Discovering clinical phronesis.

IF 2.3 2区 哲学 Q1 ETHICS Medicine Health Care and Philosophy Pub Date : 2024-06-01 Epub Date: 2024-03-07 DOI:10.1007/s11019-024-10198-8
Donald Boudreau, Hubert Wykretowicz, Elizabeth Anne Kinsella, Abraham Fuks, Michael Saraga
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Abstract

Phronesis is often described as a 'practical wisdom' adapted to the matters of everyday human life. Phronesis enables one to judge what is at stake in a situation and what means are required to bring about a good outcome. In medicine, phronesis tends to be called upon to deal with ethical issues and to offer a critique of clinical practice as a straightforward instrumental application of scientific knowledge. There is, however, a paucity of empirical studies of phronesis, including in medicine. Using a hermeneutic and phenomenological approach, this inquiry explores how phronesis is manifest in the stories of clinical practice of eleven exemplary physicians. The findings highlight five overarching themes: ethos (or character) of the physician, clinical habitus revealed in physician know-how, encountering the patient with attentiveness, modes of reasoning amidst complexity, and embodied perceptions (such as intuitions or gut feeling). The findings open a discussion about the contingent nature of clinical situations, a hermeneutic mode of clinical thinking, tacit dimensions of being and doing in clinical practice, the centrality of caring relations with patients, and the elusive quality of some aspects of practice. This study deepens understandings of the nature of phronesis within clinical settings and proposes 'Clinical phronesis' as a descriptor for its appearance and role in the daily practice of (exemplary) physicians.

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发现临床phronesis。
箴言通常被描述为适应日常生活的 "实用智慧"。"实践智慧 "使人们能够判断在某种情况下什么是利害攸关的,以及需要采取什么手段才能取得好的结果。在医学中,人们往往要求phronesis来处理伦理问题,并对作为科学知识的直接工具性应用的临床实践提出批评。然而,对 "相思 "的实证研究却很少,包括在医学中的研究。本研究采用诠释学和现象学方法,探讨了 "相性 "如何体现在 11 位模范医生的临床实践故事中。研究结果突出了五大主题:医生的职业道德(或性格)、医生诀窍中揭示的临床习惯、用心接触病人、复杂性中的推理模式以及体现性知觉(如直觉或直觉)。研究结果引发了关于临床情况的偶然性、临床思维的诠释学模式、临床实践中 "存在 "和 "行动 "的隐性维度、与患者之间关爱关系的中心地位以及实践中某些方面难以捉摸的质量等问题的讨论。本研究加深了对临床环境中 "phronesis "性质的理解,并提出了 "临床phronesis "这一描述,以说明其在(模范)医生日常实践中的表现和作用。
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来源期刊
CiteScore
4.30
自引率
4.80%
发文量
64
期刊介绍: Medicine, Health Care and Philosophy: A European Journal is the official journal of the European Society for Philosophy of Medicine and Health Care. It provides a forum for international exchange of research data, theories, reports and opinions in bioethics and philosophy of medicine. The journal promotes interdisciplinary studies, and stimulates philosophical analysis centered on a common object of reflection: health care, the human effort to deal with disease, illness, death as well as health, well-being and life. Particular attention is paid to developing contributions from all European countries, and to making accessible scientific work and reports on the practice of health care ethics, from all nations, cultures and language areas in Europe.
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