Medicine, Health Care and Philosophy

, Volume 8, Issue 2, pp 165–171 | Cite as

The expert patient: Illness as practice



This paper responds to the Expert Patient initiative by questioning its over-reliance on instrumental forms of reasoning. It will be suggested that expertise of the patient suffering from chronic illness should not be exclusively seen in terms of a model of technical knowledge derived from the natural sciences, but should rather include an awareness of the hermeneutic skills that the patient needs in order to make sense of their illness and the impact that the illness has upon their sense of self-identity. By appealing to MacIntyre’s concepts of “virtue” and “practice”, as well as Frank’s notion of the “wounded story-teller”, it will be argued that chronic illness can be constituted as a practice, by building a culture of honest and courageous story-telling about the experience of chronic suffering. The building of such a practice will renew the cultural resources available to the patient, the physician and the rest of the community in understanding illness and patient-hood.


chronic illness MacIntyre narrative practice virtue 


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  1. Department of Health2001The Expert Patient: A New Approach to Chronic Disease Management for the 21st CenturyDepartment of HealthLondonGoogle Scholar
  2. Department of Health2001The Expert Patient UpdateDepartment of HealthLondonIssue 8Google Scholar
  3. Frank, A.W. 1995The Wounded Storyteller: Body, Illness, and EthicsUniversity of Chicago PressChicagoGoogle Scholar
  4. Levinas, E. 1988‘Useless Suffering’Bernasconi, R.Wood, D. eds. The Provocation of LevinasRoutledgeLondonGoogle Scholar
  5. MacIntyre, A. 1981After Virtue: A Study in Moral TheoryDuckworthLondonGoogle Scholar

Copyright information

© Springer 2005

Authors and Affiliations

  1. 1.Centre for Applied EthicsUniversity of Wales CardiffCardiffUK

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