Wisdom and Ethico-Legal Practice

Abstract

Ways of Seeing and Ways of Being ON WISDOM: WHY "WAYS OF SEEING, KNOWING AND BEING"? This chapter considers how different ways of seeing, knowing and being might inform how clinicians and practitioners make judgements, particularly in relation to the ethico-legal questions and considerations that arise in their work. What is meant by "ways of seeing, knowing and being" and why are these useful when thinking about the nature of wisdom? Since Foucault (1976) conceptualised the medical "gaze" that characterised work in the clinic, the lens of healthcare work has been a preoccupation of philosophers, anthropologists and sociologists. The way in which a healthcare professional is trained to see is detached, expert and powerful, yet there are other ways of seeing that, it is argued, inform wise practice. Ways of knowing describes the different types of knowledge and discernment that are required when practising medicine and engaging with its ethico-legal dimensions. Ways of being refers to the characteristics, behaviours and qualities that inform how someone responds when managing different types of knowledge in a context where uncertainty, emotion, complexity and pressure are common. Both ways of knowing and ways of being in practice are often implicit and underconsidered yet are fundamental to practice, choice and, specifically, the nature of wisdom. This chapter discusses that relationship between wisdom, ways of seeing, knowing and being, and the ethico-legal questions, considerations and challenges of medical practice. I argue, drawing on Havi Carel's (Carel, 2013, 2016; Carel & Kidd, 2014, 2016) work on epistemic justice in healthcare, that wisdom, when understood as shaped by ways of seeing, knowing and being, serves as a valuable force in healthcare: as a counter to inherent imbalances of power, as a guide for education and development, as protection against burnout and compassion fatigue and as a reminder of the essence of what it is to be an individual clinician and an individual patient in a demanding, resource-constrained system. WHAT IS WISDOM? Wisdom has been a feature of virtue ethics since Ancient times; from the scepticism of Socrates about the possibility and limits of knowledge (Miller & Platter, 2010; Plato, c. 400 BC/2010) to Aristotle's distinction between theoretical and practical wisdom (Aristotle, 349 BC/2004; Dowie, 2000). The nature of wisdom has preoccupied philosophers for centuries with the focus being predominantly, although not exclusively, on the personal rather than the systemic.

Enacted Phronesis (Practical Wisdom) in Medical Practitioners: An Empirical Mixed Methods Study

“…Ardelt suggests that a high criterion for wisdom in her 3DWS would correlate with high subjective wellbeing. 29 The use of the 3DWS was to provide a purposive sample of exemplars that would proceed to the qualitative part of the research -biographic narrative interviews. The participants were UK General Practitioners who also had an educator role (Educational supervisor, Clinical supervisor, or Appraiser), or were in a training grade (GP trainee).…”