摘要
叙事医学是对生物医学某种程度上的纠偏,探究二者不同的哲学基础有助于更好地理解叙事医学的纠偏功能。生物医学的哲学基础为笛卡尔哲学的身心二元论,笛卡尔把古希腊柏拉图对理性的尊崇发扬到极致,认为知识及科学与身体的感受完全无关,人的身体就是一个需要医生用知识修补的机器,把疾病和患者的人分离了。叙事医学则建立在后现代的哲学基础之上,从身体现象学、叙事诠释学、关于后现代科学知识的认识论、工具理性和价值理性等的论述中汲取养分,强调身体的感受,认为医生的诊断行为也是一种诠释过程,需要听到患者对自己疾病的诠释;同时认为,医生应认识到现在的医学知识不是永恒的真理,要尊重患者故事这种叙事知识,在临床决策时,不仅要关注医学知识的工具理性,更要关注患者的价值理性。
Narrative medicine is a kind of correction to biomedicine.Exploring the different philosophical foundations of both can help us better understand this corrective function of narrative medicine.The philosophical foundation of biomedicine is Cartesian dualism.Descartes develops Platonic rationality to its utmost form and regards knowledge/science as totally detached from the body,and the human body is a machine that can be fixed by the scientific knowledge of the physician.Narrative Medicine is built upon postmodern philosophy and takes theories from phenomenology of the body,narrative hermeneutics,postmodern understanding of knowledge,the contrast between institutional rationality and value rationality.Narrative Medicine stresses bodily perception,and regards diagnostic behavior as a hermeneutic behavior in which patients’explanation of their illness should be heard.Postmodern thinking argues for the transient quality of medical knowledge,therefore,such narrative knowledge of patients’story should be honored.Finally,in clinical decision making,physicians should pay attention not only to institutional rationality,but also to patients’value rationality.
作者
郭莉萍
Guo Liping(The School of Health Humanities,Peking University,Beijing 100191,China)
出处
《叙事医学》
2021年第1期27-32,共6页
Narrative Medicine
关键词
叙事医学
身心二元论
身体现象学
叙事诠释学
后现代的科学知识
工具理性与价值理性
Narrative medicine
Mind-body dualism
Phenomenology of the body
Narrative hermeneutics
Postmodern knowledge
Institutional rationality and value rationality
