Caring for autonomous Being: identity, addiction and dementia
PhD Thesis Abstract:
In this thesis I call into question the metaphysical assumptions that inform western thought and which dominate our understanding of the world and ourselves within it. I argue that the abstract theoretical orientation of western metaphysics is inherently flawed, generating concepts and structures of thought that have framed a defective understanding of our human way of Being. In seeking explanations in foundational, essentialist terms, metaphysical theorizing has construed human beings and the world in terms of isolated and independent units which work together according to functional, mechanistic associations established through rational processes. Its misguided approach misconceives and thereby loses most of what it means to be human.
Our dominant socio-political practices and institutions have emanated from this metaphysical theorizing, and they have led to a distorted form of life that alienates us from our human way of Being. As our healthcare practices and institutions embody these abstract metaphysical suppositions, I argue that they are unable to attend appropriately to the ways in which health and illness manifest themselves in unique individuals.
In order to go beyond the attenuated paradigm of western theorizing I take a hermeneutic-phenomenological approach, which takes care not to lose sight of our human life-world through abstractions that distort our worldly encounters. I argue that we are not isolated, independent beings that come to know the world and ourselves through detached reflection. Instead we are embodied beings who are fundamentally involved and embedded in a world of significance, constituted and sustained by our dynamic, discursive relations with others. Our involved, discursive relationality has significant implications for addressing questions about our human condition, especially those concerned with cognition, personal identity and autonomy. Grounding these phenomena in the human life-world shows that the way in which we come to understand the world and ourselves within it is fundamentally related to and shaped by the voices of others, so that cognition, identity and autonomy are dynamic, dialogical activities that are phenomenologically implicated in one another. It is an existential situation that requires us to question the dominant abstract theoretical accounts that have distorted these phenomena, along with the socio-political practices and institutions that such abstractions sustain. Accordingly, I argue that if we are to Care for the health of autonomous Being, we cannot condone institutional practices that isolate and alienate individuals from a meaningful life-world. I illustrate this by considering situations of addiction and dementia.