Clinical interpretation: The hermeneutics of medicine

I argue that clinical medicine can best be understood not as a purified science but as a hermeneutical enterprise: that is, as involved with the interpretation of texts. The literary critic reading a novel, the judge asked to apply a law, must arrive at a coherent reading of their respective texts. Similarly, the physician interprets the text of the ill person: clinical signs and symptoms are read to ferret out their meaning, the underlying disease. However, I suggest that the hermeneutics of medicine is rendered uniquely complex by its wide variety of textual forms. I discuss four in turn: the experiential text of illness as lived out by the patient; the narrative text constituted during history-taking; the physical text of the patient's body as objectively examined; the instrumental text constructed by diagnostic technologies. I further suggest that certain flaws in modern medicine arise from its refusal of a hermeneutic self-understanding. In seeking to escape all interpretive subjectivity, medicine has threatened to expunge its primary subject — the living, experiencing patient.     

Horizons of hermeneutics: Intercultural hermeneutics in a globalizing world

Starting from the often-used metaphor of the “horizon of experience” this article discusses three different types of intercultural hermeneutics, which respectively conceive hermeneutic interpretation as a widening of horizons, a fusion of horizons, and a dissemination of horizons. It is argued that these subsequent stages in the history of hermeneutics have their origin in—but are not fully restricted to—respectively premodern, modern and postmodern stages of globalization. Taking some striking moments of the encounter between Western and Chinese language and philosophy as example, the particular merits and flaws of these three types of hermeneutics are being discussed. The claim defended is that although these different types of hermeneutics are mutually exclusive from a theoretical point of view, as interpreting beings in the current era we depend on each of these distinct hermeneutic practices and cannot avoid living them simultaneously.     

Multimodal signaling in the visuo-acoustic mismatch paradigm: similarities between dogs and children in the communicative approach

Animal Cognition - In this review, we have analyzed the studies on the “mismatch paradigm” or “contrasting paradigm”, in which the word indicates an intent that is opposite...     

The two hermeneutics of psychotherapy

The American Journal of Psychoanalysis -     

The hyperreality of clinical ethics: A unitary theory and hermeneutics

Medical ethics nowadays is dominated by a conception of ethics as the application of moral theories and principles. This conception is criticized for its depreciation of the internal morality of medical practice and its narrow view of external morality. This view reflects both a lack of interest in the empirical realities of medicine and a neglect of the socio-cultural value-contexts of medical ethical issues, including the creative development of a broader philosophical framework for a practicable medical ethics. Several alternative approaches and conceptions have been proposed. The unified clinical ethics theory, developed by Graber and Thomasma, is an interesting attempt to synthesize these alternative approaches. It correctly identifies as the crucial problem the present disconnectedness of medical ethics from theoretical philosophy as well as the practice of medicine. In this paper, however, it is argued that the unitary theory should take more serious attention to the hermeneutic character of medicine as well as ethics. This implies that the unitary theory must in fact transform itself into aninterpretive clinical ethics theory. The theoretical characteristics and practical consequences of an interpretive theory of medical ethics are discussed in the present paper.     

Some aspects of medical hermeneutics: The role of dialectic and narrative

This essay constructs an argument for a dialectic between the scientific and clinical aspects of medicine using the hermeneutical approach of Paul Ricoeur as a theoretical and philosophical guide. Additionally, the relationship between this dialectic and narrative case histories is examined as a way of expressing this abstract and theoretical concept in more concrete terms.     

The diaconate after the signing of the Porvoo Declaration: an overview of methods and hermeneutics

This article examines development in the deacon's ministry in the Porvoo Communion. Some of the initiatives which have contributed in significant ways to the common understanding of diaconal ministry in its member churches, since the signing of the Porvoo Declaration in 1996, are presented and analysed. The main focus is on methods used and on the way material has been interpreted by the churches or their representatives. The article also considers developments on two levels: first, on methods applied specifically by the individual Porvoo member churches, when presenting and interpreting the ministry of deacons; secondly, on the presupposed understanding behind the interpretations of deacons’ ministry in the Porvoo churches as a whole. The author's interest also encompasses the way in which the churches interpret significant differences and variety in the ministry of deacons within the Porvoo Communion, and what they regard as characteristic in current developments.