Theoretical Medicine and Bioethics

, Volume 32, Issue 1, pp 33–46 | Cite as

Phenomenology and its application in medicine

Article

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.

Keywords

Embodiment Disease Illness Phenomenology Experience of illness Medical training Merleau-Ponty Philosophy of medicine 

References

  1. 1.
    Moran, D. 2000. Introduction to phenomenology. London: Routledge.Google Scholar
  2. 2.
    Kant, I. 1999 [1781]. Critique of pure reason. Cambridge: Cambridge University Press.Google Scholar
  3. 3.
    Gardner, S. 1999. Kant and the critique of pure reason. New York: Routledge.Google Scholar
  4. 4.
    Husserl, E. 1988 [1931]. Cartesian meditations. Dordrecht: Kluwer.Google Scholar
  5. 5.
    Merleau-Ponty, M. 1962 [1945]. Phenomenology of perception. New York: Routledge.Google Scholar
  6. 6.
    Heiddeger, M. 1962 [1927]. Being and time. London: Blackwell.Google Scholar
  7. 7.
    Heidgger, M. 1993. The origin of the work of art. In Basic writings, ed. D.F. Krell, 143–212. New York: Routledge.Google Scholar
  8. 8.
    Merleau-Ponty, M. 1964. Cezanne’s doubt. In Sense and nonsense, trans. P.A. Dreyfus and H.L. Dreyfus, 9–25. Evanston, IL: Northwestern University Press.Google Scholar
  9. 9.
    Husserl, E. 1990 [1928]. On the phenomenology of the consciousness of internal time. Dordrecht: Kluwer.Google Scholar
  10. 10.
    MacKinnon, C. 1993. Only words. Boston: Harvard University Press.Google Scholar
  11. 11.
    Gallagher, S., and D. Zahavi. 2008. The phenomenological mind. New York: Routledge.Google Scholar
  12. 12.
    Toombs, S.K. 1988. Illness and the paradigm of lived body. Theoretical Medicine 9: 201–226.CrossRefGoogle Scholar
  13. 13.
    Zaner, R.M. 1981. The context of self. Athens, OH: Ohio University Press.Google Scholar
  14. 14.
    Zaner, R.M. 2005. A work in progress. Theoretical Medicine 26: 89–104.CrossRefGoogle Scholar
  15. 15.
    Wiggins, O.P., and J.Z. Sadler, eds. 2005. Clinical ethics of Richard M. Zaner. Special issue. Theoretical Medicine and Bioethics 26 (1): 1–104.Google Scholar
  16. 16.
    Wiggins, O.P., and M.A. Schwartz. 2005. Richard Zaner’s phenomenology of the clinical encounter. Theoretical Medicine 26: 73–87.CrossRefGoogle Scholar
  17. 17.
    Toombs, S.K. 1987. The meaning of illness: A phenomenological approach to the patient–physician relationship. Journal of Medicine and Philosophy 12: 219–240.Google Scholar
  18. 18.
    Toombs, S.K. 2001. The role of empathy in clinical practice. Journal of Consciousness Studies 8(5–7): 247–258.Google Scholar
  19. 19.
    Svenaeus, F. 2000. Das Unheimliche—Towards a phenomenology of illness. Medicine, Health Care and Philosophy 3: 3–16.CrossRefGoogle Scholar
  20. 20.
    Svenaeus, F. 2000. The body uncanny—Further steps towards a phenomenology of illness. Medicine, Health Care and Philosophy 3: 125–137.CrossRefGoogle Scholar
  21. 21.
    Svenaeus, F. 2001. The hermeneutics of medicine and the phenomenology of health. Linköping: Springer.Google Scholar
  22. 22.
    Kirkengen, A.L. 2007. Heavy burdens and complex disease—An integrated perspective. Journal of the Norwegian Medical Association 127: 3228–3231.Google Scholar
  23. 23.
    Merleau-Ponty, M. 1964. The primacy of perception and its philosophical consequences. In The primacy of perception, trans. W. Cobb, 12–42. Evanston, IL: Northwestern University Press.Google Scholar
  24. 24.
    Clark, A. 1997. Being there. Cambridge, MA: MIT Press.Google Scholar
  25. 25.
    Clark, A. 2008. Supersizing the mind. Oxford: Oxford University Press.CrossRefGoogle Scholar
  26. 26.
    Wheeler, M. 2005. Reconstructing the cognitive world. Cambridge, MA: MIT Press.Google Scholar
  27. 27.
    Petitot, J., F. Varela, B. Pachoud, and J.M. Roy. 1999. Naturalising phenomenology. Stanford: Stanford University Press.Google Scholar
  28. 28.
    Calvo, P., and T. Gomila. 2008. Handbook of cognitive science: An embodied approach. Oxford: Elsevier.Google Scholar
  29. 29.
    Lakoff, G., and M. Johnson. 1999. Philosophy in the flesh. New York: Basic Books.Google Scholar
  30. 30.
