Background The significance of medical implants goes beyond technical functioning and reaches into everyday life, with consequences for individuals as well as society. Ethical aspects associated with the everyday use of implants are relevant for individuals’ lifeworlds and need to be considered in implant care and in the course of technical developments. Methods This scoping review aimed to provide a synthesis of the existing evidence regarding ethically relevant psychosocial and cultural aspects in cochlear, glaucoma and cardiovascular implants in patient-centered empirical (...) research. Systematic literature searches were conducted in EBSCOhost, Philpapers, PsycNET, Pubmed, Web of Science and BELIT databases. Eligible studies were articles in German or English language published since 2000 dealing with ethically relevant aspects of cochlear, glaucoma and passive cardiovascular implants based on empirical findings from the perspective of (prospective) implant-wearers and their significant others. Following a descriptive-analytical approach, a data extraction form was developed and relevant data were extracted accordingly. We combined a basic numerical analysis of study characteristics with a thematically organized narrative synthesis of the data. Results Sixty-nine studies were included in the present analysis. Fifty were in the field of cochlear implants, sixteen in the field of passive cardiovascular implants and three in the field of glaucoma implants. Implant-related aspects were mainly found in connection with autonomy, freedom, identity, participation and justice, whereas little to no data was found with regards to ethical principles of privacy, safety or sustainability. Conclusions Empirical research on ethical aspects of implant use in everyday life is highly relevant, but marked by ambiguity and unclarity in the operationalization of ethical terms and contextualization. A transparent orientation framework for the exploration and acknowledgment of ethical aspects in “lived experiences” may contribute to the improvement of individual care, healthcare programs and research quality in this area. Ethics-sensitive care requires creating awareness for cultural and identity-related issues, promoting health literacy to strengthen patient autonomy as well as adjusting healthcare programs accordingly. More consideration needs to be given to sustainability issues in implant development and care according to an approach of ethics-by-design. (shrink)

Unchosen transformative experiences—transformative experiences that are imposed upon an agent by external circumstances—present a fundamental problem for agency: how does one act intentionally in circumstances that transform oneself as an agent, and that disrupt one’s core projects, cares, or goals? Drawing from William James’s analysis of conversion and Matthew Ratcliffe’s account of grief, I give a phenomenological analysis of transformative experiences as involving the restructuring of systems of practical meaning. On this analysis, an agent’s experience of the world is structured (...) by practically significant possibilities that form organized systems on the basis of the agent’s projects and relationships. Transformative experiences involve shifts to systems of possibility, that is, changes to habitual meanings and to how an agent’s projects are situated in relation to one another. I employ the enactivist notion of sense-making to analyze how an agent rebuilds the meaning structures disrupted by a transformative experience. In an unchosen transformative experience, an agent adjusts to a significant disruption through a process of sense-making in precarious conditions. By establishing new patterns of bodily and social interaction with the world, one alters the practical meanings of one’s surroundings, and thereby reconstitutes oneself as an intentional agent. (shrink)

The phenomenology of medicine is that part of the research field of the philosophy of medicine that asks about the subjective experience of illness. In contrast to the philosophy of medicine, the phenomenological approaches explicitly include medical and bioethical questions as part of their research interests. The paper provides an overview of the most important questions and topics of the phenomenology of medicine. Subsequently I will refer to the fundamental critique articulated by feminist positions in the field of phenomenology of (...) medicine. In addition to the socio-political contextualisation of the experience of illness, this also includes the necessary recourse to empirical research. (shrink)

This article explores the nature of "the phenomenological attitude," which is understood as the process of retaining a wonder and openness to the world while reflexively restraining pre-understandings, as it applies to psychological research. A brief history identifies key philosphical ideas outlining Husserl's formulation of the reductions and subsequent existential-hermeneutic elaborations, and how these have been applied in empirical psychological research. Then three concrete descriptions of engaging the phenomenological attitude are offered, highlighting the way the epoché of the natural sciences, (...) the psychological phenomenological reduction and the eidetic reduction can be applied during research interviews. Reflections on the impact and value of the researcher's stance show that these reductions can be intertwined with reflexivity and that, in this process, something of a dance occurs—a tango in which the researcher twists and glides through a series of improvised steps. In a context of tension and contradictory motions, the researcher slides between striving for reductive focus and reflexive self-awareness; between bracketing pre-understandings and exploiting them as a source of insight. Caught up in the dance, researchers must wage a continuous, iterative struggle to become aware of, and then manage, pre-understandings and habitualities that inevitably linger. Persistance will reward the researcher with special, if fleeting, moments of disclosure in which the phenomenon reveals something of itself in a fresh way. (shrink)

This paper offers an account of how to engage one phenomenologically orientated version of relational research based on ideas from existential phenomenological philosophy as well as Gestalt theory, relational psychoanalysis, intersubjectivity theory and feminist methodology. Relational dynamics (both conscious and unconscious) between researcher and co-researcher are explored reflexively using illustrations from various phenomenological projects in which the author has been involved. The relational approach to phenomenology described involves attending to four interlinked dimensions: open presence, embodied intersubjectivity, dialogic co-creation and entangled (...) selves. The paper aims to show the importance of retaining an open, empathic, embodied presence to another's personhood while acknowledging the power of dialogue to bring to life new realities. Data is seen to emerge out of the researcher/co-researcher relationship and is mutually co-created in this encounter as each touches and impacts on the other. What we can learn and know about another arises within the intersubjective space between. In this zone of ambiguity and uncertainty, the unforeseen hovers and layered meanings invite discovery. (shrink)

In this paper, I seek to contribute to post-phenomenological descriptions of human-technological relations and the intentionalities exhibited in them by focusingon the intentionality exhibited in the use of a cochlear implant. To do so, I will use concepts developed by Don Ihde and further extended by Peter-Paul Verbeek to show that while post-phenomenological categories illuminate the intentional relationship of a cochlear implant wearer to her world, this relationship defies easy categorization. An examination of successful functioning with a cochlear implant will (...) reveal a distinct form of technological embodiment and intentionality that confirms and extends previous post-phenomenological analyses. (shrink)