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)

This paper presents a phenomenological account of empathy inspired by the proposal put forward by Edith Stein in her book On the Problem of Empathy, published originally 1917. By way of explicating Stein’s views, the paper aims to present a characterization of empathy that is in some aspects similar to, but yet essentially different from contemporary simulationist theories of empathy. An attempt is made to show that Stein’s proposal articulates the essential ingredients and steps involved in empathy and that her (...) proposal can be made even more comprehensive and elucidating by stressing the emotional aspect of the empathy process. Empathy, according to such a phenomenological proposal, is to be understood as a perceptual-imaginative feeling towards and with the other person’s experiences made possible by affective bodily schemas and being enhanced by a personal concern for her. To experience empathy does not necessarily or only mean to experience the same type of feeling as the target does; it means feeling alongside the feeling of the target in imagining and explicating a rich understanding of the experiences of the very person one is facing. (shrink)

Phenomenology is a useful methodology for describing and ordering experience. As such, phenomenology can be specifically applied to the first person experience of illness in order to illuminate this experience and enable health care providers to enhance their understanding of it. However, this approach has been underutilized in the philosophy of medicine as well as in medical training and practice. This paper demonstrates the usefulness of phenomenology to clinical medicine. In order to describe the experience of illness, we need a (...) phenomenological approach that gives the body a central role and acknowledges the primacy of perception. I present such a phenomenological method and show how it could usefully illuminate the experience of illness through a set of concepts taken from Merleau-Ponty. His distinction between the biological body and the body as lived, analysis of the habitual body, and the notions of motor intentionality and intentional arc are used to capture the experience of illness. I then discuss the applications this approach could have in medicine. These include narrowing the gap between objective assessments of well-being in illness and subjective experiences which are varied and diverse; developing a more attuned dialogue between physicians and patients based on a thick understanding of illness; developing research methods that are informed by phenomenology and thus go beyond existing qualitative methods; and providing medical staff with a concrete understanding of the impact of illness on the life-world of patients. (shrink)

This dissertation contributes to the philosophy of empathy and biomedical ethics by drawing on phenomenological approaches to empathy, intersubjectivity, and affectivity in order to contest the primacy of the intersubjective aspect of empathy at the cost of its affective aspect. Both aspects need to be explained in order for empathy to be accurately understood in philosophical works, as well as practically useful for patient care in biomedical ethics. In the first chapter, I examine the current state of clinical empathy in (...) medicine including professional opinions about empathy, the dominant definition being employed, and the problems that arise from this definition. By trying to define empathy in a way that is useful to the current presuppositions in medicine, clinical empathy aligns with simulation theory, which has three problems: the discrepancy between the way empathy is defined and the way it is explained, the lack of diversity that this theory of empathy allows in our understanding of others, and the lack of affective understanding and affective engagement involved in the patient-physician interaction. These three problems are used to derive three questions that are important for any theory of empathy: (1) What is the phenomenon being explained? (2) What is the intersubjective context of empathy? (3) What is the affective dimension of empathy? The best theory of clinical empathy can be formulated by answering these three questions as they relate to phenomenological theories, which are more attuned to overcoming presuppositions. Chapters two and three each examine a different phenomenological approach to empathy from opposite extremes in their theories of intersubjectivity. Husserl and Stein begin from an isolated, transcendental subject that needs empathy to bridge the gap between itself and others, while Scheler begins from a primary intersubjectivity in which self and other are undifferentiated, making empathy a largely unnecessary skill. Despite their strongly opposed positions, and the acknowledgement that their theories of intersubjectivity necessitate their theories of empathy, I argue that both fail to understand the affective dimension of empathy. Husserl and Stein leave no room in empathy for it to be an affect, while Scheler prioritizes affects that reunite subjects, but leaves empathy itself as a non-affective skill. Chapter four explains Gallagher’s interaction theory as a more moderate approach to the relation between empathy and intersubjectivity. He draws on the insights of the other two theories, but conceives of empathy as a multi-leveled phenomenon that allows for an understanding of others. While this theory does aid in addressing the intersubjective context of empathy in a way that best solves the first two problems with clinical empathy, interaction theory still fails to fully address the affectivity of empathy, maintaining empathy as a largely cognitive ability. Gallagher does acknowledge the affective core of empathy, but he does not explain the way in which it is affective. In response to this problem, I explain Anya Daly’s application of Merleau-Ponty’s theory of reversibility to affectivity as a possible solution to the problematic gap in Gallagher’s theory. Chapter five focuses on theories of clinical empathy in order to address the neglected affective aspects of empathy, and respond to the problem of detached concern. The problems caused by detached concern are explained, as well as why the theories discussed in the middle chapters are still unable to solve them. This is done in two parts. In the first part, I explain the basis of this issue in the cognitive/feeling divide, as explained in the philosophy of emotion. Then, I give a brief overview of the phenomenology of affectivity to be used as a guide to the affectivity of empathy. In the second part, I examine three theories of clinical empathy that attempt to solve the problem of detached concern, noting their strengths and weaknesses based on their similarities to phenomenological approaches to empathy and affectivity. (shrink)

Peer learning involves processes whereby inexperienced persons learn from persons with more experience. Previous research has shown the benefit of peer learning to the rehabilitation process of people with spinal cord injuries and others using a wheelchair, yet discussions of problematic aspects are scant. Thus, the purpose of this article is to highlight two problems with peer learning. By presenting a vignette elaborated from a phenomenologically oriented case study of a wheelchair skills program at a Norwegian rehabilitation unit, the problem (...) of a naive view of empathy and the danger of inflicting symbolic violence are reflected upon. These reflections, though tentative, draw attention to the ethical responsibility of rehabilitation professionals who use peer learning as a part of their intervention. (shrink)

El presente artículo se propone identificar los fundamentos de la teoría de la comunicabilidad de la Obra de Arte que se puede extraer de los escritos de Edith Stein. Tras presentar el problema de la empatía y la base antropológica que afecta a los sujetos y objetos del mundo del arte, además de los posibles problemas en la transmisión de dicho mensaje artístico, se ahonda en las implicaciones de la consideración del arte como objeto y sujeto de empatía y el (...) sistema comunicativo que se puede establecer en el mundo del arte. (shrink)

Recovery is a commonly used concept in both professional and everyday contexts. Yet despite its extensive use, it has not drawn much philosophical attention. In this paper, I question the common understanding of recovery, show how the concept is inadequate, and introduce new and much needed terminology. I argue that recovery glosses over important distinctions and even misrepresents the process of moving away from malady as "going back" to a former state of health. It does not invite important nuances needed (...) to distinguish between biomedical, phenomenological, and social perspectives. In addition, I claim that there are many conditions where we are making use of the concept of recovery, although the person recovered from the condition in question, has not regained the same degree of soundness. I show how the concept of recovery leads to conceptual discrepancies that can result in worsening patients' conditions. To gain a fuller understanding, I propose to rethink the direction of the process in question. I define the process of moving away from malady as a move forward towards a new state of soundness. I also suggest three terms, corresponding to different perspectives, to describe this movement forward: 'curing', 'healing', and 'habilitating'. This new terminology provides a more nuanced understanding of the states of both malady and soundness and an attentiveness as to how they differ and relate. (shrink)