ATTENDING TO THE PATIENT
Bioethics and Medical Literature
Keywords:
bioethics, vulnerability, blindspotAbstract
Robyn Bluhm’s recent paper draws our attention to the critical reality that “neither bioethics nor the philosophy of medicine has paid much attention to the relationship between vulnerability and health or illness.”1 Robyn Blum states that “attending to vulnerability due to diminished health solves some problems in current accounts of health and disease and also allows us to better understand the ways in which health problems can change people’s lives.”2 Her paper, together with the works3 of scholars such as Rogers, Mackenzie and Dodd indexes the fact that, within the context of illness and healing, the nature of vulnerability is relatively under researched. These scholars add that by focussing on patients’ vulnerability we are capable of illuminating the vital relationship between health and illness. For it is this very vulnerability, that is capable of granting us potentially profound insight into the social face of the illness and access to ‘seeing’ the person within the patient. I suggest that a medical ‘blind spot’ or ‘ignoring’ of patient vulnerability is not only embedded in (much of) the interaction between a large segment of health care workers and the patient, but is also insidiously present in much of the way that the medical literature is constructed. This proves to be ‘circular’ as the literature in turn is used as ‘instructional’ by the health care workers and medical practitioners,4 who further structure their patient relationships along the lines of what the medical literature says.
References
Bluhm Robyn, “Vulnerability, Health and Illness,” International Journal of Feminist Approaches to Bioethics: Special Issue on Vulnerability, 2012, 147-161, 147.
Rogers Wendy, Mackenzie Catriona and Dodds Susan, “Why Bioethics Needs a Concept of Vulnerability,” International Journal of Feminist Approaches to Bioethics: Special Issue on Vulnerability, 2012, 11-38, 11.
Naidu Maheshvari, “Performing Illness and Health: The Humanistic Value of Cancer Narratives,” Anthropology Southern Africa 35, 3&4 (2012), 71-80.
Carel Havi, Illness: The Cry of the Flesh, Stocksfield, UK: Acumen Publishing Limited, 2008, 20, cited in Bluhm, “Vulnerability, Health, and Illness,” 158.
J. Fox Nick, “The Ill-Health Assemblage: Beyond the Body-with Organs,” Health Sociology Review 20, 4 (2011), 359-371, 359.
Kristeva Julia, Powers of Horror: An Essay on Abjection, New York: Columbia University Press, 1982, 2.
Van der Riet Pamela, “The Sexual Embodiment of the Cancer Patient,” Nursing Inquiry, 5, 1998, 248-257, 495. Wong Nancy and King Tracey, “The Cultural Construction of Risk Understandings through Illness Narratives,” Journal of Consumer Research, 34, 5 (2008), 579-594, 581.
J. Fox Nick, Postmodernism, Sociology and Health, Toronto: University of Toronto Press, 2004; The Body, Cambridge, UK: Polity, 2012.
Tovey Philip, “Narrative and Knowledge Development in Medical Ethics,” Journal of Medical Ethics 24, 3 (1998), 176-181, 177.
J. Twigg, “The Body in Social Policy: Mapping a Territory,” Journal of Social Policy 31, 3 (2002), 421-439;
S. Harrison and C. Smith, “Trust and Moral Motivation: Redundant Resources in Health and Social Care?” Policy and Politics 32, 3 (2004), 371-86; Julia Twigg, The Body in Health and Social Care, Basingstoke: Palgrave Macmillan, 2006.
Foucault Michel, The Birth of the Clinic: An Archaeology of Medical Perception, New York: Vintage, 1975; Discipline and Punish: The Birth of the Prison, New York: Vintage, 1979.
M. Cancian Francesca, “Paid Emotional Care: Organizational Forms that Encourage Nurturance” in Care Work: Gender Labour and the Welfare State, ed., Madonna Harrington Meyer, New York: Routledge, 2000, 136-48, 141 cited in Hamington Maurice, “Care Ethics and Corporeal Inquiry in Patient Relations,” International Journal of Feminist Approaches to Bioethics 5, 1 (2012), 52-69, 53.
http://www.med.cornell.edu/ deans/pdf/hippocratic_oath.pdf
Mukherjee Siddhartha, The Emperor of All Maladies, New York: Scribner, 2010, 46.
Nicholas Barbara and Gillett Grant, “Doctors’ Stories, Patients' Stories: A Narrative Approach to Teaching Medical Ethics,” Journal of Medical Ethics 23, 5 (1997), 295-299.
Greenhalgh Trisha, “Narrative Based Medicine in an Evidence Based World,” BMJ 318 (7179), 1999, 323-335, 323
Dasgupta Sayantani, “Between Stillness and Story: Lessons of Children's Illness Narratives,” Journal of American Academy of Paediatrics 119, 6 (2007), 1384 -1391, 1384.
Aronson Jeffrey K., “Group Autopathography: The Patient’s Tale,” British Medical Journal 321 (2000), 1599-1602. Dasgupta, “Between Stillness and Story,” 1386. See also the works Charon Rita, “Narrative Medicine: A Model for Empathy, Reflection, Profession, and Trust,” JAMA 286, 15 (2001), 1897-1902; “What to Do with Stories: The Sciences of Narrative Medicine,” Canadian Family Physician 53 (2005), 1265-1267.
Tovey Philip, “Narrative and Knowledge Development in Medical Ethics,” Journal of Medical Ethics 24, 3 (1998), 176-181, 181.
Goodfield June, The Siege of Cancer, New York: Random House, 1975, 219.
