Abstract

This project is an interdisciplinary study of the contemporary medical model practiced throughout the Western world. The study explicates the history and structure of the model as objective and reductionist. It also explores possibilities for expanding the model toward the subjective through an interpretation of disease as suffering. ;Chapter I outlines the historical and philosophical bases for the clinical medicine paradigm. The eighteenth century work of Julien Offray de la Mettrie, who advocated an experiential, observational approach to medical practice, is expanded historically and structurally to objectify both body and disease and to confine the study of disease in the clinic, or teaching hospital. ;Chapter II introduces an expanded medical model expressed as the organismic or holistic theory of Kurt Goldstein. Chapter III is an exposition of Maurice Merleau-Ponty's phenomenology of perception. His view of phenomenal body directs the study of disease away from objective and causal relationships toward subjective and dialectical relationships. ;An interpretation of disease as suffering is developed in Chapter IV. Karl Jaspers' philosophy of boundary situations informs the translation of disease from an organic immanent occurrence to a transcendent biographical event. Angel Medina's fourfold methodology for reflective communication provides the contemplative basis for effecting that translation. ;Finally, a case study using Medina's methodology completes the interpretation of disease as suffering. Progressive and regressive reflection provide the patient, R.S., the opportunity for dialogue about the meaning of his illness. ;The project concludes with some implications for further investigation of disease as suffering through longitudinal biographical narratives. The importance of this subjective, phenomenal interpretation of disease for restructuring therapeutic relationships and for expanding the medical model is elaborated