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Subjunctive medicine: A manifesto

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  • Hardman, Doug
  • Ongaro, Giulio

Abstract

Despite the manifest advantages of modern medicine, many aspects of the experience of illness and healing are not reducible to bodily dysfunction and its restoration. Clinicians and researchers now largely understand that medical practice needs to accommodate a dual aspectivity of the physical body and the lived body. This is increasingly operationalised through the framework of person-centred care, focussed on initiating, integrating, and safeguarding the partnership between the patient-as-person and the clinician-as-person, informed by a narrative perspective on selfhood. In this manifesto, we develop the narrative focus of person-centred care into an alternative framework for medical practice – subjunctive medicine – grounded in ritual efficacy and an explicit appeal to the imagination. We argue that the healing effects of a clinical encounter are reliant on the subjunctive co-construction of a temporary shared social world for a particular purpose. More explicit awareness of the subjunctive nature of the clinical encounter may expand clinicians’ opportunities for healing, whilst fostering resilience. We further suggest that, to be fully actualised, subjunctive medicine requires a shift towards conscious appreciation of the nature of subjunctivity at the social level; a social reawakening to the power of the imagination in modern medicine.

Suggested Citation

  • Hardman, Doug & Ongaro, Giulio, 2020. "Subjunctive medicine: A manifesto," Social Science & Medicine, Elsevier, vol. 256(C).
  • Handle: RePEc:eee:socmed:v:256:y:2020:i:c:s0277953620302586
    DOI: 10.1016/j.socscimed.2020.113039
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    References listed on IDEAS

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    1. Mead, Nicola & Bower, Peter, 2000. "Patient-centredness: a conceptual framework and review of the empirical literature," Social Science & Medicine, Elsevier, vol. 51(7), pages 1087-1110, October.
    2. Good, Byron J. & Del Vecchio Good, Mary-Jo & Togan, Isenbike & Ilbars, Zafer & Güvener, A. & Gelisen, Ilker, 1994. "In the subjenctive mode: Epilepsy narratives in Turkey," Social Science & Medicine, Elsevier, vol. 38(6), pages 835-842, March.
    3. Hardman, Doug & Geraghty, Adam W.A. & Lown, Mark & Bishop, Felicity L., 2020. "Subjunctive medicine: Enacting efficacy in general practice," Social Science & Medicine, Elsevier, vol. 245(C).
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