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Why should physicians read? Understanding clinical judgement and its relation to literary experience

AHLZEN, ROLF (2010) Why should physicians read? Understanding clinical judgement and its relation to literary experience. Doctoral thesis, Durham University.



Is literary experience of any practical relevance to the clinician? This is the over-all question addressed by this investigation, which starts by tracing the historical roots of scientific medicine. These are found to be intimately linked to a form of rationality associated with the scientific revolution of the 17th century and with “modernity”. Medical practice, however, is dependent also on another form of rationality associated with what Stephen Toulmin calls “the epistemology of the biographical”. The very core of clinical medicine is shown to be the clinical encounter, an interpretive meeting where the illness experience is at the centre of attention. The physician can reach the goals of medicine only by developing clinical judgement. Clinical judgement is subjected to close analysis and is assumed to be intimately connected to the form of knowledge Aristotle called phronesis.

In order to explore how literature – drama, novels, poetry – may be related to clinical judgement, a view of literature is presented that emphasizes literature as an invitation to the reader, to be met responsibly and responsively. Literature carries a potential for a widened experience, for a more nuanced perception of reality – and this potential is suggested to be ethically relevant to the practice of medicine. The “narrative rationality” of a literary text constitutes a complement to the rationality pervading scientific medicine.

The final step in my analysis is a closer exploration of the potential of the literary text to contribute to the growth of clinical judgement, in relation to the challenges of everyday clinical work. Some of the conditions that may facilitate such growth are outlined, but it is also shown that full empirical evidence for the beneficial effects of reading on the clinician reader is beyond reach.

Item Type:Thesis (Doctoral)
Award:Doctor of Philosophy
Keywords:Clinical judgement, literary experience, phronesis, narrative rationality, potential
Faculty and Department:Faculty of Social Sciences and Health > Medicine and Health, School of
Thesis Date:2010
Copyright:Copyright of this thesis is held by the author
Deposited On:19 Oct 2010 16:23

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