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Title [sv]
Existensfilosofins plats i hälso- och sjukvården: exemplen Tyskland, Danmark och Sverige
Title [en]
The Role of Existential Philosophy in Health Care: The Cases of Germany, Denmark, and Sweden
Abstract [en]
The aim of the present research project is to explore how existential issues occur and are dealt with in health care against the backdrop of existential philosophy. We focus upon three specific practices in which existential matters are acute: 1) screening for Downs syndrome in early pregnancy, 2) the role of care coordinators in the care of terminal renal failure and abdominal cancer, and 3) the issue of physician assisted death in palliative care. Comparative studies of the situations in Germany, Denmark, and Sweden will be carried out by way of in depth interviews, participant observation, and media studies, and the collected material will be analysed through a focus on issues central to existential philosophy, such as freedom, vulnerability, responsibility, empathy, limit situation, and life narrative. In connection with the empirical studies, philosophical and ethical issues will be dealt with in normative analyses of how existential philosophy may enrichen the practices focused upon in the empirical investigations and how these in turn could develop issues in existential philosophy. The project focuses particularly on the philosophy of Karl Jaspers, a key thinker in philosophy of psychiatry and existential philosophy, the work of whom we believe to be under researched and potentially very fruitful for a study of existential issues in health care. The key works of existential philosophy were written in the 1910s-40s and had their main impact during the heydays of the existentialism made famous by philosophers such as Heidegger and Sartre. Since then the practical issues of dealing with limit situations – the concept is taken from Jaspers’ philosophy – have to a large extent been transferred from philosophy departments and religious institutions to hospitals. Doctors and other health care professionals have become our new experts in existential issues but the question is if they in every case have the adequate competence and interests to deal with these issues in a thorough manner. We will explore if existential philosophy – and in particular the work of Jaspers – has the potential to make us better understand and deal with ethical issues occurring in: 1) screening for Downs syndrome in early pregnancy, 2) the role of care coordinators in the care of terminal renal failure and abdominal cancer, and 3) making decisions concerning physician assisted death in palliative care.
Publications (10 of 26) Show all publications
Svenaeus, F. (2023). The Phenomenology of Objectification in and Through Medical Practice and Technology Development. Journal of Medicine and Philosophy, 48(2), 141-150
Open this publication in new window or tab >>The Phenomenology of Objectification in and Through Medical Practice and Technology Development
2023 (English)In: Journal of Medicine and Philosophy, ISSN 0360-5310, E-ISSN 1744-5019, Vol. 48, no 2, p. 141-150Article in journal (Refereed) Published
Abstract [en]

Objectification is a real problem in medicine that can lead to bad medical practice or, in the worst case, dehumanization of the patient. Nevertheless, objectification also plays a major and necessary role in medicine: the patient's body should be viewed as a biological organism in order to find diseases and be able to cure them. Listening to the patient's illness story should not be replaced, but, indeed, developed by the physical examination of his body searching for the causes of his complaints. Whereas phenomenologists have so far mainly been identifying the back sides of objectification in medicine, in this paper the aim is to analyze differences between detrimental objectifications and objectifications that do not deprive the patient of his subjectivity but, rather, at least in some cases, may lead the patient to feel more at home with his body.

Place, publisher, year, edition, pages
Oxford University Press, 2023
Keywords
genetic diagnosis, lived body, medical hermeneutics, objectification, phenomenology of medicine, quantified self
National Category
Philosophy
Research subject
Critical and Cultural Theory
Identifiers
urn:nbn:se:sh:diva-51384 (URN)10.1093/jmp/jhad007 (DOI)000972883200004 ()37078731 (PubMedID)2-s2.0-85153413546 (Scopus ID)
Funder
The Foundation for Baltic and East European Studies, 4/2017
Available from: 2023-04-25 Created: 2023-04-25 Last updated: 2023-07-10Bibliographically approved
Svenaeus, F. (2023). Världen vaknar: känslornas plats i människans liv. Möklinta: Gidlunds förlag
Open this publication in new window or tab >>Världen vaknar: känslornas plats i människans liv
2023 (Swedish)Book (Other academic)
Abstract [sv]

