Open Access Open Access  Restricted Access Subscription Access

Moving past phronesis: clinical reasoning in person-centered care

Samantha Copeland

Abstract


Phronesis has been a popular concept among those attempting to categorize and understand the kind of reasoning that doctor’s employ in the clinic. However, this paper argues that it is not the best possible concept for understanding the kind of reasoning necessary for person-centred care. First, it attends to what is lacking in that concept, and then it proposes an alternative (the concept of effectual reasoning) to demonstrate the potential for a better understanding of clinical reasoning as both open-ended and strategic. That approach is better than phronesis because it allows us to address both relational aspects of autonomy, and the need to center all persons, as such, including healthcare practitioners as well as patients, in healthcare.

Keywords


Clinical reasoning, effectual reasoning, person-centred care, phronesis, effectual reasoning, strategies in uncertainty

Full Text:

PDF

References


Buetow, S. (2011). Person-centred care: Bridging current models of the clinician-patient relationship. International Journal of Person Centered Medicine 1 (1) 196-203.

Sullivan, M. (2017). The Patient as Agent of Health and Health Care. New York: Oxford University Press.

Anjum, R.L. (2016). Evidence based or person centered? An ontological debate. European Journal for Person Centered Healthcare 4 (2) 421-429.

Copeland, S.M. (2020). The Guidelines Challenge. In: Rethinking Causality, Complexity and Evidence for the Unique Patient: A CauseHealth Resource for Healthcare Professionals and the Clinical Encounter. Anjum, R.L., Copeland, S. & Rocca, E., (Eds.). Switzerland: Springer.

Engebretsen, K.M. (2020). Reflections on the Clinician’s Role in the Clinical Encounter. In: Rethinking Causality, Complexity and Evidence for the Unique Patient: A CauseHealth Resource for Healthcare Professionals and the Clinical Encounter. Anjum, R.L., Copeland, S. & Rocca, E., (Eds.). Switzerland: Springer.

Moffatt, F. (2014). Working the production line: Productivity and professional identity in the emergency department. PhD thesis, University of Nottingham. Available at: http://eprints.nottingham.ac.uk/14355/ (last accessed 23 May 2019).

Montgomery, K. (2006). How Doctors Think. Clinical Judgment and the Practice of Medicine. Oxford: Oxford University Press.

Sackett, D.L., Rosenberg, W.M.C., Gray, J.A.M., Haynes, R.B. & Richardson, W.S. (1996). Evidence based medicine: What it is and what it isn’t. British Medical Journal 312, 71.

Hofmann, B. (2002). Medicine as practical wisdom (phronesis). Poiesis Prax 1, 135-149.

McKenzie, C. & Stoljar, N. (Eds.). (2000). Relational Autonomy: Feminist Perspectives on Autonomy, Agency, and the Social Self. Oxford University Press.

McLeod, C. & Sherwin, S. (2000). Relational autonomy, self-trust, and health care for patients who are oppressed. In: Relational Autonomy: Feminist Perspectives on Autonomy, Agency, and the Social Self. McKenzie & Stoljar (Eds.), pp.259-279. Oxford: Oxford University Press.

Jasanoff, S. (2003). (No?) Accounting for expertise. Science and Public Policy 30 (3) 157-162.

Paavola, S. (2004). Abduction as a logic and methodology of discovery: The importance of strategies. Foundation of Science 9, 267-283.

Sarasvathy, S.D. (2003). Entrepreneurship as a science of the artificial. Journal of Economic Psychology 24, 203-220.

Dew, N., Read, S., Sarasvathy, S.D. & Wiltbank, R. (2009). Effectual versus predictive logics in entrepreneurial decision-making. Differences between experts and novices. Journal of Business Venturing 24, 287-309.

Bandini, J. (2015). The medicalization of bereavement: (Ab)normal grief in the DSM-5. Death Studies 39 (6) 347-352.

Aquino, Y.S.J. (2017). “Big eye” surgery: the ethics of medicalizing Asian features. Theoretical Medicine and Bioethics 38 (3) 213-225.




DOI: http://dx.doi.org/10.5750/ejpch.v8i3.1860

Refbacks

  • There are currently no refbacks.