20 - Living well and health studies

Summary

Existential phenomenological approaches to questions of health and medicine highlight the patient's experience of illness as key to understanding the medical encounter. Merleau-Ponty's philosophy has been central to this project. Whilst medical science is concerned with the manifestation of physical symptoms, phenomenologists focus on the subjective aspects of ill health. The distinction between Körper (physical body/matter) and Leib (living body/organism) can and has been used to articulate the difference (Leder 1992). According to these accounts, medicine tends to focus on people in terms of their physical bodies, bodies that can be diagnosed, manipulated, technically managed and cured. Sartre uses this distinction to formulate how the medical gaze transforms Leib (in his terms, body-for-itself) into Körper (body-for-others). For Sartre, the subjective experience of illness becomes something else when apprehended by another:

[A]t times it is revealed to the Other by the “twinges” of pain, by the “crises” of my Illness, but the rest of the time it remains out of reach without disappearing. It is then objectively discernible for Others. Others have informed me of it, Others can diagnose it; it is present for Others even though I am not conscious of it … If I have hepatitis, I avoid drinking wine so as not to arouse pains in my liver. But my precise goal – not to arouse pains in my liver – is in no way distinct from that other goal – to obey the prohibitions of the physician who revealed the pain to me. Thus another is responsible for my disease. […]