Alltför ofta har känslorna genom historien betraktats som en förvrängning av filosofins och vetenskapens objektiva beskrivning av verkligheten. Känslorna blir då något som vi bör sträva efter att befria oss ifrån i stället för det som utgör hjärtat av vår existens. Men det är fel. Verkligheten får i själva verket sin struktur och mening genom känslor som öppnar upp en värld som vi kan dela med andra människor. Det är känslornas skapande kraft som skiljer oss från maskiner och som gör att vi kan erövra kunskap om världen i kontrast till att bearbeta information och göra beräkningar. Boken tar sig an känslornas natur genom att kombinera filosofisk analys med empirisk forskning från biologi, psykologi och antropologi. Resonemangen illustreras med hjälp av erfarenheter av känslors makt och betydelse från vardagen och samtiden. Känslans mellanmänskliga funktion får stort utrymme, alltifrån den känsla av empati och samvaro som är avgörande för ett gott liv, till de mer problematiska gruppkänslor som växer sig starka genom massan och som kan exploateras inom politiken. Vägen går från de allra första till de allra sista känslorna från födelsen till döden och på vägen passeras de viktigaste typerna av känslor i livet, inte minst sådana som är förknippade med kärlek och lycka eller lidande och sjukdom.

Place, publisher, year, edition, pages
Möklinta: Gidlunds förlag, 2023. p. 210
Keywords
Känslor, Medvetandet, Människan
National Category
Philosophy
Identifiers
urn:nbn:se:sh:diva-51956 (URN)9789178445073 (ISBN)
Funder
The Foundation for Baltic and East European Studies, 4/2017
Available from: 2023-07-10 Created: 2023-07-10 Last updated: 2023-07-10Bibliographically approved
Gunnarson, M. (2022). Det lilla och stora screeningtestet. In: Anette Wickström; Sofia Morberg Jämterud; Kristin Zeiler (Ed.), Screeningens mångsidighet: Dess möjligheter och utmaningar. Lund: Nordic Academic Press
Open this publication in new window or tab >>Det lilla och stora screeningtestet
2022 (Swedish)In: Screeningens mångsidighet: Dess möjligheter och utmaningar / [ed] Anette Wickström; Sofia Morberg Jämterud; Kristin Zeiler, Lund: Nordic Academic Press, 2022Chapter in book (Other academic)
Place, publisher, year, edition, pages
Lund: Nordic Academic Press, 2022
National Category
Philosophy, Ethics and Religion Medical Genetics
Identifiers
urn:nbn:se:sh:diva-49940 (URN)9789188909862 (ISBN)9789188909879 (ISBN)
Funder
The Foundation for Baltic and East European Studies, 4/2017
Available from: 2022-09-22 Created: 2022-09-22 Last updated: 2023-07-10Bibliographically approved
Gunnarson, M. (2022). Disclosing the person in renal care coordination: why unpredictability, uncertainty, and irreversibility are inherent in person-centred care. Medicine, Health care and Philosophy, 25(4), 641-654
Open this publication in new window or tab >>Disclosing the person in renal care coordination: why unpredictability, uncertainty, and irreversibility are inherent in person-centred care
2022 (English)In: Medicine, Health care and Philosophy, ISSN 1386-7423, E-ISSN 1572-8633, Vol. 25, no 4, p. 641-654Article in journal (Refereed) Published
Abstract [en]

This article explores an example of person-centred care: the work of so-called renal care coordinators. The empirical basis of the article consists of qualitative interviews with renal care coordinators, alongside participant observations of their patient interactions. During the analyses of the empirical material, I found that one of the coordinators’ most fundamental ambitions is to get to know who the patient is. This is also a central tenet of person-centred care. The aim of the article is not only to argue for the plausibility of this tenet, but also, and more importantly, to highlight and explore its implications in the context of healthcare, through the example of renal care coordination. By drawing on the philosophy of Hannah Arendt, the article shows that the disclosure of who the patient is that takes place in person-centred care requires speech and action, which are modes of human activity that initiate processes characterized by unpredictability, uncertainty, and irreversibility. This unpredictability, uncertainty, and irreversibility, found to be inherent in person-centred care, is then discussed in relation to the pursuit of certainty characterizing contemporary evidence-based medicine. At the end of the article the conclusion is drawn that, if healthcare is to be person-centred, it must find ways of accommodating the contradictory pursuits of certainty and uncertainty found in evidence-based medicine and person-centred care respectively.

