Patients' ‘thingification’, unexplained symptoms and <i>response‐ability</i> in the clinical context: in response to ‘Patients' substantialization of disease, the hybrid symptom and the <i>meta</i>physical care’, by <scp>A</scp>lexandra <scp>P</scp>arvan

There is now broad agreement that ideas like person‐centred care, patient expertise and shared decision‐making are no longer peripheral to health discourse, fine ideals or merely desirable additions to sound, scientific clinical practice. Rather, their incorporation into our thinking and planning of health and social care is essential if we are to respond adequately to the problems that confront us: they need to be seen not as “ethical add‐ons” but core components of any genuinely integrated, realistic and conceptually sound account of healthcare practice. This, the tenth philosophy thematic edition of the journal, presents papers conducting urgent research into the social context of scientific knowledge and the significance of viewing clinical knowledge not as something that “sits within the minds” of researchers and practitioners, but as a relational concept, the product of social interactions. It includes papers on the nature of reasoning and evidence, the on‐going problems of how to ‘integrate’ different forms of scientific knowledge with broader, humanistic understandings of reasoning and judgement, patient and community perspectives. Discussions of the epistemological contribution of patient perspectives to the nature of care, and the crucial and still under‐developed role of phenomenology in medical epistemology, are followed by a broad range of papers focussing on shared decision‐making, analysing its proper meaning, its role in policy, methods for realising it and its limitations in real‐world contexts.

Section: Person‐centred Care and The Phenomenology Of Illnessmentioning

confidence: 85%

Section: Person-centred Care and The Phenomenology Of Illnessmentioning

confidence: 98%

Interactions between persons—Knowledge, decision making, and the co‐production of practice

Loughlin

Buetow

Cournoyea

et al. 2019

“…Crucial information is lost along the way. The transformation of a particular person into 1 or several defined disease entities in the same body provokes the alienation of this particular person from her or his lifeworld, imposing a “thingification” to serve such medical purposes as taxonomy and classification . What is lost in translation may be nothing less than the most salient source of knowledge as to the origin or source of the particular person's current health problem(s), namely the lived experiences that both ignite and maintain inflammation and other disturbances on the physiological level which provoke bad health and lead to premature death.…”

Section: A Problematic Nexusmentioning

confidence: 99%

From wholes to fragments to wholes—what gets lost in translation?

Kirkengen

2018

Self Cite

The highly demanding and, in a certain sense, unique, working conditions of general practitioners (GPs) are characterized by two phenomena: First, they involve an increasing familiarity with individual patients over time, which promotes a deepening of insight. Second, they enable the GP to encounter all kinds of health problems, which in turn facilitates pattern recognition, at both individual and group levels, particularly the kind of patterns currently termed "multimorbidity." Whereas the term "comorbidity" is used to denote states of bad health in which 1 disease is considered to predate and evoke other ailments or diseases, the term multimorbidity is applied when finding several presumably separate diseases in a person who suffers from them either sequentially or simultaneously. Encounters with patients whose suffering fits the biomedical concept and terminology of multimorbidity are among the most common which GPs face, presenting them with some of their most demanding tasks. The term multimorbidity needs to be examined, however. As it alludes to a multiplicity of diseases, it rests on an assumption of separateness of states of bad health that might not be well founded. An adequate determination of what to deem a "separate" state of bad health would require that the biomedical concept of causation be scrutinized.

“…This year's debates section contains two responses to previously published articles in this journal. Responding to Parvan's paper in the previous philosophy thematic [32] on patients' 'substantialization of disease' and metaphysical care, Eriksen and Kirkengen [51] begin by providing their own reflection on the epistemological and ontological questions raised by the phenomenon of medically unexplained symptoms or syndromes. They argue that 'such health challenges can serve as the basis for an exploration of how the suffering person as well as the medical caretaker come to grips with disease, incapacitation or suffering'.…”

Section: Debatesmentioning

confidence: 99%

Theory, experience and practice

Loughlin¹,

Fuller

Bluhm

et al. 2016

Despite its potential hazards, the activity of questioning theoretical frameworks and proposing solutions is necessary if progress is even to be possible. Intellectual history has by no means ended, so we cannot expect to have all the answers, and from time to time the activity of critical questioning will be frustrating. But intellectual progress requires us to continue the process of asking fundamental questions. The alternative to thinking in this way is indeed unthinkable.