Kottow Andrea R, Kottow Michael H
Universitat zu Köln, Philosophische Fakultät, Romanisches Seminar, Albertus-Magnus-Platz, 50923, Köln.
Philos Ethics Humanit Med. 2007 Jun 29;2:10. doi: 10.1186/1747-5341-2-10.
Based on the distinction between living body and lived body, we describe the disease-subject as representing the impact of disease on the existential life-project of the subject. Traditionally, an individual's subjectivity experiences disorders of the body and describes ensuing pain, discomfort and unpleasantness. The idea of a disease-subject goes further, representing the lived body suffering existential disruption and the possible limitations that disease most probably will impose. In this limit situation, the disease-subject will have to elaborate a new life-story, a new character or way-of-being-in-the-world, it will become a different subject. Health care professionals need to realize that patients are not mere observers of their body, for they are immersed in a reassesment of values, relationships, priorities, perhaps even life-plans. Becoming acquainted with literature's capacity to create characters, modify narratives and depict life-stories in crisis, might sharpen physicians' hermeneutic acumen and make them more receptive to the quandaries of disease-subjects facing major medical and existential decisions in the wake of disruptive disease.
基于活体与体验之体的区别，我们将患病主体描述为疾病对主体生存性生命规划的影响。传统上，个体的主体性体验身体的紊乱，并描述随之而来的疼痛、不适和不愉快。患病主体的概念更进一步，代表着体验之体遭受生存性破坏以及疾病极有可能带来的种种限制。在这种极限情境下，患病主体将不得不精心构思一个新的人生故事、一个新的角色或一种新的在世方式，它将成为一个不同的主体。医护人员需要认识到，患者并非仅仅是自身身体的观察者，因为他们沉浸在对价值观、人际关系、优先事项乃至生活规划的重新评估之中。了解文学塑造人物、修改叙事以及描绘处于危机中的人生故事的能力，或许能够提升医生的诠释敏锐度，使他们更能理解患病主体在疾病造成破坏后面对重大医疗和生存抉择时的困境。
