Aho Kevin A
Florida Gulf Coast University, 10501 FGCU Boulevard South, Fort Myers, FL, 33965-6565, USA.
Med Health Care Philos. 2016 Mar;19(1):55-63. doi: 10.1007/s11019-015-9639-4.
In Being and Time, Martin Heidegger introduces a unique interpretation of death as a kind of world-collapse or breakdown of meaning that strips away our ability to understand and make sense of who we are. This is an 'ontological death' in the sense that we cannot be anything because the intelligible world that we draw on to fashion our identities and sustain our sense of self has lost all significance. On this account, death is not only an event that we can physiologically live through; it can happen numerous times throughout the finite span of our lives. This paper draws on Arthur Frank's (At the will of the body: reflections on illness. Houghton, Boston, 1991) narrative of critical illness to concretize the experience of 'ontological death' and illuminate the unique challenges it poses for health care professionals. I turn to Heidegger's conception of 'resoluteness' (Entschlossenheit) to address these challenges, arguing for the need of health care professionals to help establish a discursive context whereby the critically ill can begin to meaningfully express and interpret their experience of self-loss in a way that acknowledges the structural vulnerability of their own identities and is flexible enough to let go of those that have lost their significance or viability.
在《存在与时间》中，马丁·海德格尔对死亡提出了一种独特的诠释，即死亡是一种世界的崩塌或意义的瓦解，它剥夺了我们理解自身以及明确自身身份的能力。这是一种“本体论意义上的死亡”，因为我们无法再有所作为，我们赖以塑造自身身份并维系自我意识的那个可理解的世界已失去了所有意义。据此观点，死亡不仅是一个我们能够在生理上经历的事件；在我们有限的生命历程中，它可能会多次发生。本文借鉴亚瑟·弗兰克（《身体的意志：关于疾病的思考》，霍顿出版社，波士顿，1991年）对危重病的叙述，以具体呈现“本体论意义上的死亡”的体验，并阐明它给医护人员带来的独特挑战。我将借助海德格尔的“决断”（德语：Entschlossenheit）概念来应对这些挑战，主张医护人员需要帮助建立一种话语语境，使重症患者能够开始以一种有意义的方式表达和诠释他们自我丧失的体验，这种方式既要承认他们自身身份的结构性脆弱，又要足够灵活，能够舍弃那些已失去意义或可行性的身份认同。
