Casey Rentmeester

The events on January 6th should signal to us just how divided the United States is as a country and prompt us to think through some of the challenges we face—as well as what we can reasonably hope for in terms of restoring a belief in the most coveted ideals of American democracy as outlined in the Declaration of Independence, namely, the right to life, liberty, and the pursuit of happiness. Upon analyzing Trump’s rise to political power via the lenses of Hannah Arendt’s concept of ideology and Louis Althusser’s notion of interpellation, I try to find hope through these dark times through looking at the increased momentum of the Black Lives Matter movement and the Youth Climate Movement, two social movements I interpret through the frame of Johan Galtung’s conception of positive peace, that is, as potential infrastructural social systems aligned with social justice that we should enact to promote human flourishing.

There has been increased interest in what the philosophical subdiscipline of phenomenology can contribute to medical humanities due to its dual emphases on practicality and its attempt to understand the experience of others, thus positioning it as a potentially helpful conceptual toolkit to guide clinical care. Using various figures from the phenomenological tradition, most prominently Martin Heidegger and Martin Buber, the authors illuminate relevant philosophical concepts, employ them in various examples, and provide three principles revolving around empathy, communication, and listening to patients’ individual values to guide medical professionals who practice the art of medicine in cancer care settings.

In December of 1899, Sir John Scott Burdon-Sanderson delivered an address to the Middlesex Hospital Medical Society in London on the relation between science and medicine. Commenting specifically on the future of medicine in the upcoming century, he criticized the gap between scientific research in academic settings and the practice of medicine in the clinical setting. He ends by stating that “all depends on whether you accept the proposition I have submitted to you—namely, that the science of medicine, even more than the art, holds the promise of the future” (Burdon-Sanderson 1900, 255). Burdon-Sanderson’s proposition was actualized in the United States through the Flexner Report of 1910, which helped to universalize what medical education would come to look like in the country: the emphasis was placed squarely on science, rather than art (Flexner 1910). While there are still gaps between clinical practice and scientific research, there is no doubt that modern medicine is scientific medicine. There is also no doubt that scientific medicine leads to better health outcomes (Duffin 2010).However, some have argued that the emphasis of medicine as a science has left the art of medicine behind, to the detriment of modern medicine. Thomas Duffy, for instance, an internist at the Yale School of Medicine, states that the aftermath of the Flexner Report “created an excellence in science that was not balanced by a comparable excellence in clinical caring” (2011,276). Indeed, at the onset of our current century, many called for a reinvestment in the art of medicine so as to balance the emphasis on science (The Commonwealth Fund 2002; Committee on the Roles of Academic Health Centers in the 21 st Century 2003; Association of American Medical Colleges 2004). The burgeoning field of medical humanities—that is, the interdisciplinary field dedicated to demonstrating “how the arts and humanities inform and 2elevate the work of healing” (Campo 2005)—is evidence that such calls have been heard. While we surely want to celebrate scientific medicine, there are certain areas of medical practice where the art of medicine is as important, if not more important , as the science of medicine. We argue that one of those areas is the sphere of cancer care in which health professionals are asked not only to treat patients with cancer, but also to help them navigate through what is oftentimes one of the scariest, most vulnerable, and suffering-ridden times of their lives. Using concepts from the phenomenological tradition, we aim to provide philosophical clarity to situations in the medical setting in which health professionals must treat the whole person, rather than simply the person’s body, in order to provide proper patient care, thus highlighting an element of the art of medicine. We end by providing three principles that we think can help guide phenomenologically-informed cancer care.

