Roxana Baiasu

The paper offers a phenomenological approach to dementia, and consideres certain ethical issues related to epistemic injustice in healthcare settings. The phenomenological analysis indicates that there are fundamental layers of sense making which are preserved in dementia. By shifting the focus away from deficits to basic sense-making capabilities maintained in this condition it is possible to understand how certain new practices of sense-making can be developed in social, collaborative ways which involve both caregivers and patients, and can overcome epistemic injustices in healthcare settings and institutions. The focus on deficits and incapacities can lead to the devaluation, marginalisation and disempowering of individuals affected by dementia, and can also cover up valuable resources for potential restructuring of experiences and modes of being in the world. Considering mental illness in terms of such resources for meaning reconstitution through resilient strategies of life-coping can be empowering for both individuals affected by dementia and caregivers, and can improve the well-being of both groups. This paper contributes in this way to person-based and value-based practices which can be pursued in partnership with evidence-based healthcare.

Many classical approaches in the area of phenomenological pscyhopathology focus on structures of lived experience of mental illness and overlook the role social context plays in the formation of lived experiences. The paper addresses this issue and contributes to recent research which has pointed out that there is a need for an approach to mental health which investigates the role of context in shaping lived experiences. We propose a conception of contextuality (or situatedness) which we develop in terms of two main characteristics: intersectionality and social relationality of the human condition. We take context to be shaped by social interdependence and by the intersection of multiple factors including gender, race, ethnicity, class, socio-economic status and power relations. We develop this analysis in relation to substance misuse, refer to, and compare, certain case studies and perspectives from Brazil to illustrate our approach which can, however, be applied to other areas of mental health. We suggest that the proposed contextual approach is crucial for an in-depth understanding of psychopathology from a phenomenological perspective and in relation to contemporary ethico-political issues concerning social differences and inequalities in mental health.

It can be said that the concept of vulnerability is crucial for the understanding of health and wellbeing. Wellbeing has been taken to be at the core of the concept of health (as the World Health Organisation also defines it). In this paper, I suggest that a proper understanding of health and wellbeing should start with an investigation of vulnerability and ill health and, in particular, the lived experience of these aspects of the human condition. The lived experience of vulnerability and, in particular, ill health involves physical, mental and social suffering as well as experiences of wrongs, harms and injustices which are often rooted in certain misconceptions and myths about vulnerability, illness and mental ill health. I argue that dominant notions of ‘vulnerability’, ‘health’, ‘wellbeing’ are not only unclear but unrealistic and ethically problematic. This paper seeks to expose some of these limitations and, at the same time, offers a contribution to the clarification of the concepts at issue. The aim is to develop a more inclusive and realistic conception of health and wellbeing which, in its turn, can help promote life-enhancing possibilities to be and to live well in health or illness. The basic plan of the paper is this: I discuss two concepts of vulnerability, and point out certain limitations of dominant approaches to them. I offer an alternative understanding of these two concepts of vulnerability, and of the relation between them. I apply this analysis to certain discussions concerning illness and mental health in order to identify life-enhancing possibilities of vulnerability that constitute resilient wellbeing and are conducive to health. As part of this discussion, I point out the social, relational and intersectional aspects of vulnerability, resilient wellbeing and health, and indicate how the approach I propose can contribute to current ethical and political discussions about these issues.

A positive reconceptualization of vulnerability involves a number of levels of inquiry; arguably, a fundamental or, at least, central level is the phenomenology of vulnerability with which I am concerned in my paper. By drawing on existential phenomenology and by engaging with Pamela Sue Anderson’s positive account of vulnerability, I develop a phenomenological conception of vulnerability as “openness” and pursue it in new directions which connect it to the metaphysics and epistemology of vulnerability. This approach brings to the fore the possibility of resilience in the face of serious adversities which affect our lives, and draws some ethical implications in relation to this. I engage with recent work in the area of the phenomenology of illness to elaborate certain parts of the investigation.

This paper takes issue with Heidegger's claim that discourse and understanding are equally basic in the constitution of our making sense of the world. I argue that Heidegger cannot consistently establish this claim, and that discourse can be thought of as being more basic than understanding. The proposed line of thinking has the advantage of shedding light on both the finitude and the normativity of our making sense of the world. Thus, by setting up an exchange with the later Wittgenstein's discussion of rule-following makes it possible to develop an approach to the normativity of meaning which was not readily available on Heidegger's account. Further, the paper offers an inquiry into a certain aspect of our finite sense of the world which, in spite of Heidegger's marked attention to finitude, was obscured by his approach to discourse. The implications of the argument might be far-reaching. The view of a basic role of discourse can put into question Heidegger's guiding vision according to which time alone is ultimately the fundamental constituent of our sense of what there is. The engagement with Wittgenstein indicates, in conjuction with other themes of the paper, that there are certain perspectives and issues in phenomenology which are much closer to aspects of the analytic tradition than is usually granted.

