ABSTRACT
Phronesis is often described as a 'practical wisdom' adapted to the matters of everyday human life. Phronesis enables one to judge what is at stake in a situation and what means are required to bring about a good outcome. In medicine, phronesis tends to be called upon to deal with ethical issues and to offer a critique of clinical practice as a straightforward instrumental application of scientific knowledge. There is, however, a paucity of empirical studies of phronesis, including in medicine. Using a hermeneutic and phenomenological approach, this inquiry explores how phronesis is manifest in the stories of clinical practice of eleven exemplary physicians. The findings highlight five overarching themes: ethos (or character) of the physician, clinical habitus revealed in physician know-how, encountering the patient with attentiveness, modes of reasoning amidst complexity, and embodied perceptions (such as intuitions or gut feeling). The findings open a discussion about the contingent nature of clinical situations, a hermeneutic mode of clinical thinking, tacit dimensions of being and doing in clinical practice, the centrality of caring relations with patients, and the elusive quality of some aspects of practice. This study deepens understandings of the nature of phronesis within clinical settings and proposes 'Clinical phronesis' as a descriptor for its appearance and role in the daily practice of (exemplary) physicians.
Subject(s)
Hermeneutics , Philosophy, Medical , Physician-Patient Relations , Humans , Physician-Patient Relations/ethics , Physicians/psychology , Physicians/ethics , EmpathyABSTRACT
We commend Prof. Fuchs's analysis of anorexia as a conflict of embodiment. We find it important to underline the role of the environment. In particular, in reference to a study that will soon be published, we mention the difficulties patients experience in relation to their home.
Subject(s)
Anorexia , Anorexia/etiology , HumansABSTRACT
Phenomenology suggests that the clinician should not only focus on the patient's body as it can be objectively grasped, and not only on the patient's inner, psychic world, notably the representations and fears about the body, but should also explore the patient's body as it is experienced and lived, what we call the « bodily experience ¼.
La phénoménologie invite le clinicien à s'intéresser, non seulement au corps du malade tel qu'il peut l'appréhender de façon objective, non seulement à la vie psychique du malade et notamment à ses représentations et craintes portant sur son corps, mais aussi au corps du malade en tant que celui-ci le vit, ce que nous appelons « l'expérience corporelle ¼.