Place, publisher, year, edition, pages
Springer, 2022
National Category
Philosophy
Research subject
Baltic and East European studies
Identifiers
urn:nbn:se:sh:diva-49941 (URN)10.1007/s11019-022-10113-z (DOI)000855614200001 ()36125646 (PubMedID)2-s2.0-85138333203 (Scopus ID)
Funder
The Foundation for Baltic and East European Studies, 2017-0004
Available from: 2022-09-22 Created: 2022-09-22 Last updated: 2022-11-10Bibliographically approved
Svenaeus, F. (2022). Dödshjälp – ett privilegium för de rika?. Svenska Dagbladet (2022-06-20), pp. 20
Open this publication in new window or tab >>Dödshjälp – ett privilegium för de rika?
2022 (Swedish)In: Svenska Dagbladet, ISSN 1101-2412, no 2022-06-20, p. 20-Article in journal, News item (Other (popular science, discussion, etc.)) Published
Place, publisher, year, edition, pages
Svenska dagbladets AB & Co, 2022
National Category
Health Sciences
Research subject
Critical and Cultural Theory
Identifiers
urn:nbn:se:sh:diva-50429 (URN)
Funder
The Foundation for Baltic and East European Studies, 4/2017
Note

Under strecket

Available from: 2022-12-21 Created: 2022-12-21 Last updated: 2022-12-22Bibliographically approved
Svenaeus, F. (2022). Health and Illness as Enacted Phenomena. Topoi: An International Review of Philosophy, 41, 373-382
Open this publication in new window or tab >>Health and Illness as Enacted Phenomena
2022 (English)In: Topoi: An International Review of Philosophy, ISSN 0167-7411, E-ISSN 1572-8749, Vol. 41, p. 373-382Article in journal (Refereed) Published
Abstract [en]

In this paper I explore health and illness through the lens of enactivism, which is understood and developed as a bodily-based worldly-engaged phenomenology. Various health theories - biomedical, ability-based, biopsychosocial - are introduced and scrutinized from the point of view of enactivism and phenomenology. Health is ultimately argued to consist in a central world-disclosing aspect of what is called existential feelings, experienced by way of transparency and ease in carrying out important life projects. Health, in such a phenomenologically enacted understanding, is an important and in many cases necessary part of leading a good life. Illness, on the other hand, by such a phenomenological view, consist in finding oneself at mercy of unhomelike existential feelings, such as bodily pains, nausea, extreme unmotivated tiredness, depression, chronic anxiety and delusion, which make it harder and, in some cases, impossible to flourish. In illness suffering the lived body hurts, resists, or, in other ways, alienates the activities of the ill person.

Place, publisher, year, edition, pages
Springer, 2022
Keywords
Biopsychosocial, Enactivism, Existential feelings, Health theory, Phenomenology of illness, Philosophical anthropology
National Category
Health Sciences Philosophy
Identifiers
urn:nbn:se:sh:diva-45495 (URN)10.1007/s11245-021-09747-0 (DOI)000652109400001 ()34024965 (PubMedID)2-s2.0-85106034283 (Scopus ID)
Funder
The Foundation for Baltic and East European Studies, 4/2017
Available from: 2021-06-02 Created: 2021-06-02 Last updated: 2024-01-08Bibliographically approved
Zeiler, K., Karlsson, G. & Gunnarson, M. (2022). Opportunistic cognitive screening in Sweden: What the tests mean and do for patients and healthcare professionals. Dementia, 21(1), 236-249
Open this publication in new window or tab >>Opportunistic cognitive screening in Sweden: What the tests mean and do for patients and healthcare professionals
2022 (English)In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 21, no 1, p. 236-249Article in journal (Refereed) Published
Abstract [en]

