Logic of care versus logic of choice in modern concepts of medical practice

Abstract

The article compares two fundamental and conflicting principles in the ethical interpretation of clinical experience — the patient's right to medical choice and care as an immanent ethics of healing. Conceptual attempts to theoretically and empirically justify an unconditional priority of care in modern social and humanitarian research of medicine, as well as the desire to include the logic of choice in the logic of care are made from different methodological perspectives and on the basis of different intellectual traditions. Thus it is more important to compare the key concepts of care on this issue in order to reveal the global trend in understanding the essence of medical experience. The article offers a comparative analysis of the following: firstly, the arguments of an American researcher Joan C. Tronto, formulated in the context of universal political theory and ethics, but relevant to the field of medicine, secondly, the theory of care of the German doctor and philosopher of medicine Klaus Dörner and his opposition to the principle of autonomy, carried out in the practice of informed consent, thirdly, “involved ethnography” of the logic of care, carried out by the Dutch philosopher and anthropologist Annemarie Mol. The comparative analysis of the main texts of these authors on this problem revealed many general statements expressed by them, mainly, the general idea that in the case of chronic disease, which is a typical case of pathology in modern society, the most important is the logic of good care, the logic of interdependence of all subjects of care as a process, and that it is not the political opposition of power and equality here that comes to the centre, but the opposition of care and neglect in everyday medical practices.