THE WOUNDED SELF AND THE DISMEMBERED FLESH: ANTHROPOLOGICAL SENSE OF COMMUNICATION DYSFUNCTIONS
DOI: 10.23951/2312-7899-2021-3-176-194
The article analyzes communication dysfunctions between patients, consulting geneticists and doctors in the practice of medical genetic counseling. Despite the obvious usefulness of genetic advice for the counseled and their family members, as well as the fact that patients pay for counseling services, they (the counseled) often do not follow these recommendations, putting both their own lives and the lives of the loved ones at risk. How to understand this oddity? As a virtual participation in a hybrid forum, two cases from the practice of genetic counseling are discussed, which, with a significant similarity of the situation, differ from each other in the presence or absence of patient confidence in the scientific knowledge and expert judgments of the geneticist. In order to theoretically interpret the problem posed, an assumption is introduced about the self as a communication dysfunction, which is diagnosed in various value coordinates either as noncompliance in directive models of counseling, or as nonadherence in non-directive ones. If we consider that medicine as a cultural practice is based on a sense of solidarity in the face of bodily suffering, then, in this regard, the patient’s strange, counterproductive behavior may indicate the presence of deep problems in the foundations of modern sociality. The formulation of the narrative imperative is proposed.
Keywords: биоэтика, гибридный форум, коммуникативная дисфункция, комплаентность, уязвлённая самость, расчленённая плоть, множественное тело, коммуникация с одним языком
References:
Augustine. (2013). Ispoved’ [Confessions]. Book 11(XIV). Translated from Latin by M. E. Sergienko. St. Petersburg. (In Russian).
Brown, M. T., & Dussel, J. K. (2011). Medication adherence: WHO cares? Mayo Clinic Proceedings, 86(4), 304–314.
Canguilhem, G. (1991). The normal and the pathological. Zone Books.
Gorbuleva, M. S., Melik-Gaykazyan, I. V., & Pervushina, N. A. (2020). Pedagogical bioethics initiatives. Vysshee obrazovanie v Rossii – Higher Education in Russia, 29(6), 122–128. (In Russian). https://doi.org/10.31992/0869-3617-2020-6-122-128
Grebenshchikova, E. G. (2018). Socio-humanistic contours of technical science: Relevance of humanitarian expertise. Znanie. Ponimanie. Umenie – Knowledge. Understanding. Skill, 1, 28–37. (In Russian). http://dx.doi.org/10.17805/zpu.2018.1.2
Hofmann, B. (2016). Disease, illness, and sickness. In M. Solomon, J. R. Simon, & H. Kincaid (Eds.), The Routledge Companion to Philosophy of Medicine. Routledge. https://www.routledgehandbooks.com/doi/10.4324/9781315720739.ch2 (Accessed: 04.12.2020).
Husserl, E. (2005). (2005). Izbrannye raboty [Selected works]. Translated from German. Territoriya budushchego.
Lekhzyer, V. L. (2009). Subjective meanings of illness: basic methodological distinctions and approaches to research. Sotsiologicheskiy Zhurnal – Sociological Journal, 4, 22–40. (In Russian).
Lotman, Yu. M. (2000). Semiosfera [Semiosphere]. Iskusstvo-SPB.
Melik-Gaykazyan, I. V. (2013). Memory turn: Manifested by bioethics the frailty of intellectual traditions. Idei i idealy – Ideas and Ideals, 1(15):1, 49–63. (In Russian).
Mol, A. (2017). Mnozhestvennoe telo. Ontologiya v meditsinskoy praktike [The body multiple: Ontology in medical practice]. Translated from French. Gile Press.
Rumyantseva, V. A., Shirokov, A. A., & Kurlenkova, A. S. (2019). “Gibridnyy forum”: genetik, sotsiolog i antropolog obsuzhdayut kommunikatsiyu s patsientami i ikh sem’yami [“Hybrid Forum”: A geneticist, a sociologist, and an anthropologist discuss communication with patients and their families]. In P. D. Tishchenko, & S. Yu. Shevchenko (Eds.), Mezhdistsiplinarnaya kommunikatsiya: kazus genomnoy meditsiny [Interdisciplinary communication: The case of genome medicine] (pp. 31–47). OOO “4 Print”.
Sackett, D. L. (1976). Compliance with therapeutic regimens (pp. 1–25). John Hopkins University Press.
Shevchenko, S. Yu., Lavrent’eva, S. V., & Shkomova, E. M. (2019). “Khozhdenie po vracham”, mezhdistsiplinarnost’ i biovlast’ [Attending doctors, interdisciplinarity, and biopower]. In P. D. Tishchenko, & S. Yu. Shevchenko (Eds.), Mezhdistsiplinarnaya kommunikatsiya: kazus genomnoy meditsiny [Interdisciplinary communication: The case of genome medicine] (pp. 48–60). OOO “4 Print”.
Tishchenko, P. D. (2011). Na granyakh zhizni i smerti: filosofskie issledovaniya osnovaniy bioetiki [On the verge of life and death: Philosophical studies of the foundations of bioethics]. Mir”.
WHO. (2003). Adherence to long-term therapies. Evidence for action. https://www.who.int/chp/knowledge/publications/adherence_report/en/ (Accessed: 03.12.2020).
Issue: 3, 2021
Series of issue: Issue 3
Rubric: ARTICLES
Pages: 176 — 194
Downloads: 640