“Bodily autonomy” has received significant attention in bioethics, medical ethics, and medical law in terms of the general inviolability of a patient’s bodily sovereignty and the rights of patients to make choices (e.g., reproductive choices) that concern their own body. However, the role of the body in terms of how it can or does contribute to a patient’s capacity for, or exercises of their autonomy in clinical decision-making situations has not been explicitly addressed. The approach to autonomy in this paper (...) is aligned with traditional theories that conceive autonomy in terms of an individual’s capacities for, and exercises of rational reflection. However, at the same time, this paper extends these accounts by arguing that autonomy is, in part, embodied. Specifically, by drawing on phenomenological conceptions of the experience of autonomy, we argue that, in principle, the body is a necessary component of the capacity for autonomy. Secondly, through the presentation of two different cases, we highlight ways in which a patient’s body can contribute to the autonomy of treatment choices. Ultimately, we hope to encourage others to explore additional conditions under which a concept of embodied autonomy should be employed in medical decision making, how its underlying principles might be operationalised in clinical situations, and its consequences for approaches to patient autonomy in healthcare practice, policy, and law. (shrink)

Mental health research faces a suite of unresolved challenges that have contributed to a stagnation of research efforts and treatment innovation. One such challenge is how to reliably and validly account for the subjective side of patient symptomatology, that is, the patient’s inner experiences or patient phenomenology. Providing a structured, standardised semantics for patient phenomenology would enable future research in novel directions. In this contribution, we aim at initiating a standardized approach to patient phenomenology by sketching a tentative formalisation within (...) the framework of an applied ontology, in the broader context of existing open-source Open Biomedical Ontologies resources such as the Mental Functioning Ontology. We further discuss a number of prevailing challenges and observations bearing on this task. (shrink)

Loneliness is a near-universal experience. It is particularly common for individuals with (so-called) psychopathological conditions or disorders. In this paper, we explore the experiential character of loneliness, with a specific emphasis on how social goods are experienced as absent in ways that involve a diminished sense of agency and recognition. We explore the role and experience of loneliness in three case studies: depression, anorexia nervosa, and autism. We demonstrate that even though experiences of loneliness might be common to many psychopathologies, (...) these experiences nevertheless have distinctive profiles. Specifically, we suggest that: (i) loneliness is often a core characteristic of depressive experience; (ii) loneliness can drive, and even cement, disordered eating practices and anorectic identity in anorexia nervosa; iii) loneliness is neither a core characteristic of autism nor a driver but is rather commonly experienced as stemming from social worlds, environments, and norms that fail to accommodate autistic bodies and their distinctive forms of life. We aim to do justice to the pervasiveness of loneliness in many — if not all — psychopathologies, while also highlighting the need to attend to psychopathology-specific experiences of loneliness, agency, and (non-)recognition. (shrink)

This study clarifies the need for a renewed account of the body in physiotherapy to fill sizable gaps between physiotherapeutical theory and practice. Physiotherapists are trained to approach bodily functioning from an objectivist perspective; however, their therapeutic interactions with patients are not limited to the provision of natural-scientific explanations. Physiotherapists’ practice corresponds well to theorisation of the body as the bearer of original bodily intentionality, as outlined by Merleau-Ponty and elaborated upon by enactivists. We clarify how physiotherapeutical practice corroborates Merleau-Ponty’s (...) critical arguments against objectivist interpretations of the body; particularly, his analyses demonstrate that norms of optimal corporeal functioning are highly individual and variable in time and thus do not directly depend on generic physiological structures. In practice, objectively measurable physical deviations rarely correspond to specific subjective difficulties and, similarly, patients’ reflective insights into their own motor deficiencies do not necessarily produce meaningful motor improvements. Physiotherapeutical procedures can be understood neither as mechanical manipulations of patients’ machine-like bodies by experts nor as a process of such manipulation by way of instructing patients’ explicit conscious awareness. Rather, physiotherapeutical practice and theory can benefit from the philosophical interpretation of motor disorders as modifications of bodily intentionality. Consequently, motor performances addressed in physiotherapy are interpreted as relational features of a living organism coupled with its environment, and motor disorders are approached as failures to optimally manage the motor requirements of a given situation owing to a relative loss of the capacity to structure one’s relation with their environment through motor action. Building on this, we argue that the process of physiotherapy is most effective when understood as a bodily interaction to guide patients towards discovering better ways of grasping a situation as meaningful through bodily postures and movements. (shrink)

Phenomenology’s return to lived experience and “to the things themselves” is often contrasted with the synthesized perspective of science and its “view from nowhere.” The extensive use of neuropsychological case reports in Merleau-Ponty’s Phenomenology of Perception, however, suggests that the relationship between phenomenology and science is more complex than a sheer opposition, and a fruitful one for the praxis of medicine. Here, I propose a new reading of how Merleau-Ponty justifies his use of Adhémar Gelb and Kurt Goldstein’s reports on (...) Johann Schneider for his phenomenology of embodied perception. I argue that for Merleau-Ponty these neuropsychological case reports represent a coherent deformation of the intercorporeally expressed existence of Schneider that through speech fall again onto the common ground of perception, thereby allowing Merleau-Ponty to understand, in the equivalent sense delivered by language, Schneider’s total being and fundamental illness. I then discuss what Merleau-Ponty’s method implies for a phenomenological praxis of medicine, and for the role of science in this praxis. (shrink)

Despite a recent surge in publications on Tourette Syndrome, we still lack substantial insight into first-personal aspects of “what it is like” to live with this condition. This is despite the fact that developments in phenomenological psychiatry have demonstrated the scientific and clinical importance of understanding subjective experience in a range of other neuropsychiatric conditions. We argue that it is time for Tourette Syndrome research to tap into the sophisticated frameworks developed in the philosophical tradition of phenomenology for describing experience (...) in a way that integrates discrete symptoms into an overarching experiential framework concerning the self, the body, and its modes of experience. Following a historical introduction that contextualises the pertinence of phenomenology to psychopathology, we distinguish this approach from the existing, psychologically oriented studies on TS that are also qualitative. We then outline gaps and opportunities for future research, including the sorts of questions that might be utilised in phenomenological interviews and why they are of potential benefit to research programs in philosophy, psychology, and neuroscience. In conclusion we address some of the broader implications for phenomenology of the body and philosophy of action. (shrink)