Page 47 - Contribution To Phenomenology

40 RICHARD M ZANER

a more embracing philosophical understanding. Several of these themes
may be delineated here [43].

I. Situation and Context

(1) Whatever the clinically presented problems may be, they are strictly
problems facing the people whose situation it is—for instance, that
specific couple and their physicians.^ By the same token, the problems,
alternatives, decisions, and outcomes, are strictly theirs. Any encounter
presents its own set of issues, moral and other, and these are context-
specific in the sense that working with and on behalf of such persons,
helping them appreciate and advising them regarding specific issues
needing resolution, and the like, requires a strict focus on the situational
definitions of each involved person ([29]; [43]). To understand the clinical
situation, there is nothing for it but to try one's best to get at the
concrete ways in which the participants themselves experience and
understand their situation, and endow its various components (objects,
people, things, relationships) with meaning.
Thus in one case, although the attending physician had told me that
"abortion" was the "problem" needing attention, this was not in fact an
issue—neither for the couple nor for the attending physician, as each of
them were prepared to accept the possibility of early induction and fetal
demise. However, when the dismal prognosis was mentioned and the
couple seemed to become "angry," the attending physician thought they
were angry at him for using the word "abortion." One issue was thus
obvious: to straighten out the different understandings in order to identify
precisely what was at issue for each of those involved, so as to work
toward a common understanding of problems, needed decisions, and,
hopefully, acceptable solutions.
(2) This suggests that in such clinical situations, moral issues are
presented for deliberation, decision, and resolution solely within the contexts
of their actual occurrence. To find out and understand what's going on in
any clinical encounter—^what's troubUng the people, what's on their minds,
and thus to know what has to be addressed and how—requires cautious,
attentive probing of their ongoing discourse, conducts, the setting, and
other matters presented as constituting this specific context. For instance.

^ As I note later, others—persons, professions, and institutions (with their
departments, units, etc.)—are also invariably involved, albeit in different ways.