Nordby Halvor
Department of Philosophy and Faculty of Medicine, Centre of Health Administration, University of Oslo, Oslo, Norway.
Nurs Philos. 2004 Apr;5(1):30-40. doi: 10.1111/j.1466-769X.2004.00159.x.
The paper explores consequences of applying the view that illness is negative first-person experience in caring practice. The main reason this is an important issue is that it is empirically documented that patients conceive of illness in different ways. Communicating about illness in caring practice can therefore involve difficulties. I argue that many of these difficulties can be avoided if nurses focus directly on the extension of the concept of illness--patients' experiences like the state of being in pain--and not on how this extension is represented as (the intension) illness. This argument is compatible with different views on the nurse-patient relationship as a communicative process. All it requires is the acceptance of minimal assumptions about concepts and concept possession. The argument has a descriptive and a normative dimension. It is descriptive in the sense that it seeks to use concepts from philosophy of mind to explain how many nurses succeed in talking about illness without applying the concept of illness. It is normative in the sense that it provides a philosophical justification for this practice.
本文探讨了在护理实践中应用“疾病是负面的第一人称体验”这一观点所产生的后果。这之所以是一个重要问题，主要原因在于有实证表明患者对疾病的理解方式各不相同。因此，在护理实践中关于疾病的沟通可能会存在困难。我认为，如果护士直接关注疾病概念的外延——患者诸如疼痛状态之类的体验，而不是关注这种外延如何被表征为（内涵）疾病，那么许多此类困难是可以避免的。这一论点与将护患关系视为交流过程的不同观点是兼容的。它所需要的仅仅是接受关于概念和概念拥有的最低限度假设。该论点具有描述性和规范性两个维度。其描述性在于它试图运用心灵哲学的概念来解释许多护士如何在不应用疾病概念的情况下成功谈论疾病。其规范性在于它为这种实践提供了一种哲学上的正当理由。
