Reinterpreting Medicine: Critical Engagement with Medicine’s Technological Hermeneutic
Isaac Korver, Duke Divinity School, Durham, University of South Carolina School of Medicine Greenville
Modernity, generally, and modern biomedicine, particularly, operate under the assumption that technology is the application of scientific knowledge to accomplish specific ends. This definition of technology is alluring in its simplicity and apparent truthfulness, and it assumes that technology is morally neutral and can be used for good or evil. In his essay, “The Question Concerning Technology,” Martin Heidegger notes that while this “anthropological definition” of technology is correct on one level of meaning, it is incomplete.[1] For Heidegger, technology is not merely neutral but an active process by which reality discloses itself (revealing). This disclosure of reality through technology allows humanity to know and make meaning of the world around us in ways that were previously concealed. In modernity, the characteristic way in which reality discloses itself is through enframing, which is to see and inhabit the world as if nature can be coerced, ordered, and directed in whatever way humanity desires.
While modern medicine has expanded its technological capabilities, it has simultaneously limited humanity’s ability to make meaning of the world around us. Technology is always revealing, according to Heidegger, but enframing marks the singular mode of revealing of modernity because its logic excludes other ways of understanding the world. Under enframing, medicine’s work becomes meaningful only insofar as medicine understands the body in light of utility and functionality. This totalizing way of engaging with the world could also be called a hermeneutic as it operates as an assumed disposition and way in which the world is interpreted. This technological hermeneutic crowds out the ability of the natural world, including the body, to reveal itself on its own terms because its meaning has been determined a priori.
In conjunction with Heidegger’s analysis of technology, I will first argue that medicine is prone to adopting a technological hermeneutic in which the natural world, including the human body, is reduced to resources that are “on call” in service of efficiency and control. This singular mode of interpreting the clinical situation diminishes the clinician’s ability to understand their work and the patients they care for. To demonstrate the shortcomings of this technological hermeneutic, I will examine how this approach fails to attend to the illness narrative of a patient with chronic disease.
I will then argue that, while Heidegger provides an important critique of modern technology, he does not sufficiently develop an alternative hermeneutic that can resist the prevailing technological hermeneutic. I will draw on the work of Hans-Georg Gadamer, Pope John Paull II, and Stanley Hauerwas, to offer a constructive hermeneutic alternative. I will argue that tending to a patient with chronic disease with this hermeneutic entails the following key elements: (1) the primacy of the dialogue between patient and physician as the location of medicine’s work which arises from the nature of heath and (2) a recognition of the “givenness” of the patient and their body, which naturally places limits on the application of technology to the work of medicine, based on what is revealed by the body and the patient’s context.
Finally, I will argue that this hermeneutic can be sustained only insofar as medicine is understood as a moral, interpretive practice, as opposed to a technological one. In this alternative hermeneutic, medicine is not primarily concerned with controlling the body but with forming the character necessary to wisely interpret the disruption in the patient’s body and determine how that disruption ought to be addressed. To adopt an alternative hermeneutic to the technological hermeneutic is to expand medicine’s capacity to understand the kind of work it participates in and to experience the revelation of the body as it is—a gift from God.
[1] Martin Heidegger, “The Question Concerning Technology,” in Basic Writings: From Being and Time (1927) to The Task of Thinking (1964), rev. and ex. ed., ed. David Farrell Krell (San Francisco: HarperSanFrancisco, 1993), 307-341.
While modern medicine has expanded its technological capabilities, it has simultaneously limited humanity’s ability to make meaning of the world around us. Technology is always revealing, according to Heidegger, but enframing marks the singular mode of revealing of modernity because its logic excludes other ways of understanding the world. Under enframing, medicine’s work becomes meaningful only insofar as medicine understands the body in light of utility and functionality. This totalizing way of engaging with the world could also be called a hermeneutic as it operates as an assumed disposition and way in which the world is interpreted. This technological hermeneutic crowds out the ability of the natural world, including the body, to reveal itself on its own terms because its meaning has been determined a priori.
In conjunction with Heidegger’s analysis of technology, I will first argue that medicine is prone to adopting a technological hermeneutic in which the natural world, including the human body, is reduced to resources that are “on call” in service of efficiency and control. This singular mode of interpreting the clinical situation diminishes the clinician’s ability to understand their work and the patients they care for. To demonstrate the shortcomings of this technological hermeneutic, I will examine how this approach fails to attend to the illness narrative of a patient with chronic disease.
I will then argue that, while Heidegger provides an important critique of modern technology, he does not sufficiently develop an alternative hermeneutic that can resist the prevailing technological hermeneutic. I will draw on the work of Hans-Georg Gadamer, Pope John Paull II, and Stanley Hauerwas, to offer a constructive hermeneutic alternative. I will argue that tending to a patient with chronic disease with this hermeneutic entails the following key elements: (1) the primacy of the dialogue between patient and physician as the location of medicine’s work which arises from the nature of heath and (2) a recognition of the “givenness” of the patient and their body, which naturally places limits on the application of technology to the work of medicine, based on what is revealed by the body and the patient’s context.
Finally, I will argue that this hermeneutic can be sustained only insofar as medicine is understood as a moral, interpretive practice, as opposed to a technological one. In this alternative hermeneutic, medicine is not primarily concerned with controlling the body but with forming the character necessary to wisely interpret the disruption in the patient’s body and determine how that disruption ought to be addressed. To adopt an alternative hermeneutic to the technological hermeneutic is to expand medicine’s capacity to understand the kind of work it participates in and to experience the revelation of the body as it is—a gift from God.
[1] Martin Heidegger, “The Question Concerning Technology,” in Basic Writings: From Being and Time (1927) to The Task of Thinking (1964), rev. and ex. ed., ed. David Farrell Krell (San Francisco: HarperSanFrancisco, 1993), 307-341.