Logic of care versus logic of choice in modern concepts of medical practice
How to Cite
Lekhtsierv V.L. Logic of care versus logic of choice in modern concepts of medical practice. Interaction. Interview. Interpretation. 2019. Vol. 11. No. 20. P. 36-53. DOI: https://doi.org/10.19181/inter.2019.20.2 (in Russ.).
Abstract
The article compares two fundamental and conflicting principles in the ethical interpretation of clinical experience — the patient's right to medical choice and care as an immanent ethics of healing. Conceptual attempts to theoretically and empirically justify an unconditional priority of care in modern social and humanitarian research of medicine, as well as the desire to include the logic of choice in the logic of care are made from different methodological perspectives and on the basis of different intellectual traditions. Thus it is more important to compare the key concepts of care on this issue in order to reveal the global trend in understanding the essence of medical experience. The article offers a comparative analysis of the following: firstly, the arguments of an American researcher Joan C. Tronto, formulated in the context of universal political theory and ethics, but relevant to the field of medicine, secondly, the theory of care of the German doctor and philosopher of medicine Klaus Dörner and his opposition to the principle of autonomy, carried out in the practice of informed consent, thirdly, “involved ethnography” of the logic of care, carried out by the Dutch philosopher and anthropologist Annemarie Mol. The comparative analysis of the main texts of these authors on this problem revealed many general statements expressed by them, mainly, the general idea that in the case of chronic disease, which is a typical case of pathology in modern society, the most important is the logic of good care, the logic of interdependence of all subjects of care as a process, and that it is not the political opposition of power and equality here that comes to the centre, but the opposition of care and neglect in everyday medical practices.
Keywords:
good care, medical choice, autonomy, narrative, interdependence
References
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Borozdina Е. А. (2015) Zabota i soczial`noe grazhdanstvo [Care and Social Citizenship]. Sotsiologicheskie Issledovaniya [Sociological Studies]. No. 10. P. 84–93. (In Russ.)
Charon R. (2006) Narrative Medicine: Honoring the Stories of Illness. NY: Oxford University Press.
Derner K. (2006) Khoroshij vrach. Uchebnik osnovnoj poziczii vracha [Good doctor. Textbook of the main position of the doctor]. M.: Aleteya. (In Russ.)
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Good M. J., Good B. J., Schaffer C., Lind S. E. (1990) American Oncology and the Discourse of Hope. Culture, Medicine and Psychiatry. No. 14. P. 59–79. DOI: https://doi.org/10.1007/bf00046704
Harbers H., Mol A., Stollmeijer A. (2002) Food Matters. Arguments for an Ethnography of Daily Care. Theory, Culture and Society.No.19 (5–6). P.207–226. DOI:https://doi.org/10.1177/026327602761899228
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Lekhtsier V. L. (2018) Bolezn`: opy`t, narrativ, nadezhda. Ocherk soczial`ny`kh i gumanitarny`kh issledovani medicziny`[Illness: experience, narrative, hope. Essay of social and humanitarian studies of medicine]. Vilnius: Logvino literatūros namai. (In Russ.)
Mol A. (2002) The Body Multiple. Ontology in Medical Practice. Durham: Duke University Press. DOI: https://doi.org/10.1215/9780822384151
Mol A. (2008) The Logic of Care: Health and the Problem of Patient Choice. London: Routledge.
Noddings N. (1984) Caring. A Feminine Approach to Ethics and Moral Education. Berkeley: University of California Press.
Ozhygnova A. A., Kurlenkova A. S., Shevchenko S. Y., Zolotukhina M. V., Vait A. G., Andreev A. N. (2018) Vy`bor i/ili zabota? [Choice and/or care?]. Medicinskaya antropologiya i bioetika [Medical anthropology and bioethics]. No. 1 (15). URL: http://www.medanthro.ru/?page_id=3572 (accessed 05 November 2019). (In Russ.)
Sivkov D. (2015) Takoj razny`j ateroskleroz. Reczenziya na knigu: Mol A. The Body Multiple: Ontology in Medical Practice. Durham; London: Duke University Press, 2002 [So different atherosclerosis. Review of the book: Mol A. The Body Multiple: Ontology in Medical Practice. Durham; London: Duke University Press, 2002]. Sociologiya vlasti [Sociology of power]. Vol. 27. No. 1. P. 267–277. (In Russ.)
Tronto J. C. (1993) Moral Boundaries: A Political Argument for an Ethic of Care. NY: Routledge.
Tronto J. C. (2013) Caring Democracy: Markets, Equality, and Justice. NY: University Press.
Ugarova A. (2019) Logika zaboty` pri vzaimodejstvii vrachej i onkologicheskikh paczientov: neformal`ny`e praktiki i praktiki nadezhdy`[Logic of care in the interaction between doctors and cancer patients: informal practices and practices of hope] / In: E. Borozdina, E. Zdravomyslova, A. Temkina (eds) Kriticheskaya socziologiya zaboty`: perekrestki soczial`nogo neravenstva [Critical Care Sociology: Crossroads of Social Inequality: A Compilation of Articles]. SPb.: EUSPb. P. 88–115. (In Russ.)
