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Basic Bioethics
Afflicted: How Vulnerability Can Heal Medical Education and Practice
How medical education and practice can move beyond a narrow focus on biological intervention to recognize the lived experiences of illness, suffering, and death.
In Afflicted, Nicole Piemonte examines the preoccupation in medicine with cure over care, arguing that the traditional focus on biological intervention keeps medicine from addressing the complex realities of patient suffering. Although many have pointed to the lack of compassion and empathy in medical practice, few have considered the deeper philosophical, psychological, and ontological reasons for it. Piemonte fills that gap, examining why it is that clinicians and medical trainees largely evade issues of vulnerability and mortality and, doing so, offer patients compromised care. She argues that contemporary medical pedagogy and epistemology are not only shaped by the human tendency to flee from the reality of death and suffering but also perpetuate it. The root of the problem, she writes, is the educational and institutional culture that promotes reductionist understandings of care, illness, and suffering but avoids any authentic confrontation with human suffering and the fear and self-doubt that can come with that confrontation. Through a philosophical analysis of the patient-practitioner encounter, Piemonte argues that the doctor, in escaping from authentic engagement with a patient who is suffering, in fact “escapes from herself.”
Piemonte explores the epistemology and pedagogy of medicine, examines its focus on calculative or technical thinking, and considers how “clinical detachment” diminishes physicians. She suggests ways that educators might cultivate the capacity for authentic patient care and proposes specific curricular changes to help students expand their moral imaginations.
In Afflicted, Nicole Piemonte examines the preoccupation in medicine with cure over care, arguing that the traditional focus on biological intervention keeps medicine from addressing the complex realities of patient suffering. Although many have pointed to the lack of compassion and empathy in medical practice, few have considered the deeper philosophical, psychological, and ontological reasons for it. Piemonte fills that gap, examining why it is that clinicians and medical trainees largely evade issues of vulnerability and mortality and, doing so, offer patients compromised care. She argues that contemporary medical pedagogy and epistemology are not only shaped by the human tendency to flee from the reality of death and suffering but also perpetuate it. The root of the problem, she writes, is the educational and institutional culture that promotes reductionist understandings of care, illness, and suffering but avoids any authentic confrontation with human suffering and the fear and self-doubt that can come with that confrontation. Through a philosophical analysis of the patient-practitioner encounter, Piemonte argues that the doctor, in escaping from authentic engagement with a patient who is suffering, in fact “escapes from herself.”
Piemonte explores the epistemology and pedagogy of medicine, examines its focus on calculative or technical thinking, and considers how “clinical detachment” diminishes physicians. She suggests ways that educators might cultivate the capacity for authentic patient care and proposes specific curricular changes to help students expand their moral imaginations.
- GenresNonfictionPhilosophy
304 pages, Hardcover
Published January 12, 2018
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About the author
Nicole M. Piemonte
2 books1 followerNicole M. Piemonte is an Assistant Professor in the Department of Medical Education at Creighton University, School of Medicine, and Academic Consultant at St. Joseph's Hospital and Medical Center, Phoenix.
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September 15, 2023
"In other words, I contend that depersonalization in medicine is not primarily an epistemological but an ontological problem—that is, it is related to who we are as finite, mortal beings and our beliefs about what it means to live and to be."
A book that is as much about being human in the face of death as it is about the medical profession, Piemonte shows how medical professionals in their quest to "Cure" disease (as it is defined in the biomedical sense) fail to grapple with the human half of the patient before them, particularly in situations of suffering/dying. Using the philosophy of Heidegger, Levinas, Foucalt, and others, Piemonte makes the case for the medical humanities as an essential part of medical practice, and how a paradigm shift is required if we are to adequately deal with suffering and death in patient care.
A book that is as much about being human in the face of death as it is about the medical profession, Piemonte shows how medical professionals in their quest to "Cure" disease (as it is defined in the biomedical sense) fail to grapple with the human half of the patient before them, particularly in situations of suffering/dying. Using the philosophy of Heidegger, Levinas, Foucalt, and others, Piemonte makes the case for the medical humanities as an essential part of medical practice, and how a paradigm shift is required if we are to adequately deal with suffering and death in patient care.
Displaying 1 of 1 review