Philosophy is commonly criticized for being too abstract and detached from practical spheres. Upon chronicling how philosophy has gained this reputation, the authors explore the philosophical fields of phenomenology and hermeneutics that have explicitly attempted to merge philosophy with everyday life contexts. In recent decades, phenomenology and hermeneutics have been applied to healthcare. In the realm of nursing, Patricia Benner's nursing theory is especially informed by phenomenology, which is briefly explored through her relationship with one of her mentors, the philosopher Hubert Dreyfus. The authors then turn their attention to Hans-Georg Gadamer's philosophy in an attempt to mine concepts relevant to the practice of nursing. Gadamer juxtaposed the human sciences from the natural sciences and thought that both needed different approaches: whereas natural sciences are guided by episteme, that is, universal knowledge, human sciences are guided by phronesis, that is, practical wisdom. Gadamer's philosophy is especially helpful in understanding how to cultivate phronesis in nursing wherein a nurse relies upon one's clinical experience to masterfully navigate each unique patient relationship. Nurses must serve as authorities in the realm of healthcare but also be open to the authority of their patients, who ultimately choose their course of treatment in our contemporary era of patient autonomy. Gadamer's philosophy can help us understand why phronesis requires not only practice but also reflection on that practice to be appropriately cultivated. The authors apply this to the realm of nursing in showing how both practice—clinically and via simulation—and reflection—through journaling or dialogue—are necessary for phronesis to emerge.

There have been significant changes in the ways in which humans experience music from the time of the publication of Gadamer’s Truth and Method in 1960 until today. While music was formally listened to in “earthier” formats, whether that be through live concerts or huddled around vinyl record players, we now live in a digital age in which music is largely experienced through what we can refer to as more “liquidated” formats, such as music streaming services or smart speakers and similar modalities in which the music is plugged into an easily accessible system whose very accessibility makes the music easily disposable. Using concepts from Gadamer’s hermeneutics, I think through what it means for music to be in these various formats. While certain modes of musical experience allow for the possibility of auditory Ereignis, that is, a musical event so full of meaning that it is capable of transforming one’s world, others more easily relegate the experience of music to episodic insignificance, that is, as lacking inner coherence. Ultimately, I argue that it matters how we experience music and in which contexts, since those very choices can render the musical elements of our lives as meaningful or meaningless.

Humans face wide-ranging and global challenges in the Anthropocene, the most prominent of which is anthropogenic climate change. One initial pivot towards sustainability, particularly in my home country of the United States, has been to rely heavily on technological innovation powered most obviously by engineers. Using the climate activist Greta Thunberg ’ s speech at the 2018 United Nations Climate Change Conference as my inspiration, I try to show how some of the technology- based solutions only entrench what I call the “ Bestance” mentality, that is, a fundamental stance or orientation toward the natural world in the Anthropocene wherein all entities show up as mere resources. Upon showing the various ways in which traditional ethical approaches and environmental philosophical approaches have proved unhelpful in navigating the challenges of the Anthropocene, I try to demonstrate how a Heideggerian ecophenomenological approach can help us not only understand how the world appears to many of us in the Anthropocene, but also what a more graceful way of being might look like in Heidegger ’ s concept of “ dwelling.” Using specific examples of current technologies pervasively normalized in the United States, including hydraulic fracturing, horizontal drilling, desalination, and artificial nitrogen-based fertilization, I use Heidegger ’ s philosophical concepts to show how the land, sea, and air can show up as Bestand in the Anthropocene, that is, mere materials on hand to be manipulated in order to serve human interests. Ithen utilize Heidegger ’ s notion of dwelling as a useful concept to guide a more graceful way of living in which we respect the way in which things unfold on their own terms using examples similarly embedded in the land, sea and air.

The current breakdown in the relationship between humans and the rest of the natural world is evident in the crisis of anthropogenic climate change. This critical situation has prompted intellectuals to think through a proper name for our contemporary era. Some opt for the “Anthropocene,” the era of humans, which highlights the uniquely human role in planetary destruction. Others prefer the “Capitalocene” to emphasize capitalism’s role in the crisis. Still others argue that our era is marked by an age of information, which the author labels the “Pliroforicene” since pliroforia roughly means “information” in ancient Greek. Having discussed the pros and cons of these labels, the author discusses conscious rebellions against the Capitalocene and the Pliroforicene through the lenses of the work of sociologist Erik Olin Wright and philosopher Richard Polt. The author then argues that Martin Heidegger’s concept of Gelassenheit, which is defined as a comportment towards beings in which one is open to the ways in which they reveal themselves as they are rather than subsuming them into one’s own interests, may prove to play a crucial role in our contemporary era, regardless of what we call it since it allows us to respect the integrity of things.