Page 58 - Contribution To Phenomenology

PHENOMENOLOGY AND THE CLINICAL EVENT 51

Science and medicine are practices in this sense. Indeed, precisely
because the practitioner experiences the field, s/he comes to recognize
what Maclntyre terms the "goods" internal to it (its "standards of
excellence" or ^Virtues") ([19], p. 175) and perhaps even periodically
reflects on one or another aspect of it. On the basis of such experien-
ces and reflections, one can (and sometimes must) stop and think about
the field and one's involvement.
To reflect in this sense requires a specific shift of focal attention
(epoch6)—away from actual involvement in clinical cases for their own
sake, to considering them as examples of the practice—an attentional shift
that needs to be sustained throughout the reflective project (reduction).
To stop and think about the efforts and actions specific to any field of
practice is, on the basis of one's own practical experiences, to become
reflectively attentive to its inherent "intention" ([38], pp. 125-141). This
complex act might be termed a sort of "practical distantiation," or
circumstantial understanding. It is, more simply, to reflect in the
specifically phenomenological sense.
At one point Husserl observed that this method is the very same as
that which "a cautiously shrewd person follows in practical life wherever
it is seriously important for him to *find out how matters actually are'"
([12], pp. 278-279). Just this type of seriousness is quite evident in every
clinical encounter, where patients and physicians (and others) know how
vital it is for everyone involved to know and understand what they face.
To the extent that situational participants seek to understand, they engage
in at least a form (perhaps only the first stages) of reflection—"stages,"
for they rarely go further into philosophical issues. Moreover, although
their reflections are (Husserl might have noted) only the "beginning" of
wisdom, it is "a wisdom we can never do without, no matter how deep
we go with our theorizings" ([12], p. 279).

C. Evidence
Whatever may be at issue, the point is that the "seriously shrewd"
person must judge and decide on the basis of sound evidence—precisely
because the issues faced are vital. To apply Husserl's words, the patient
no less than the physician must judge "on the basis of a giving of some-
thing itself, while continually asking what can be actually *seen' and given
faithful expression" ([12], pp. 278-279). Whether one has practical or
theoretical concerns (a patient trying to understand what's going on and
what to do, or a physician trying to interpret diagnostic tests), to seek