The Living Body and the Lived Body in the Clinical Encounter: How Does the Body Shape Ethical Practice

Abstract

How does the body shape the clinical encounter? In contemporary debates, evidence-based medicine is thought to favor exclusively the body as object: palpated by the clinician’s hands, submitted to a laser, and captured in a medical image. Such approach to medicine has been challenged by alternative conceptions and practices, notably grounded on a phenomenological characterization of the body as distinctively subjective. Among such alternatives, narrative approaches to illness and medicine encourage, on the patient’s side, a self-empowerment through the mastery of one’s own illness story and, on the clinician’s side, an empathic attitude allowing the interpretation of such narratives. In turn, such approaches are challenged by the consideration of the patient’s and the clinician’s relation to sufferance. Before the clinician can take the patient’s sufferance as an object of scrutiny, at an intentional level, he may be experiencing it, at a pre-intentional level, through his own body, thanks to a bodily intersubjectivity in which one body resonates with the other. Moreover, also at a pre-intentional level, the patient’s suffering is irreducible to any resonating affect in the clinician’s body. As such, to suffer is to be passively subjected to self-entrapment. Only the encounter with another subject can open and thus alleviate such suffering, when the patient addresses it to the clinician as a call for recognition and when the clinician assumes the responsibility to give hospitality and to respond to such suffering. Such is the responsive stance held in the clinical encounter.