Understanding patient care in an existential framework

Abstract

Aim of this study is to show how a deep understanding of the existential aspects of patient care would improve ethical aspects in health care and the quality of health care management. Contemporary medical ethics is based on ethical codes and guidelines built up using multiple ethical theories such as utilitarianism, deontology, virtue ethics and ethics of care, incorporated externally to the doctor whose practicing is grounded in a completely different environment of scientific reasoning and market commitments. Since patients are humans, health care is embedded in human existence. Therefore, understanding patient care in an existential framework would foster the doctor’s ethical behavior would fulfill the patient’s expectations. Since my concern is with the existential aspects of patient care, I will be using the existential methodology. My aim is to conceptualise the preconceptual understanding of being a patient, being a doctor and being with the patient by using patient narratives in my experiential point of view and my life story as a doctor. I will be using hermeneutic methodology also by interpreting some philosophical texts. Even though, the doctor visiting to see the patient is supposed to be dealing with a particular disease manifestation, he/ she is having a broad intentionality. When the doctor is seeing an ulcer of a patient, we feel that he/ she is concentrating on the ulcer. However, in his/ her intentionality he/ she is thinking about various other aspects simultaneously, such as; the hospital setting, his work schedule, the patient’s social background and financial background etc. In his book, The Ideas, Husserl explains this as the qualitative space of our understanding. As a result, the doctor’s behavior is influenced more by these aspects, than the disease conditions explained in medical textbooks. There are some more important aspects of the patient, which are not appreciated in science and technology. In Heidegger’s book, Being and Time, he tries to understand human existence in a qualitative time. Similarly, the doctor should understand the patient’s feeling as a being strange to the hospital, with his/ her usual beliefs as a projection towards the doctor’s medicine. With such an existential understanding, the doctor will be able to understand his/ her duty and the patient’s existence in a complete way. This foundation will foster the ethical behavior of the doctor.