The Experience of Pain and its Clinical Implications

  • Drew Leder
Part of the Philosophy and Medicine book series (PHME, volume 40)


Diagnosis is an ontological event. That is, to arrive at a diagnosis is not simply to solve a puzzle; it is to ratify a vision of reality. When the words “peptic ulcer disease”, for example, are pronounced, the ambiguous complaints of the patient — gnawing pain, hunger, and the like — are reorganized into a medically defined world. Events take on a new spatial contour: they now center around and radiate from the duodenum. Causality is given a mechanistic reading. It is physiological mechanisms — the secretion of acid, the erosion of tissues — that order this world. As diagnosis goes hand-in-hand with prognosis, a projected future is brought into being. Moreover, a certain course of action is prescribed, as diagnosis helps determine the proper mode of treatment. The symptoms of the patient are thus captured within a structured world-view, with spatial, temporal, causal, and prescriptive dimensions.


Peptic Ulcer Disease Medical Encounter Voluntary Euthanasia Ontological Event Therapeutic Encounter 


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Copyright information

© Kluwer Academic Publishers 1992

Authors and Affiliations

  • Drew Leder
    • 1
  1. 1.Loyola College in MarylandBaltimore

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