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comparable with any man-made machine or computer. And in the last part of this
paper I try to show why therefore no medical expert system could work not even in
the future.
To be or to act as an individual patient
or
as a physician means to play a game
of your own, although you are part of a social interplay, that always frames (but
never totally determines) your thinking, feeling and acting in a certain situation and
context, also your state of health and the very own reaction on therapy. It does not
mean, to make 'the' game of your own, but to be involved in an open and uncertain
game - of communication in between others, of responding and reacting to what
happens - in an individual way.
7.2.2
The Integrity of an Individual in Conflict with the Primacy
of the Third Person's Perspective
It is common sense to say, that the intactness or integrity of a person (physically or
in a psychological sense) is a measure and criteria for being 'healthy' or not.
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But
'integrity' of a person or its 'intactness' is not a distinct concept, even not for one
and the same person. In fact it's a function of time and task, of the environment
and of the individual estimation, so it cannot be evaluated from the third person's
perspective.
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What the integrity of an individual means in a certain context and situation relies
(i) on the persons self-perception, (ii) on the individually estimated special situation
(the individual feelings and fears, thoughts and aims, dispositions and former ex-
periences); and it depends also on (iii) the influence and impact of the environment
and social affiliation.
But in medicine, just the non-functioning part of the individual is taken into ac-
count as far as it can be generalized and traced back to a supra-individual bench
mark.
Let me take a self-experienced example: As I was five years old, I wanted to
play the trumpet. The precondition to be allowed to take lessons was a medical
checkup. The check-up found an above-average narrowing of the nose inside walls.
As a consequence the physicians told my parents, that it would not be possible for
me to play the trumpet. Even to have enough breath and power for doing any sports
would be a problem. In consequence of this diagnosis they recommended a complex
surgery to enhance and restructure the nose as a whole.
The other side was my own experience and my parent's point of view, that in fact
I never have had a problem with breathing, nor with sports or running or swimming.
So they decided to refuse this surgery, and I was not allowed to play the trumpet.
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In reference to part (7.1.3) of this paper it should be necessary to extend this criteria also
on the person's environment!
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The 'intactness' depends on the task a person is dedicated to: Handicapped people e.g.
without leg do not feel a lack of intactness if they read a book or playing an instrument.
Only challenged by situations where they would need their leg, they are handicapped.
