maße kohärent und in sich konsistent ist, da die folgenden Ideen Schleiermachers philosophische und theologische Schriften durchdringen: die (...) Untrennbarkeit der transzendentalen Freiheit von den sinnlichen Trieben, die Untrennbarkeit von Materie und Form und die Untrennbarkeit von Gott und Welt. Auf diese Weise können wir den Geist von Schleiermachers Lehre der Erbsünde besser verstehen. (shrink)