[MD] LC Comments

[John Carl]

Ian and Magnus concerning dr. and patient,

I just read an apropos chapter on the subject  and I'd like to offer it for
your consideration.  For one thing, it highly pertains to my thesis that
Royce's thought is compatible with the MoQ, for in it she considers the
problem of Dr. examining the patient as an object, rather than a multi-level
pattern:

"Unfortunately the traditional medical model sees experiences as
epiphenominal and only "facts" about the body-machine as real and of any
significance to the healing process.  Thus doctors focus on these elements.
The listen only to those apsects of a patient's story considered important
as medical history, the biomedical interpretation of the disease-state.
What is need in addition is another kind of narrative or history.  This
narrative would provide the story of the illness from the patient's point of
view. ... Elliott Mishler, in his analysis of medical interviews between
physician and patient, reports that in standard interviews the voice of
medicine predominates, controlling the form and content of the interview.
The physician treats the voice of the lifeworld of the patient as
non-medically relevant and therefore quickly suppresses this voice in the
interviews.

Thus the patient becomes objectified and rationalized, and the person's
lived experience and personal meaning of the illness is ignored.  It thus
becomes clear that in addition to a better model of 'body' and "disease'
what is needed in medicine is a different view of the person.

The Roycean perspective on person, mind/body, and self, I believe, would
serve medicine well in its search for a new foundation.  First, Royce's view
is decidedly anti-cartisian in two significant respects: it is
non-reductionistic, arguing for a multi-varied view of the human self/person
as a complex phenomenon resulting from interactive factors.  Second, Royce
emphatically denies a mind/body dichotomy and views self in terms of process
and not in any manner as a thing or object.  However, he also clearly
accepts the self as naturally embedded and embodied and the human person as
having essential biological aspects."

Kegely, Genuine Individuals and Genuine Community