Over the last decade, personalized medicine has become a buzz word, which covers a broad spectrum of meanings and generates many different opinions. The purpose of this article is to achieve a better understanding of the reasons why personalized medicine gives rise to such conflicting opinions. We show that a major issue of personalized medicine is the gap existing between its claims and its reality. We then present and analyze different possible reasons for this gap. We propose an hypothesis inspired (...) by the Windelband’s distinction between nomothetic and idiographic methodology. We argue that the fuzzy situation of personalized medicine results from a mix between idiographic claims and nomothetic methodological procedures. Hence we suggest that the current quandary about personalized medicine cannot be solved without getting involved in a discussion about the complex epistemological and methodological status of medicine. To conclude, we show that the Gadamer’s view of medicine as a dialogical process can be fruitfully used and reveals that personalization is not a theoretical task, but a practical one, which takes place within the clinical encounter. (shrink)

The past 10 years have seen considerable developments in the use of narrative in medicine, primarily through the emergence of the so-called narrative medicine. In this article, I question narrative medicine’s self-understanding and contend that one of the most prominent issues is its lack of a clear epistemological framework. Drawing from Gadamer’s work on hermeneutics, I first show that narrative medicine is deeply linked with the hermeneutical field of knowledge. Then I try to identify which claims can be legitimately expected (...) from narrative medicine, and which ones cannot be. I scrutinize in particular whether narrative medicine can legitimately grasp the patient’s lived experience of his or her illness. In the last section of this article, I begin to explore the potential usefulness of this epistemological clarification. This analysis allows for a further understanding of what is really at stake with narrative medicine, and thus to identify when it may be convenient, and when it may not. Furthermore, this clarification opens up promising new possibilities of dialogue with critics of the field. I conclude that narrative medicine finds its proper place as a possible tool available to mediate dialogue, which is at the heart of the clinical encounter in medical practice. (shrink)

A revival of the dialogue between phenomenology and psychiatry currently takes place in the best international journals of psychiatry. In this article, we analyse this revival and the role given to phenomenology in this context. Although this dialogue seems at first sight interesting, we show that it is problematic. It leads indeed to use phenomenology in a special way, transforming it into a discipline dealing with empirical facts, so that what is called “phenomenology” has finally nothing to do with phenomenology. (...) This so-called phenomenology tallies however with what we have always called semiology. We try to explain the reasons why phenomenology is misused in that way. In our view, this transformation of phenomenology into an empirical and objectifying discipline is explained by the role attributed to phenomenology by contemporary authors, which is to solve the problems raised by the Diagnostic and Statistical Manual of Mental Disorders. (shrink)

BackgroundOver the past decade, the exponential growth of the literature devoted to personalized medicine has been paralleled by an ever louder chorus of epistemic and ethical criticisms. Their differences notwithstanding, both advocates and critics share an outdated philosophical understanding of the concept of personhood and hence tend to assume too simplistic an understanding of personalization in health care.MethodsIn this article, we question this philosophical understanding of personhood and personalization, as these concepts shape the field of personalized medicine. We establish a (...) dialogue with phenomenology and hermeneutics (especially with E. Husserl, M. Merleau-Ponty and P. Ricoeur) in order to achieve a more sophisticated understanding of the meaning of these concepts We particularly focus on the relationship between personal subjectivity and objective data.ResultsWe first explore the gap between the ideal of personalized healthcare and the reality of today’s personalized medicine. We show that the nearly exclusive focus of personalized medicine on the objective part of personhood leads to a flawed ethical debate that needs to be reframed. Second, we seek to contribute to this reframing by drawing on the phenomenological-hermeneutical movement in philosophy. Third, we show that these admittedly theoretical analyses open up new conceptual possibilities to tackle the very practical ethical challenges that personalized medicine faces.ConclusionFinally, we propose a reversal: if personalization is a continuous process by which the person reappropriates all manner of objective data, giving them meaning and thereby shaping his or her own way of being human, then personalized medicine, rather than being personalized itself, can facilitate personalization of those it serves through the data it provides. (shrink)

« L’essence ou – ce qui est le même – l’être de l’homme consiste à ex-ister. Que ceux qui y voient une simple tautologie aillent apprendre (πάθει μάθος) ce que veut dire ex-ister ». Point n’est besoin de multiplier les exemples pour comprendre que le travail d’Henri Maldiney peut être vu comme une tentative inédite pour expliciter ce que veut dire exister, et pour élaborer une anthropologie phénoménologique radicale capable de tenir le droit fil du programme de l’absence de préjugé. (...) Ainsi, c’... (shrink)

« Événement et vécu » est un article du philosophe et psychiatre suisse Ludwig Binswanger initialement paru en 1931 puis secondairement repris en 1955 dans le deuxième volume des Ausgewählte Vorträge und Aufsätze. Notre traduction se base sur la version publiée en 1994 chez Asanger dans les Ausgewählte Werke,...

Le thème autour duquel tournent les travaux non strictement neurologiques d’Erwin Straus est les formes et les « principes » dans et à partir desquels la construction et le développement de l’individu humain s’accomplit dans les moments de bonne santé et de maladie. Qu’il s’agisse de la recherche sur le temps et l’espace vécu, de la recherche sur la façon dont l’homme se comporte à l’égard du monde...