Hastings Cent Rep. 2020 Sep;50(5):20-29. doi: 10.1002/hast.1182.
There are two widespread beliefs about the use of metaphors in clinical medicine. The first is that military metaphors are harmful to patients and should be discouraged in medical practice. The second is that the metaphors of clinical practice can be judged by and standardized in reference to neutral criteria. In this article, I evaluate both these beliefs, exposing their shared flawed logic. This logic underwrites the false empiricist assumptions that metaphorical language and literal language are fundamentally distinct, play separate roles in communication, and therefore can be independently analyzed, systematized, and prescribed. Next, using the resources of ordinary language philosophy, I lay out a theoretical view of medical metaphors that is grounded in metaphor use within clinician-patient relationships. Finally, drawing on the work of philosopher Max Black, I diagram a practical conceptual framework for clinicians to use when they consider whether a metaphor is appropriate for a specific patient encounter.
关于临床医学中使用隐喻，有两种普遍的看法。第一种是军事隐喻对患者有害，在医疗实践中应予以劝阻。第二种是临床实践中的隐喻可以参照中立标准进行判断和规范。在本文中，我评估了这两种观点，揭示了它们共同存在的逻辑缺陷。这种逻辑隐含着错误的经验主义假设，即隐喻语言和字面语言在根本上是不同的，在交流中起着不同的作用，因此可以独立分析、系统化和规定。接下来，我利用日常语言哲学的资源，提出了一种医学隐喻的理论观点，这种观点以医患关系中隐喻的使用为基础。最后，借鉴哲学家马克斯·布莱克的工作，我为临床医生绘制了一个实用的概念框架，供他们在考虑隐喻是否适合特定的患者时使用。