    Gallagher, S. 2005. How the body shapes the mind. Oxford: Oxford University Press.CrossRefGoogle Scholar
  31. 31.
    Noë, A. 2004. Action in perception. London: MIT Press.Google Scholar
  32. 32.
    Young, I.M. 2005.Throwing like a girl: A phenomenology of feminine body comportment, motility and spatiality. In On female body experience, 27–45. Oxford: Oxford University Press.Google Scholar
  33. 33.
    Ratcliffe, M. 2008. Touch and situatedness. International Journal of Philosophical Studies 16(3): 299–322.CrossRefGoogle Scholar
  34. 34.
    Boorse, C. 1977. Health as a theoretical concept. Philosophy of Science 44(4): 542–573.CrossRefGoogle Scholar
  35. 35.
    Boorse, C. 1997. A rebuttal on health. In What is disease?, ed. J. Humber, and R. Almeder, 3–134. New Jersey: Humana Press.Google Scholar
  36. 36.
    Carel, H. 2008. Illness. Stockfield: Acumen.Google Scholar
  37. 37.
    Baron, R.J. 1985. An introduction to medical phenomenology. Annals of Internal Medicine 103: 606–611.Google Scholar
  38. 38.
    Carel, H. 2010. The lived experience of illness: Developing a phenomenological toolkit for patients. Working paper, University of the West of England, Bristol.Google Scholar
  39. 39.
    Ratcliffe, M. 2008. Feelings of being: Phenomenology, psychiatry and the sense of reality. Oxford: Oxford University Press.Google Scholar
  40. 40.
    Matthews, E. 2007. Body-subjects and disordered minds. Oxford: Oxford University Press.Google Scholar
  41. 41.
    Stanghellini, G. 2004. Disembodied spirits and deanimated bodies. Oxford: Oxford University Press.Google Scholar
  42. 42.
    Carel, H. 2009. ‘I am well, apart from the fact that I have cancer’: Explaining wellbeing within illness. In The philosophy of happiness, ed. L. Bortolloti, 82–99. Basingstoke: Palgrave.Google Scholar
  43. 43.
    Carel, H. 2007. Can I be ill and happy? Philosophia 35(2): 95–110.CrossRefGoogle Scholar
  44. 44.
    Angner, E., M. Ray, K. Saag, and J. Allison. 2009. Health and happiness among older adults: A community-based study. Journal of Health Psychology 14(4): 503–512.CrossRefGoogle Scholar
  45. 45.
    Malpass, A., M. Bowden, J. Calvert, H. Carel, D. Kessler, D. Sharp, and A. Shaw. Currently underway. Mindfulness based cognitive therapy for patients with COPD or asthma and anxiety or depression. A NIHR funded feasibility study being conducted at the Academic Unit of Primary Health Care, University of Bristol.Google Scholar
  46. 46.
    Fulford, K.W.M., S. Ersser, and T. Hope. 1996. Essential practice in patient-centred care. London: Blackwell.Google Scholar
  47. 47.
    Little, P., H. Everitt, I. Williamson, et al. 2001. Preferences of patients for patient centred approach to consultation in primary care: Observational study. British Medical Journal 322(7284): 468.CrossRefGoogle Scholar
  48. 48.
    Sitzia, J., and N. Wood. 1997. Patient satisfaction: A review of issues and concepts. Social Science and Medicine 45(12): 1829–1843.CrossRefGoogle Scholar
  49. 49.
    McClimans, L. 2011. Choosing a patient-reported outcome measure. Theoretical Medicine and Bioethics 32(1). doi:10.1007/s11017-010-9163-8.
  50. 50.
    Paterson, M. 2009. Haptic geographies: Ethnography, haptic knowledges and sensuous dispositions. Progress in Human Geography 33(6): 766–788.CrossRefGoogle Scholar
  51. 51.
    Mulhall, S. 2005. Routledge philosophy guidebook to Heidegger and Being and time. New York and London: Routledge.Google Scholar
  52. 52.
    Carel, H. 2008. What is illness? Philosophical perspectives. Continuing professional development workshop for health care practitioners held at the University of the West of England, Bristol, on April 17.Google Scholar
  53. 53.
    Jonas, H. 1985. The imperative of responsibility. Chicago: Chicago University Press.Google Scholar
  54. 54.
    Levinas, E. 1969. Totality and infinity. The Hague: Martinus Nijhoff.Google Scholar

Copyright information

© Springer Science+Business Media B.V. 2010

Authors and Affiliations

  1. 1.Department of History, Philosophy and PoliticsUniversity of the West of EnglandBristolUK

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