Alasdair MacIntyre's recent thinking both about the concept of a practice and the existence of narrative unity in human life raises important questions about how we should view clinical medicine today. Is it possible for clinical medicine to pursue patient well-being in a society (allegedly) afflicted with what he calls ‘modernity’? Here it is argued that MacIntyre's pessimistic view of the individual in contemporary society makes his call for patient autonomy in the clinical setting pointless. Finally, recent work in gerontology is cited to make three points: first, MacIntyre's pessimism about us is too extreme; second, the concept of a ‘fictionalized’ personal history is closer to reality than either MacIntyre's notion of narrative unity or the ideas of his imagined opponent (Sartre); and finally, we should not expect clinical medicine to produce patient well-being, when this is understood narratively.
Key wordsPractice Narrative unity Patient well-being ‘Fictionalized’ history
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- Buchanan, A.: 1978, ‘Medical paternalism’, Philosophy and Public Affairs 7, 370–390.Google Scholar
- David, M.: 1976, The Diaries of Evelyn Waugh, Little, Brown and Company, London, p. 609.Google Scholar
- Dilthey, W.: 1962, Pattern and Meaning in History, H. P. Richman (ed.), Harper Torchbooks, New York, p. 86.Google Scholar
- Kalish, R. A. and A. I. Johnson: 1972, ‘Value similarities and differences in three generations of women’, Journal of Marriage and the Family 34 49–54.Google Scholar
- Kermode, F.: 1967, The Sense of an Ending, Oxford University Press, New York, pp. 44–47.Google Scholar
- MacIntyre, A.: 1977, ‘Patients as agents’, in H. T. Engelhardt, Jr., S. F. Spicker (eds.), Philosophical Medical-Ethics: Its Nature and Significance, D. Reidel, Dordrecht, pp. 197–212.Google Scholar
- MacIntyre, A.: 1979, ‘Seven traits for the future’, Hastings Center Report 1, 5–7.Google Scholar
- MacIntyre, A.: 1981, After Virtue, Notre Dame University Press, South Bend.Google Scholar
- Marshall, V.: 1980, Last Chapters: A Sociology of Aging and Dying, Brooks/Cole Publishing Company, Monterey, CA., pp. 76, 108, 124, 159–160.Google Scholar