Gavin W J
J Med Philos. 1981 Feb;6(1):45-65. doi: 10.1093/jmp/6.1.45.
Three types of thought about the world are put forth by James in Pragmatism: common sense, science, and philosophy. The worlds of science and philosophy reified and idealized aspects of the vague, intersubjective world of common sense. However, once "formed" these two worlds are themselves "formative." They can and have infected the vague world of common sense with a quest for certainty and immediacy. Empathy arises as a problem through the conceptual world views of science and philosophy, insofar as the vague is not acceptable. Using James' views on language and his metaphysics, I argue that empathy appears epistemically as an issue unsolvable in terms of certainty, and empathy appear ontologically as an issue which compels action. In medicine, empathy exists as a problem because pure consciousness has come upon the scene as a "rip" or "tear," in Sartrean terminology. The physician finds himself "encrusted twice over"; consciousness has arisen and also professional consciousness has arisen. He/she works back, not simply toward the world of common sense, now infected, but toward the pre-reflective world. Such a recovery is never complete, yet such a recovery must always be attempted.
詹姆斯在《实用主义》中提出了关于世界的三种思维方式:常识、科学和哲学。科学和哲学的世界将常识中模糊的、主体间的世界的某些方面具体化和理想化了。然而,一旦这两个世界“形成”,它们自身就具有“塑造性”。它们能够且已经用对确定性和直接性的追求影响了模糊的常识世界。由于科学和哲学的概念性世界观认为模糊是不可接受的,所以共情作为一个问题出现了。运用詹姆斯关于语言和形而上学的观点,我认为,从认知角度看,共情是一个在确定性方面无法解决的问题,从本体论角度看,共情是一个促使行动的问题。在医学中,共情作为一个问题存在,是因为按照萨特的术语来说,纯粹意识以“裂缝”或“裂口”的形式出现了。医生发现自己“被双重束缚”;意识出现了,职业意识也出现了。他/她要追溯回去,不只是追溯到现在已受影响的常识世界,而是追溯到前反思世界。这样的追溯永远不会完整,但这样的追溯必须始终尝试。