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Phenomenology and its application in medicine

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Abstract

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.

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Notes

  1. Its transcendental, rather than empirical, data is what differentiates phenomenology from experimental psychology. While experimental psychology generates empirical data about different mental acts, phenomenology generates transcendental data on the conditions of possibility of certain mental acts. Famously, space and time are such conditions of possibility, without which experience would be impossible [2, A32/B48; 3, pp. 75ff.].

  2. Thus we can find a broad range of metaphysical views in this tradition. Husserl’s idealism [4] can be contrasted with Merleau-Ponty’s realism [5] and with Heidegger’s emphasis on ontology [6].

  3. A special issue of Theoretical Medicine [15] was dedicated to Zaner’s work.

  4. It can be used to understand any type of bodily experience, e.g., the experience of being pregnant [32].

  5. It is also useful for a number of other issues in medicine, as will be explained below.

  6. I thank an anonymous referee for pointing out that the experience of wellness can also be explicit and draw attention to the body.

  7. Similarly, when one is ill or disabled, tools may become conspicuous because of the body’s inability to use them. For example, a pen is normally a tool to be used. But for a quadriplegic the pen presents a challenge or even becomes an obstacle [18, p. 251].

  8. Toombs provides a list of essential (or ‘eidetic’) characteristics of the experience of illness, including the perception of loss of wholeness, loss of certainty and control, loss of freedom to act, and loss of the familiar world [17, p. 229].

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Carel, H. Phenomenology and its application in medicine. Theor Med Bioeth 32, 33–46 (2011). https://doi.org/10.1007/s11017-010-9161-x

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