The concepts of disease, illness and sickness capture fundamentally different aspects of phenomena related to human ailments and healthcare. The philosophy and theory of medicine are making manifold efforts to capture the essence and normative implications of these concepts. In parallel, socio-empirical studies on patients’ understanding of their situation have yielded a comprehensive body of knowledge regarding subjective perspectives on health-related statuses. Although both scientific fields provide varied valuable insights, they have not been strongly linked to each other. Therefore, the (...) article aims to scrutinise the normative-ethical implications of patient perspectives in building a bridge to the empirical ethics debates. Three potential fields of tension between the illness and the disease perspective are presented. Consequently, findings from empirical research examining patient perspectives on illness are displayed and the practical implications and associated ethical issues which arise are discussed. This leads to the conclusion that an explicit and elaborate empirical-ethical methodology is needed to deal appropriately with the complex interaction between patients’ views and the medico-professional view of disease. Kon’s four-stage model of normative-empirical collaboration is then applied against the background of empirical data on patient perceptions. Starting from this exemplary approach, the article suggests employing empirical-ethical frameworks for further research on the conceptual and normative issues, as they help to integrate perspectives from the philosophy of medicine with socio-empirical research. The combination of theoretical and empirical perspectives suggested contributes to a more nuanced discussion of the normative impact of patients’ actual understanding of illness. Further empirical research in this area would profit from explicitly considering potential ethical issues to avoid naturalistic fallacies or crypto-normative conclusions that may compromise healthcare practice. Vice versa, medico-theoretical debates could be enriched by integrating subjective views of those people who are immediately affected. (shrink)

It has been a fundamental assumption in management theory that communication is a key condition for successful management. This assumption has been linked to Habermas’ model of communicative rationality, but it is very difficult for managers to implement this model in real-life leadership relations. The reason is that practical obstacles, resource limitations and knowledge gaps make it impossible to achieve Habermas’ ideal aim of ‘shared horizons’. The article argues that it is possible for managers to meet fundamental communication conditions in (...) employee interaction and other forms of leadership relations if the holistic concept of a shared horizon is replaced with an idea of contextual agreement. Within this alternative conceptual framework, a key strategic aim for managers is to communicate as well as realistically possible how organisational strategies and action-guiding principles are justified. This presupposes that managers are able to uncover ‘hidden’ language meaning and transcend contextual power relations. Within a speech act theory of meaning, the article articulates three basic communication conditions that can function as conceptual tools for achieving these communicative aims. (shrink)