Dissertations, Theses, and Capstone Projects

Date of Degree

9-2024

Document Type

Dissertation

Degree Name

Ph.D.

Program

Philosophy

Advisor

John D. Greenwood

Committee Members

Rosamond Rhodes

Justin Garson

Subject Categories

Applied Ethics | Bioethics and Medical Ethics | COVID-19 | Diagnosis | Disability Law | Disease Modeling | Epistemology | Ethics and Political Philosophy | History of Science, Technology, and Medicine | Internal Medicine | Medical Education | Medical Physiology | Mental Disorders | Philosophy of Science | Primary Care

Keywords

classically medically unexplained condition (CMUC), invisible illnesses, doctor-patient relationship, philosophy of medicine, epistemic injustice, prejudice

Abstract

Patients go to doctors because they want to know what is wrong with them, they want their symptoms to improve, and they want to be cured. But what happens when the doctors do not have the answers? This dissertation fills a lacuna in philosophy, bioethics, and medical education with regard to how to conceptualize complex, largely invisible, medically unexplained conditions, and what it is about them that presents such ethical challenges in the healthcare setting. I navigate the uncertainty of what I call “classically medically unexplained conditions” (CMUCs), with a view to gaining important conceptual and ethical insights. To provide further clarity to the notion of a CMUC, I propose a conceptual framework that includes additional categories of “CMUC-adjacent” (CMUC-a) and “CMUC-former” (CMUC-f), and I explain how, with research and scientific advances, CMUCs can migrate out of their status to become CMUC-f’s. Next, I elucidate the ontological status of CMUCs. In so doing, I identify certain paradigmatic features of these conditions, as well as certain secondary features. After offering insights into the experiences and perspectives of CMUC patients, along with the experiences and perspectives of the doctors who treat such patients, I then examine the ethics of the doctor-patient relationship and offer potential reasons for the breakdown of that relationship when patients have CMUCs. Finally, I propose recommendations to improve patient care.

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