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or measureable data, symptoms, signs of dysfunctions: this will be the answer the
medical practice is usually based on. But the problem with this very common an-
swer is, that only the third person's position is taken serious, just the perspective of
the medical expert on the biological process and physiology of the body. The thesis
I will put forward, is to extend the definition of being a 'patient' accordingly to the
threefold definition of 'person' as “a bio-psycho-social agent”. Thus, the question
how we can notice or confirm that a person is a 'patient', should be answered with
the following disjunction: A person is called a patient, needs help and gets treatment
in medical care, if either A or B is valid, that means:
(A) if a person is suffering or showing symptoms OR
(B) if a person generates suffering or induces symptoms in her surrounding.
If A, we should make a further distinction between (a) and (b) - both a function of
the observer's point of view:
(A.a) if the suffering or symptoms are perceived from the person herself, i.e. expe-
rienced from the first person's point of view. So there is an expression and
consciousness of suffering, pain or at least uneasiness by the person herself.
(A.b) if a symptom or anomaly is observable from outside, by monitoring from the
third person's perspective.
It is pretty clear, that (a) does not presuppose (b), but it may be interesting to con-
sider, that also (b) does not presuppose (a) - both kind of indications are independent
from each other. Actually (a) could be valid but not (b). Take for example a per-
son in pain without the finding of any measurable indications by medical diagnosis.
And vice versa there are persons without any feelings of pain or being unhealthy,
but for example the diagnosis of leukemia could be derived from an analysis of the
blood.
The case of B often goes unnoted in the discussion about the question how to
decide, whether a person is a patient or not. B is the case, if a person isn't able to
feel herself ill or in pain, and there's also no bodily sign of illness or disease pattern
observable from outside. But she could be called a patient, if she raises pain or
suffering in her environment, acting in a destructive way to other people's health.
There are some examples to mention: a psychopathic or a homicidal maniac like
the Norwegian Anders Breivik should be paradigmatically for this case B, but also
e.g. an alcoholic surgeon making mistakes or causing an accident. They have in
common a non-working (self-)consciousness of (mental) pain, even less for the pain
of others; they usually have no feeling for themselves being ill or having problems
in that situation, and there are no physical indications of disease. Although a person
is accepted as “a patient” in the sense of B, than the consequences of her actions are
forcing diagnosis and intervention of physicians in medical care and therapy.
