rMH 3, 2007, 11-17
Corporeal dramaturgies in the Kingdom of Surface
The exhibition of the body in illness as in curing is the actual condition of our existence. Starting from the multiplicity of its languages, from the enigma, which lives within the bodiness suspended between the unavoidable materiality of its soma, the invisibility of its being the soul’s theatre and its exposure to the world-of-life, the curing meets a third dimension, at the same time generative and generated by the curing act, the one of “flesh”, as defined by Merleau-Ponty, and that the intercorporality between carer and cured is revealed. In the body’s many dramaturgie known by man, the contemporary man finds himself increasingly impoverished and deprived by the immateriality and the hypervisibility with which tech-sciences operate on his body, saved, healed, but also dispersed. We outline here some scenarios of this disappearance-subtraction, oriented towards the “technological body”, the hybrid and the role that Medical Humanities, as thought and style, play in its rediscovery.
rMH 3, 2007, 18-23
The Figures of the body
This text examines the various meanings assumed by a new centrality of the body and its assignments in different domains. Proceeding therefore through “images”, to sketch various scenarios where the contemporary body is inscribed and manifests itself in relationship to the theme illness. Hence, the attention will be given to the ways in which the hurt, lost body, emerges in medical anthropology, taking into consideration real-life and real experiences, moving through the intersection between the social body of representations, the political one of bio-power, and the personal one. What emerges is a body no longer inert, attached to a thriving mind, but a “conscious body”, equipped with a mind. Illness is therefore a form of corporeal practice, not simple somatization, which produces rebellious and “chaotic” symptoms, and opens continual breaches within the conflict between mind and body, nature and culture, the individual and the social body. The obliteration of the body can then become visible and appear within the scenario.
Mario Rossi Monti
rMH 3, 2007, 25-32
On the traces of shame
What place does shame take in psychopathology? People are ashamed to be mad. But is shame only a consequence of madness? Or can the experience of shame also be the trigger of psychopathological experiences? In European psychopathology the centrality of guilt experiences has clouded the role of shame. The author underlines the role of shame in psychopathology and examines: the different reactions and interpretations of shame (modesty, embarrassment, ignominy, blushing); the difficulty of expressing shame through language; the complicated relationship between guilt and shame; the possibility to assemble a “compass” for shame in order to comprehend the different evolutions of this experience.
rMH 3, 2007, 33-35
In between exposure and fragility
This article, starting from a psychoanalytical experience where the patient-analyst dialogue is particularly important, examines the category of contact from a descriptive and ethical point of view, to then describe the words “body”, “nudity” and “intimacy”, in an attempt to paint a picture which expresses a particular style of writing, thinking and living.
rMH 3, 2007, 36-39
To say the body
The re-animator’s problem, in dealing with the difficulty of the research for organs to be transplanted, manifests itself above all as the problem of being confronted with something that is inevitably to be given a name, even if it is designated to something that can not be named in any language. An “unnameable” which we have, never the less, to resign ourselves to name. In naming it we necessarily attribute it a status. But what status? To say the body, one needs to pass through a whole series of qualifications, all with their own mark of the weight of life, of humanity or inhumanity. What is the body of a person who is living, whose remaining life we relentlessly try to save in reanimation? What is the body of this same person when life has abandoned him? Does it become a stock of material at our disposal or does it remain an object worthy of respect? The situation being what it is in the area of activity, in which tensions between different options manifest themselves spontaneously, it is necessary to move into an area of ethics. But if you opt for utilitarianism, believing to overcome the problem at its roots, you will do nothing except aggravate the contradiction.
rMH 3, 2007, 79-86
Necessity and Difficulty of method research
Solving the ethical dilemmas that face an increasing amount of carers, is a procedure that, although based on clinical data and regulations, remains in the domain of free will, relying on reasoning and consideration of the specific case one is confronted with. From a methodological point of view, it is therefore impossible to obtain a magic formula to automatically apply to problematic situations in an attempt at solving them. However, it is possible and necessary to define some elements that guarantee good ethical decisions within the heath care context. The starting point consists in specifying the problem and any possible scope for the care team: the factors that team members can act on and those where there is no freedom to act, ensuing no possibility for change. Therefore it is necessary to remember that for ethical decisions, reasons and choices are required. It is important to stress that facts are not evident by themselves, that they must be interpreted: therefore, the given meaning comes from human intervention and the reasons in favour or against a potential given resolution. In conclusion, analysing carefully the situation, taking into consideration the patients’ desires, complying with the legal guidelines, evaluating the case from an interdisciplinary point of view and in accordance with the principles of autonomy, charity and fairness, are the starting points to define the least insensitive solution of those available.
rMH 3, 2007, 87-88
The loneliness within the emergency
Compared to other medical branches, emergency medicine is characterized by some distinctive features, correlating particularly to temporal contingencies. In this framework, it is not always possible to have all necessary elements for an ethical decision, however the attention to basic bioethical principles must always be present. Therefore, it is not the principles that need to be adapted to the situation, but the methods, while trying to respect, as much as possible, the patient’s autonomy.
Yvonne Willems Cavalli
Valentina Di Bernardo
rMH 3, 2007, 89-93
Interdisciplinary dialogue and the everyday of treatment
Each day we face ethical problems without realizing that the clinical decisions we make, hold ethical implications. Often the difficulty in communication and a lack of collaboration, become the basis for inappropriate methods for discussion. In light of these facts we suggest a method for the decision making process, which should resolve the two main requirements: the need to find answers and solutions and the need to improve communication and collaboration between the care team members.
rMH 3, 2007, 94-100
Ethical reasoning at the bed of the patient
Once the role of clinical ethics is defined, we describe the meaning and aims of ethical consultation. What emerges is the need to define a method for facing ethical dilemmas originating at the patient’s bed. For these reasons we propose some principled arguments. Some common features become evident, above all the need to pay adequate attention the personal history of the patient and the need, through careful meditation, to unite decisions and possible solutions.