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Theoretical Medicine

, Volume 11, Issue 1, pp 9–24 | Cite as

Clinical interpretation: The hermeneutics of medicine

  • Drew Leder
Article

Abstract

I argue that clinical medicine can best be understood not as a purified science but as a hermeneutical enterprise: that is, as involved with the interpretation of texts. The literary critic reading a novel, the judge asked to apply a law, must arrive at a coherent reading of their respective texts. Similarly, the physician interprets the ‘text’ of the ill person: clinical signs and symptoms are read to ferret out their meaning, the underlying disease. However, I suggest that the hermeneutics of medicine is rendered uniquely complex by its wide variety of textual forms. I discuss four in turn: the “experiential text” of illness as lived out by the patient; the “narrative text” constituted during history-taking; the “physical text” of the patient's body as objectively examined; the “instrumental text” constructed by diagnostic technologies. I further suggest that certain flaws in modern medicine arise from its refusal of a hermeneutic self-understanding. In seeking to escape all interpretive subjectivity, medicine has threatened to expunge its primary subject — the living, experiencing patient.

Key words

clinical interpretation embodiment hermeneutics history of medicine 

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Copyright information

© Kluwer Academic Publishers 1990

Authors and Affiliations

  • Drew Leder
    • 1
  1. 1.Department of PhilosophyLoyola College in MarylandBaltimoreUSA

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