Walker M. U. (1989) Moral Understandings: Alternative ‘Epistemology’ for a Feminist Ethics. Hypatia. Vol. 4. No. 2. P. 15–28. DOI: https://doi.org/10.1111/j.1527-2001.1989.tb00570.x
Borozdina Е. А. (2015) Zabota i soczial`noe grazhdanstvo [Care and Social Citizenship]. Sotsiologicheskie Issledovaniya [Sociological Studies]. No. 10. P. 84–93. (In Russ.)
Charon R. (2006) Narrative Medicine: Honoring the Stories of Illness. NY: Oxford University Press.
Derner K. (2006) Khoroshij vrach. Uchebnik osnovnoj poziczii vracha [Good doctor. Textbook of the main position of the doctor]. M.: Aleteya. (In Russ.)
Fisher B., Tronto J. C. (1991) Toward a Feminise Theory of Care / In: E. Abel, M. Nelson (eds) Circles of Care: Work and Identity in Women’s Lives. Albany, NY: State University of New York Press. P. 35–60.
Good M. J., Good B. J., Schaffer C., Lind S. E. (1990) American Oncology and the Discourse of Hope. Culture, Medicine and Psychiatry. No. 14. P. 59–79. DOI: https://doi.org/10.1007/bf00046704
Harbers H., Mol A., Stollmeijer A. (2002) Food Matters. Arguments for an Ethnography of Daily Care. Theory, Culture and Society.No.19 (5–6). P.207–226. DOI:https://doi.org/10.1177/026327602761899228
Kraus F., Boldt J. (eds) (2018) Care in Healthcare: Reflections on Theory and Practice. Basingstoke: Palgrave Macmillan.
Kuznetsov A. (2014) Dom, kotoryj postroila Annemari Mol. Arhitektura issledovanij posle aktornosetevoj [The house that Anne-Marie built: the architecture of reseach post actor-network theory]. Zhurnal issledovanij social’noj politiki [The Journal of Social Policy Studies]. Vol. 12. No. 3. P. 474–483. (In Russ.)
Lekhtsier V. L. (2018) Bolezn`: opy`t, narrativ, nadezhda. Ocherk soczial`ny`kh i gumanitarny`kh issledovani medicziny`[Illness: experience, narrative, hope. Essay of social and humanitarian studies of medicine]. Vilnius: Logvino literatūros namai. (In Russ.)
Mol A. (2002) The Body Multiple. Ontology in Medical Practice. Durham: Duke University Press. DOI: https://doi.org/10.1215/9780822384151
Mol A. (2008) The Logic of Care: Health and the Problem of Patient Choice. London: Routledge.
Noddings N. (1984) Caring. A Feminine Approach to Ethics and Moral Education. Berkeley: University of California Press.
Ozhygnova A. A., Kurlenkova A. S., Shevchenko S. Y., Zolotukhina M. V., Vait A. G., Andreev A. N. (2018) Vy`bor i/ili zabota? [Choice and/or care?]. Medicinskaya antropologiya i bioetika [Medical anthropology and bioethics]. No. 1 (15). URL: http://www.medanthro.ru/?page_id=3572 (accessed 05 November 2019). (In Russ.)
Sivkov D. (2015) Takoj razny`j ateroskleroz. Reczenziya na knigu: Mol A. The Body Multiple: Ontology in Medical Practice. Durham; London: Duke University Press, 2002 [So different atherosclerosis. Review of the book: Mol A. The Body Multiple: Ontology in Medical Practice. Durham; London: Duke University Press, 2002]. Sociologiya vlasti [Sociology of power]. Vol. 27. No. 1. P. 267–277. (In Russ.)
Tronto J. C. (1993) Moral Boundaries: A Political Argument for an Ethic of Care. NY: Routledge.
Tronto J. C. (2013) Caring Democracy: Markets, Equality, and Justice. NY: University Press.
Ugarova A. (2019) Logika zaboty` pri vzaimodejstvii vrachej i onkologicheskikh paczientov: neformal`ny`e praktiki i praktiki nadezhdy`[Logic of care in the interaction between doctors and cancer patients: informal practices and practices of hope] / In: E. Borozdina, E. Zdravomyslova, A. Temkina (eds) Kriticheskaya socziologiya zaboty`: perekrestki soczial`nogo neravenstva [Critical Care Sociology: Crossroads of Social Inequality: A Compilation of Articles]. SPb.: EUSPb. P. 88–115. (In Russ.)
Walker M. U. (1989) Moral Understandings: Alternative ‘Epistemology’ for a Feminist Ethics. Hypatia. Vol. 4. No. 2. P. 15–28. DOI: https://doi.org/10.1111/j.1527-2001.1989.tb00570.x
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APA
Lekhtsierv, V. L. (2019). Logic of care versus logic of choice in modern concepts of medical practice. Interaction. Interview. Interpretation, 11(20), 36-53. https://doi.org/10.19181/inter.2019.20.2
Section
Theoretical discourses and debates
