Centre for Humanities and Health, King's College London, London, UK.
J Eval Clin Pract. 2012 Oct;18(5):1102-9. doi: 10.1111/j.1365-2753.2012.01926.x.
The issue of how to incorporate the individual's first-hand experience of illness into broader medical understanding is a major question in medical theory and practice. In a philosophical context, phenomenology, with its emphasis on the subject's perception of phenomena as the basis for knowledge and its questioning of naturalism, seems an obvious candidate for addressing these issues. This is a review of current phenomenological approaches to medicine, looking at what has motivated this philosophical approach, the main problems it faces and suggesting how it might become a useful philosophical tool within medicine, with its own individual, but interrelated, contribution to make to current medical debates. After the general background, there is a brief summary of phenomenological ideas and their current usage in a medical context. Next is a critique of four key claims within current phenomenological medical works, concerning both the role phenomenology plays and the supposedly clear divide between phenomenology and other approaches. There are significant problems within these claims, largely because they overlook the complexity of the questions they consider. Finally, there is some more in-depth examination of phenomenology itself and the true complexity of phenomenological debate concerning subjectivity. The aim is to show that it will be both more productive and truer to phenomenology itself, if we use phenomenology as a philosophical method for explicating and gaining deeper understanding of complex and fundamental problems, which are central to medicine, rather than as providing simple, but flawed solutions.
如何将个体对疾病的第一手经验纳入更广泛的医学理解中,是医学理论和实践中的一个重大问题。在哲学背景下,现象学强调主体对现象的感知是知识的基础,并对自然主义提出质疑,似乎是解决这些问题的明显选择。本文综述了当前医学中的现象学方法,探讨了这种哲学方法的动机、它所面临的主要问题,并提出了如何使其成为医学中一种有用的哲学工具,为当前的医学辩论做出自己独特但相互关联的贡献。在介绍一般背景之后,简要总结了现象学思想及其在医学背景下的当前应用。接下来,对当前现象学医学著作中的四个关键主张进行了批判,这些主张涉及现象学所扮演的角色以及现象学与其他方法之间据称的明确界限。这些主张存在重大问题,主要是因为它们忽略了它们所考虑的问题的复杂性。最后,更深入地考察了现象学本身以及关于主体性的现象学争论的真正复杂性。目的是表明,如果我们将现象学作为一种哲学方法来阐明和更深入地理解医学中的核心复杂问题,而不是提供简单但有缺陷的解决方案,那么它将更具成效,并且更符合现象学本身。