Round Table Discussion

Abstract

Beyond the epistemological problems of whether clinical judgment can be scientific, subjective, and logical, there is the profoundly human problem: How, if at all, is clinical judgment to be integrated into the developing life-forms of the individual? What has clinical judgment to do with the individual’s life? The answer is often “very little”, precisely as medical thought becomes more sophisticated and objective, even as it indulges in pre-systematized, enlightened subjectivity. The problem known to anyone who has been either patient or clinician, is that the carefully wrought and professionally administered medical judgment is all too often received by the patient as being either incomprehensible with respect to its personal significance, impossible to believe, the absolute truth, or — perhaps worst of all — irrelevant. In all of these cases the patient leaves the implications of the condition where they seem to have originated: with the clinician, either by submitting in helpless defiance or trustful deference, or by literally leaving (against medical advice). In none of these cases is a relation established between the person and the condition which sustains the human individuality involved.