哲学の立場から : 現代医療における患者の身体(シンポジウム 患者の身体をどう考えるか)

抄録

In this paper, I first argue from the viewpoint of philosophy that the patient's body cannot be sufficiently comprehended by the logic of the biological mechanism. In order to make this point clear, I criticize the philosophical stand of the biological mechanism. Firstly, the position of the biological mechanism views a patient's body as an object of the world, so it cannot comprehend the reality lived by the body of patient. The patient's body, the biological mechanism reveals, is an anonymous body, not the proper living body of the patient. The biological mechanism lacks the perspective of individuality. Secondly, the understanding of disease of the biological mechanism is that of being-already-objectified, so it always remains in the past aspect of time. It lacks historicity and timeness and thus ignores the life history of the patient. Following the critical argument of the biological mechanism in modern medicine I propose a new comprehension of illness. It considers the patient's body as the milieu of the auto-expression of the patient's existential suffering. The comprehension of the patient's body should be that from the viewpoint of the unity of mind and body. Moreover, taking into consideration the relationship between medical staff and the patient, the patient's body should be understood as the body-aspair (interbodility). The patient's body reflects the body of medical staff, and reciprocally the latter reflects the former. They both form the intersubjectivity and then make themselves open into the world. So we should also understand the patient's body in the socio-cultural context. Thirdly, I propose the understanding of the body as sign/metaphor. It represents the semantics of illness. I insist upon the necessity of the hermeneutics of illness to understand the meaning the patient's body auto-expresses. The metaphor of the body bears both the meaning of discrimination and the religious-symbolic meaning. So the medical staff should transcend the discriminative meaning of the patient's body to its sacred meaning. Lastly, I argue the importance of the stand of ethics. The medical staff should constantly come face to face with the patient. We need to realize the patient's rights in accordance with the patient's actual body.