In this paper, an attempt is made to develop an understanding of the essence of illness based on a reading of Martin Heidegger's pivotal work Being and Time. The hypothesis put forward is that a phenomenology of illness can be carried out through highlighting the concept of otherness in relation to meaningfulness. Otherness is to be understood here as a foreignness that permeates the ill life when the lived body takes on alien qualities. A further specification of this kind of otherness can be found with the concept of unhomelike being-in-the-world. Health, in contrast to this frustrating unhomelikeness, is a homelike being-in-the-world in which the lived body in most cases has a transparent quality as the point of access to the world in understanding activities. The paper then proposes that the temporal structure of illness can be conceptualised as an alienation of past and future, whereby one's past and future appear alien, compared with what was the case before the onset of illness. The remainder of the paper follows two paths as regards the temporality of illness. The first path explores the temporality of the body in relation to the temporality of the being-in-the-world of the self. One way of understanding the alienating character of illness is that nature, as the temporality of our bodies, ceases to obey our attempts to make sense of phenomena: the time of the body no longer fits into the time of the self. The second path explored in the paper is that of narrativity. When we make sense of the present, in relation to our future and past, we do so in a special manner, namely, by structuring our experiences in the form of stories. Illness breaks in on us as a rift in these stories, necessitating a retelling of the past and a re-envisioning of the future in an effort to address and change their alienated character. These stories, however, never allow us to leave the silent otherness of our bodies behind. They are stories nurtured by the time of nature at the heart of our existence. It is then claimed that the idea of life's being a story must be understood in a metaphorical sense, and an exploration of how phenomenology addresses the metaphoric quality of its conceptuality is ushered in. It is pointed out that metaphors can be systematically related to each other and that they always have a founding ground in the orientation and basic activities of the lived body. Therefore, if the concepts used in working out a phenomenological theory of health and illness are, to a certain extent, metaphorical, one could, nevertheless, claim that the metaphoric qualities of the phenomenological concepts are primary in referring back to the lived body and the way it inhabits the world.

The relevance of the Aristotelian concept of phronesis--practical wisdom--for medicine and medical ethics has been much debated during the last two decades. This paper attempts to show how Aristotle's practical philosophy was of central importance to Hans-Georg Gadamer and to the development of his philosophical hermeneutics, and how, accordingly, the concept of phronesis will be central to a Gadamerian hermeneutics of medicine. If medical practice is conceived of as an interpretative meeting between doctor and patient with the aim of restoring the health of the latter, then phronesis is the mark of the good physician, who through interpretation comes to know the best thing to do for this particular patient at this particular time. The potential fruitfulness of this hermeneutical appropriation of phronesis for the field of medical ethics is also discussed. The concept can be (and has been) used in critiques of the conceptualization of bioethics as the application of principle-based theory to clinical situations, since Aristotle's point is exactly that problems of praxis cannot be approached in this way. It can also point the way for alternative forms of medical ethics, such as virtue ethics or a phenomenological and hermeneutical ethics. The latter alternative would have to address the phenomena of health and the good life as issues for medical practice. It would also have to map out in detail the terrain of the medical meeting and the acts of interpretation through which phronesis is exercised.

This article develops a phenomenology of suffering with an emphasis on matters relevant to medical practice and bioethics. An attempt is made to explain how suffering can involve many different things-bodily pains, inability to carry out everyday actions, and failure to realize core life values-and yet be a distinct phenomenon. Proceeding from and expanding upon analyses found in the works of Eric Cassell and Elaine Scarry, suffering is found to be a potentially alienating mood overcoming the person and engaging her in a struggle to remain at home in the face of loss of meaning and purpose in life. Suffering involves painful experiences at different levels that are connected through the suffering-mood but are nevertheless distinguishable by being primarily about (1) my embodiment, (2) my engagements in the world together with others, and (3) my core life values. Suffering is in essence a feeling (a mood), but as such, it has implications for and involves the person's entire life: how she acts in the world, communicates with others, and understands and looks upon her priorities and goals in life. Suffering-moods are typically intense and painful in nature, but they may also display a rather subconscious quality in presenting things in the world and my life as a whole in an alienating way. In such situations, we are not focused directly upon the suffering-mood-as in the cases of pain and other bodily ailments-but rather, upon the things that the mood presents to us: not only our bodies, but also other things in the world that prevent us from having a good life and being the persons we want to be. Such suffering may in many cases be transformed or at least mitigated by a person's identifying and changing her core life values and in such a manner reinterpreting her life story to become an easier and more rewarding one to live under the present circumstances.

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In this paper I develop a phenomenology of falling ill by presenting, interpreting and developing the basic model we find in Jean-Paul Sartre's Being and Nothingness (1956). The three steps identified by Sartre in this process are analysed, developed further and brought to a five-step model: (1) pre-reflective experience of discomfort, (2) lived, bodily discomfort, (3) suffered illness, (4) disease pondering, and (5) disease state. To fall ill is to fall victim to a gradual process of alienation, and with each step this alienating process is taken to a new qualitative level. Consequently, the five steps of falling ill have not only a contingent chronological order but also a kind of logical order, in that they typically presuppose each other. I adopt Sartre's focus on embodiment as the core ground of the alienation process, but point out that the alienation of the body in illness is not only the experience of a psychic object, but an experience of the independent life of one's own body. This facticity of the body is the result neither of the gaze of the other person, nor of a reflection adopting the outer perspective of the other in an indirect way, but is a result of the very otherness of one's own body, which addresses and plagues us when we fall ill. I use examples of falling ill and being a patient to show how a phenomenology of falling ill can be helpful in educating health-care personnel (and perhaps also patients) about the ways of the lived body.