Page 69 - Contribution To Phenomenology

62 RICHARD M ZANER

The involvement of the ethicist is a work of practical distantiation:
reflective, circumstantial understanding ("detective work") whose primary
focus is the relationship itself^the set of multiple interrelationships,
significances and weights—seeking to enable or empower those whose
situation it is and who must make needed decisions. The clinical ethicist
is thus to be held accountable, in ways appropriate to that work: to be
responsible for what is and is not said and done, and responsive to those
whose situation it is (and who request the ethicist's involvement in the
first place).
The narrative forms people give to their illnesses are displayed and
embodied in a range of feehngs that are most immediately lodged in
specific images and figures, which become expressed in prevailing
commonsense categories (in some part personal, in large part socially
derived), and include the person's own understanding of the clinician's
words, gestures, settings, and conducts. Their relationship is, while
asymmetrical, a special form of mutuality: the encounter between
reflexively, intimately related selves within an experienced asymmetry of
vulnerability and power, whose exercise is under profound moral
constraints.
If nothing else, the phenomenological explication of the clinical
event—with its emphatic focus on the specific circumstances, experien-
ces, interpretations, feelings and circumstances of those actually involved;
on evidence; and on freely considering and varying the range of examples
in order to detect and give faithful expression to the themes invariant or
common to clinical encounters—forces us to re-think not only such topics
as "informed consent" or "confidentiality," but more fundamentally, to
appreciate the range of evident feelings that are situationally displayed as
embodied expressions or presentations of the participants' moral concerns,
their own sense of **what's worthwhile." Through that, interesting and
important glimpses into the sense of the moral order itself are achieved.^^

^^ An earlier version of this paper was presented at the annual meeting of
the Society for Phenomenology and the Human Sciences, in Memphis, TN, October
18, 1991.