Since 2017, opportunistic screening for cognitive impairment takes place at the geriatric ward of a local hospital in Sweden. Persons above the age of 65 who are admitted to the ward, who have not been tested for cognitive impairment during the last six months nor have a previously known cognitive impairment, are offered the Mini-Mental State Examination and the Clock-Drawing Test. This article analyses what the opportunistic screening practice means for patients and healthcare professionals. It combines a phenomenologically-oriented focus on subjectivity and sense-making with a focus that is inspired by science and technology studies on what the tests become within the specific context in which they are used, which allows a dual focus on subjectivity and performativity. The article shows how the tests become several different, not infrequently seemingly contradictory, things: an offer, an important tool for knowledge-production, something unproblematic yet also emotionally troubling, something one can fail and an indicator that one belongs to a risk group and needs to be tested. Further, the article shows how the practice is shaped by the sociocultural context. It examines the role of the affective responses to the test for subjectivity - particularly patient subjectivity - and offers a set of recommendations, if this practice were to expand to other hospitals.

Place, publisher, year, edition, pages
Sage Publications, 2022
Keywords
Cognitive impairment, Sweden, healthcare professionals’ and patients’ perspectives, lived experience, opportunistic screening, subjectivity
National Category
Nursing
Identifiers
urn:nbn:se:sh:diva-46238 (URN)10.1177/14713012211035373 (DOI)000684658700001 ()34380348 (PubMedID)2-s2.0-85112726349 (Scopus ID)
Projects
A Feminist Approach to Medical Screening
Funder
Swedish Research Council, 2016-00784The Foundation for Baltic and East European Studies, 4/2017
Available from: 2021-08-18 Created: 2021-08-18 Last updated: 2023-07-10Bibliographically approved
Svenaeus, F. (2022). The Hermeneutics of Medicine and the Phenomenology of Health: Steps towards a Philosophy of Medical Practice. Second Revised Edition (2 rev. ed.ed.). Dordrecht: Springer Netherlands
Open this publication in new window or tab >>The Hermeneutics of Medicine and the Phenomenology of Health: Steps towards a Philosophy of Medical Practice. Second Revised Edition
2022 (English)Book (Refereed)
Abstract [en]

This is the first monograph to deal with medicine as a form of hermeneutics, now in a thoroughly revised and updated edition, including a whole new chapter on medical ethics. The book offers a comprehensive philosophical argument why good medical practice cannot be curtailed to scientific investigations of the body but is a form of clinical hermeneutics performed by health-care professionals in dialogue with their patients. Medical hermeneutics is rooted in a phenomenology of illness which acknowledges and proceeds from the ill party’s bodily feelings, everyday life-world circumstances and self-understanding in aiming to restore health.

The author shows how the works of classical phenomenologists and hermeneuticians – Martin Heidegger, Maurice Merleau-Ponty, Hans-Georg Gadamer and Paul Ricoeur – may be employed to understand how medical diagnosis is enveloped by professional empathy and clinical judgement and developed by scientific investigations of the patient’s bodily condition. Health and illness are ultimately considered to be ways of feeling at home or not at home in the world, and such experiences are the starting point of medical hermeneutics when aiming to make best use of scientific knowledge. The book is aimed at researchers and teachers in philosophy of medicine and medical ethics, and at physicians, nurses and other health-care professionals meeting with patients in ethically complex and challenging situations. Phenomenology and hermeneutics, most often considered as methods belonging to the humanities, are shown to be of vital importance for the understanding of medical practice and ethical dilemmas of health care.

Place, publisher, year, edition, pages
Dordrecht: Springer Netherlands, 2022. p. 171 Edition: 2 rev. ed.
Series
The International Library of Bioethics, ISSN 2662-9186, E-ISSN 2662-9194 ; 97
Keywords
Edmund Husserl, Hans-Georg Gadamer, Interpretation, Illness, Martin Heidegger, Medical Ethics, Paul Ricœur, Health, Hermeneutics and Medicine, Phenomenology, Philosophy of Medicine
National Category
Health Sciences Philosophy
Research subject
Critical and Cultural Theory; Baltic and East European studies
Identifiers
urn:nbn:se:sh:diva-50422 (URN)10.1007/978-3-031-07281-9 (DOI)978-3-031-07280-2 (ISBN)978-3-031-07281-9 (ISBN)
Funder
The Foundation for Baltic and East European Studies, 4/2017
Available from: 2022-12-21 Created: 2022-12-21 Last updated: 2022-12-22Bibliographically approved
Svenaeus, F. (2021). Empathy and togetherness online compared to IRL: A phenomenological account. Journal of Phenomenological Psychology, 52(1), 78-95
Open this publication in new window or tab >>Empathy and togetherness online compared to IRL: A phenomenological account
2021 (English)In: Journal of Phenomenological Psychology, ISSN 0047-2662, E-ISSN 1569-1624, Vol. 52, no 1, p. 78-95Article in journal (Refereed) Published
Abstract [en]