The paper addresses two related questions: 1. the much debated issue concerning philosophy's proper way of engaging with religion, and 2. the extent to which religious concerns belong to our existence. If philosophy is understood as the hermeneutics of existence, that is, as the self-interpretation of existence, as the early Heidegger proposes, then the way the second question is answered bears on the approach to the first issue. While endorsing Heidegger's claim in the 1920s that philosophy should be autonomous and neutral in relation to religious concerns, I reject his view that this can be achieved through a silencing attitude characteristic of a “fundamentally atheistic” philosophy. I link Heidegger's failure to offer a convincing response to the first question to the way in which he addresses the second question as to whether religious concerns essentially belong to our existence. In contrast with his views on the second question, which often seem to propose a negative answer to it (but which, I claim, are not as not as clear as it is sometimes assumed), I argue that spiritual comportment is an essential aspect of our life. How can then philosophy ‘transcend’ it and be religiously neutral without becoming silent about it? I argue that philosophy can be religiously neutral and, at the same time, speak about spirituality as an open question within a shared space.

In this paper, I am concerned with certain phenomenological contributions to person-centred practices in healthcare. I propose a meaning-centred phenomenological approach to illness and contrast it with certain body-centred and feeling-centred accounts. I suggest that the proposed approach complements, rather than competes with, these other accounts in the area of phenomenology of illness. This is illustrated, for example, by the way the proposed meaning-centred approach tackles certain general challenges to the phenomenology of illness. I pursue this approach to develop an account of illness as involving a loss of meaning. However, I point out that at the heart of illness lies the possibility of resilience. Resilience is existentially understood as enacting a reconstruction of meaning. I point out that resilience and certain related cognitive mechanisms make well-being possible. Here, to be well is existentially understood as being able to find meaning in life. The phenomenological analysis of existential resilience and well-being I offer in this paper indicates that resilient ways of being which enable well-being can be learned; the analysis thus brings to light deep motivations for supporting resilient learning through healthcare practices and policies.

I take it that A. W. Moore is right when he said that ‘Wittgenstein was right: some things cannot be put into words. Moreover, some things that cannot be put into words are of the utmost philosophical importance’. There is, however, a constant threat of self-stultification whenever an attempt is made to put the ineffable into words. As Pamela Sue Anderson notes in Re-visioning gender in philosophy of religion: reason, love, and epistemic locatedness, certain recent approaches to ineffability—including Moore’s approach—attempt to find a ‘third way’ of engaging with it, which displaces the traditional dichotomy between the effable and the ineffable, that is, between what can be said and what cannot be said. In this way, they seek to overcome the threat of self-stultification mentioned above. Still, one important challenge to this kind of approach, which Moore addresses, is, as he puts it, ‘to show how it is possible’ to talk about the ineffable ‘without belying its very ineffability’. His solution to the problem of the ineffable takes the notion of ‘knowing how’ to play a central role, and is formulated in accordance with his commitments to truth and objectivity. A further important challenge to the kind of approach to the ineffable Moore proposes concerns the issue of objectivity. In Re-visioning gender in philosophy of religion, Anderson draws attention to our epistemic locatedness, which brings in questions concerning, for example, gender and culture. Pursuing this view, the challenge is to show ineffable insight without ignoring our epistemic locatedness and, in particular, the role of gender in the conceptualisation and imagery through which we seek to come to terms with the ineffable. My paper deals with these challenges. By engaging with Moore’s and Anderson’s discussions of the ineffable, I examine how it is possible to talk philosophically about the ineffable, without breaking a commitment to enlarged or objective thinking, and without ignoring the epistemic locatedness of thinking.

This paper argues against the priority of temporality over spatiality, which Heidegger defends in Being and Time. The argument, however, does not follow the turn in Heidegger's philosophy and his later retrieval of the spatial but is developed as a delimitation—that is, as an internal critique and reconstruction—undertaken within the transcendental framework of his early thinking. This delimitation proposes a demonstration of the fundamental role of spatializing, defined as dissemination, in the constitution of human Being-in-the-world. A rethinking of human Being-there in terms of the co-originality of spatiality and temporality permits a revisiting of the question of the transcendental and makes it possible to pursue the overcoming of a philosophy of the subject that, critics often point out, Heidegger unsuccessfully sought to transgress in his early work.