Medicine as dialogic rhetoric and the elderly ill woman. (Volumes I-III)
Abstract
Medicine's discursive and non-discursive practices narrowly position patients in significant ways that disempower the elderly woman in illness. Medicine currently lacks the philosophical and theoretical bases to privilege its interpretive nature, and, thus, it ignores the primacy of discourse in its theory and its practice. Part I explains the intellectual history of medicine to show how its changing concepts and practices has led contemporary (bio)medicine to its limited view of both patients and discourse. This section levels specific points of critique against biomedicine for its positioning of patients. Part II offers a multi-disciplinary explanation of why illness and medicine are particularly problematic for the old, but especially for old women. These chapters treat extensively what it means to be woman and old in contemporary America, emphasizing women in their detailed accounts of the physical, psychological, social, and medical contexts which ground the experience of being old. Part III argues for refiguring medicine as dialogic rhetoric. Critiquing correctives from several disciplines, it gathers features for a revision: a phenomenological view of the body as experiential, a return of medicine to the social and of disease to illness, and a view of medicine as relational and interpretive. The last chapter focuses upon rhetoric and dialogic in a developmental progression: noting efforts of Pellegrino and Zaner to relate medicine to the rhetorical and to dialogue; using Lain-Entralgo's healing of rhetoric derived from classical discourse theory to argue for language's ability to function therapeutically; showing Kleinman's chronic care model to provide a rhetoric of healing, the needed methodology for such a view of discourse; and offering Bakhtinian dialogic as a synthesizing theory adequate for grounding a self-aware, other-focused, interpretive medicine. Bakhtinian theory accounts for a radical reposition of the patient within medicine, one that reassigns the elderly ill, especially ill women. Throughout, the dissertation makes reference to an individual case study which the first chapter narrates.
Degree
Ph.D.
Advisors
Lauer, Purdue University.
Subject Area
Language|Gerontology|Womens studies
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