Community as Healing: Pragmatism and Medical Encounters
Dissertation, Vanderbilt University (
1998)
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Abstract
The brief history of 20$\rm\sp{th}$ century bioethics has been dominated by discussions of principles and appeals to autonomy that both divorce theory from practice and champion a notion of the individual as prior to and isolated from society . Pragmatism, on the other hand, has long sought to reconstruct ethical thought with the belief that distinctions between theory and practice, individual and society are not a priori starting points but purposeful developments of inquiry. Using insights from classic pragmatism, I propose reconstructive accounts of physician-patient relationships, from preventative practices to end-of-life issues, resulting in an emphasis on aiding the process of meaningful/significant living for all individuals involved in medical encounters. ;William James, John Dewey, and George Herbert Mead, among others, provide discussions of human relationships which accentuate the situatedness of problems and solutions and stress the need for building shared experience in order to develop both self and community. With an insistence on a recognition of a functional concept of the self , my pragmatic position illuminates the integration of self with community and leads to a need to develop new practices in the medical encounter based on an attitude of community as healing