Tuesday, May 8, 2012

"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." - Theoretical Medicine and Bioethics, Volume 11, Number 1 - SpringerLink

Theoretical Medicine and Bioethics, Volume 11, Number 1 - SpringerLink


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 lsquotextrsquo 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 ldquoexperiential textrdquo of illness as lived out by the patient; the ldquonarrative textrdquo constituted during history-taking; the ldquophysical textrdquo of the patient's body as objectively examined; the ldquoinstrumental textrdquo 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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