In this paper I aim to show with the aid of philosophers Edith Stein and Peter Goldie, how empathy and other social feelings are instantiated and developed in real life versus on the Internet. The examples of on-line communication show both how important the embodied aspects of empathy are and how empathy may be possible also in the cases of encountering personal stories rather than personal bodies. Since video meetings, social media, online gaming and other forms of interaction via digital technologies are taking up an increasing part of our time, it is important to understand how such forms of social intercourse are different from in real life (IRL) meetings and why they can accordingly foster not only new communal bonds but also hatred and misunderstanding.

Place, publisher, year, edition, pages
Brill Academic Publishers, 2021
Keywords
Edith Stein, Embodiment, Empathy, Peter Goldie, Phenomenology, Social media
National Category
Philosophy
Identifiers
urn:nbn:se:sh:diva-46422 (URN)10.1163/15691624-12341384 (DOI)2-s2.0-85113739425 (Scopus ID)
Funder
The Foundation for Baltic and East European Studies, 4/2017
Available from: 2021-09-16 Created: 2021-09-16 Last updated: 2023-07-10Bibliographically approved
Gunnarson, M., Kapeller, A. & Zeiler, K. (2021). Ethico-Political Aspects of Conceptualizing Screening: The Case of Dementia. Health Care Analysis, 29, 343-359
Open this publication in new window or tab >>Ethico-Political Aspects of Conceptualizing Screening: The Case of Dementia
2021 (English)In: Health Care Analysis, ISSN 1065-3058, E-ISSN 1573-3394, Vol. 29, p. 343-359Article in journal (Refereed) Published
Abstract [en]

While the value of early detection of dementia is largely agreed upon, populationbased screening as a means of early detection is controversial. This controversial status means that such screening is not recommended in most national dementia plans. Some current practices, however, resemble screening but are labelled “casefinding” or “detection of cognitive impairment”. Labelled as such, they may avoid the ethical scrutiny that population-based screening may be subject to. This article examines conceptualizations of screening and case-finding. It shows how the definitions and delimitations of the concepts (the what of screening) are drawn into the ethical, political, and practical dimensions that screening assessment criteria or principles are intended to clarify and control (the how of screening, how it is and how it should be performed). As a result, different conceptualizations of screening provide the opportunity to rethink what ethical assessments should take place: the conceptualizations have different ethico-political implications. The article argues that population- based systematic screening, population-based opportunistic screening, and case-finding should be clearly distinguished.

Place, publisher, year, edition, pages
Springer, 2021
Keywords
Screening, Dementia, Case-finding, Conceptualizations, Performativity
National Category
Philosophy
Identifiers
urn:nbn:se:sh:diva-44563 (URN)10.1007/s10728-021-00431-3 (DOI)000629469400001 ()33725216 (PubMedID)2-s2.0-85102849655 (Scopus ID)
Funder
Swedish Research Council, 2016-00781The Foundation for Baltic and East European Studies, 4/2017
Available from: 2021-03-17 Created: 2021-03-17 Last updated: 2023-07-10Bibliographically approved
Principal InvestigatorSvenaeus, Fredrik
Co-InvestigatorGunnarson, Martin
Research StudentWennergren, Anna
Coordinating organisation
Södertörn University
Funder
Period
2018-01-01 - 2020-12-31
Keywords [sv]
Östersjö- och Östeuropaforskning
Keywords [en]
Baltic and East European studies
National Category
PhilosophyEthics
Identifiers
DiVA, id: project:1757Project, id: 4/2017_OSS

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