Disease, health, and the person. How ontology works as a (mis)treatment tool in clinical contexts
Dr Alexandra Pârvan argued that ontology is at work in clinical contexts, and just as virtually anything else, it can either help or hinder. Both clinicians and patients answer for themselves, whether reflectively or not, the basic ontological question “what is this?” applied to disease, health, patient, person/self, treatment, medical care, the clinician’s role, the object of treatment, etc. For instance: What it is to be a person with disease – is the person something else with the disease? is the person-with-disease something less? is the person to be equated with the disease in treatment? What is the entity that needs treatment? Are person and disease to be treated and acknowledged separately, as two different entities? What is health-within-illness, and what it is to be healthy? etc. Answers to these questions are inevitably produced, and they constitute metaphysical assumptions which are often unrecognised, and which permeate the treatment settings and affect the way care is provided, received or self-administered. For this reason I argue for the need to provide “metaphysical care”. Pârvan’s focus was to show that the ontology instinctively at work in both clinicians and patients has ancient roots, conflicts with what can count as person-centred care today, and does not work well in long-term treatment. Parvân then sketched an alternative ontology, which she called “transgressive”, and which, when adopted, may be regarded as one way of providing metaphysical care and self-care.