Modern Medicine and the Hermeneutical Self: Meaning, Ethics, and Identity

This dissertation reflects critically on the culture of modern medicine, specifically, as a good for us as human beings. The organizing question is, what does it mean for us to inhabit this cultural space well, such that it is experienced as a human good? I identify a long-standing inarticulacy in modern medicine concerning this question and show that the inarticulacy is symptomatic of a deeper obscurity concerning the self's ontology. I argue that we must inhabit the space of modern medicine—broadly conceived as that of clinical, public, and global health—in terms of what I call a "hermeneutical self." This account of the self clarifies the ways in which sources of meaning that persist beyond the self constitute us as selves, and it argues that precisely such sources are increasingly obscure in our detached and empirical modes of knowing and being in modern medicine. I thus elucidate the hermeneutical self as a source and condition for experiencing modern medicine as a human good. The method of argument is hermeneutical and interdisciplinary, and I bring the analysis to bear across five areas of the modern medical experience: that of the obscurity at stake in this dissertation, that of our social ontology, that of our moral goods, that of clinician burnout, and that of health justice. The dissertation in this way constitutes a sustained argument for humanizing modern medicine in terms of what it always already is—a practice for and by hermeneutical selves.