Putting phenomenology in its place: some limits of a phenomenology of medicine

Abstract

Several philosophers have recently argued that phenomenology is well-suited to help understand the concepts of health, disease, and illness. The general claim is that by better analysing how illness appears to or is experienced by ill individuals--incorporating the first-person perspective--some limitations of what is seen as the currently dominant third-person or 'naturalistic' approaches to understand health and disease can be overcome. In this article, after discussing some of the main insights and benefits of the phenomenological approach, I develop three general critiques of it. First, I show that what is often referred to as naturalism tends to be misunderstood and/or misrepresented, resulting in straw-man arguments. Second, the concept of normality is often problematically employed such that some aspects of naturalism are actually presupposed by many phenomenologists of medicine. Third, several of the key phenomenological insights and concepts, e.g. having vs. being a body, the alienation of illness, the epistemic role of the first-person perspective, and the idea of health within illness, each bring with them new problems that limit their utility. While acknowledging the possible contributions of phenomenology, these criticisms point to some severe limitations of bringing phenomenological insights to bear on the problems facing philosophy of medicine that should be addressed if phenomenology is to add anything substantially new to its debates.

I Miss Being Me: Phenomenological Effects of Deep Brain Stimulation

“…Connected to this point is the concern that no generalizable conclusions can be drawn from such limited data. While looking at the phenomenology of DBS might be a useful tool for describing the lived experiences of implanted patients, it remains severely impoverished as a theory for explaining it (Sholl 2015). However, we are not attempting to draw generalizable conclusions on the basis of numbers, but rather, we aim to examine phenomenological first-personal reports to inform understandings of the impacts of DBS on patients' self, with a focus on self-estrangement.…”

Should phenomenological approaches to illness be wary of naturalism?

“…(Svenaeus, 2013, p. 223) Sholl points out that the proponents of PhenoMed, although right to argue that this type of naturalism is implausible regarding health and disease, end up making a strawman of naturalism, i.e. a convenient caricature of naturalism which is easy to target (Sholl, 2015). Indeed, naturalism needs not be stuck with an old-fashioned mechanistic or biological-only approach, improper for the study of human beings, their experiences and behaviours.…”

“…Despite this popularity, there is little work engaging critically with the main claims of this relatively recent trend. This paper is a contribution to this kind of critical examination (in the line of Gergel, 2012 andSholl, 2015), by addressing one important aspect of the PhenoMed approach: how it situates itself towards naturalism, and how it seems to be wary of or uncomfortable with it. Commenting on the recurrent attacks on naturalism in general, Daniel Andler has pointed out that "everybody targets or figures she's targeting something precise, has made up her mind long ago, and doesn't care much for entering again that same old never-ending debate" (Andler 2016, 11).…”

The Handbook of the Philosophy of MedicineThomasSchrammeStevenEdwards2017

“…Although interesting for newcomers to the field or for health professionals, it would have been helpful to include an overview of this specific debate as well. The phenomenology of medicine, although thought‐provoking, faces philosophical problems which should have been discussed or at least mentioned in the handbook …”