One of the Heidegger’s unfinished projects is potentially the most useful in the phronetic application of his hermeneutic ontology in an existential region of being such as nursing: metontology.
While abandoned as a distinct project in the late 1920s because of its concern with the ontic instead of the ontological, Heidegger ventured into the field of metontology late in his career, namely in the application of his phenomenological insights into questions of medicine in his dialogues with medical practitioners between 1959 and 1969 at the home of the Swiss psychiatrist Medard Boss, the transcripts of which were published as Zollikoner Seminare in 1978. Although steering close to the fundamental theme of ontological difference developed in Being and Time, Heidegger nevertheless felt challenged by the manifold instances of being (Sein) as beings (Seiende) that his audience of doctors and psychiatrists faced daily in their work. The unresolved methodological tension sometimes forced Heidegger to fall silent. For our purposes, it is precisely in this lack of resolution or disclosedness that a new pathway in phenomenological methodology may be found.
Where Heidegger encountered the boundary of language in ontology is where metontology begins and a genuine phenomenology of the ontic, which we experience through our senses, can be formulated. Respecting the richness of physis in the ontic, this is a project projecting itself in the futurity of time which is full of philosophical promise.
Phenomenologically speaking, meontology is an extension of the ontological while it deals exclusively with the ontic. The overall hermeneutic schemata of ontological difference is thus retained. This observation is based on Heidegger’s emphasis in Zollikon Seminars (Heidegger, 2001, 80-81): Dasein is embodied because it is spatial in its being in the first place. The body does not come before space. Space is the precondition of bodily being.
Thinking beyond Heidegger, the ontological priority of space over the ontic phenomenon of the body raises another question: ultimately, there may be little or no ontological difference between body and machine (such as cyborg) as far as being-embodied-in-space is concerned. This makes room for a phenomenological enquiry into artificial intelligence, or the simulation of the human mind or existential projection per se, if not even thrownness (Geworfenheit) into the world.
Reflecting further on the meaning of Dasein in this futuristic scenario, does not the traditional question of Geist – spirit or ghost – resurface as we seek to redefine the meaning of being human in Dasein?
Heidegger reflects on being (Sein) as not only the most universal concept, but also that which is ownmost – it is the hermeneutic site where “self” arises, persists and passes (as being-towards-death in the temporalisation of Dasein). Yet grounded in the fundamental phenomenon of care (Sorge), Dasein is not simply a self unto oneself but is a being (Seiende) that exists for the sake of others: its existence is thrown (geworfen) into Mitdasein, i.e. the being-with (Mitsein) of more than one Dasein (cf. Peplau on interpersonal relations). Existentially speaking, the cul de sac of solipsism – a self that is trapped within itself with no reference point outside it – is an impossibility. This is the logic of hermeneutic phenomenology.
Nursing, as a systematic, historicised and ever developing framework providing knowledge and practice of care (Pflegewissenschaft in German), thus has hermeneutic phenomenology as its logic. Pflege is a poignant form of Sorge that works directly with both healing and decline, hence life and death, or the enigma of existence tout court.
Recent interpretations of Contributions to Philosophy, Heidegger’s most significant Nachlaß, follow his hermeneutic trajectory of leaving from Dasein to the history of being as the fundamental feature of the difficult notion of Ereignis. Yet every leap is essentially a earth-sky-earth trajectory – with earth as the ground of the leap and of being itself. This is the case even if earth opens up as abyss (Abgrund) (“the staying away of ground”) in Heidegger’s diagnosis of his times as “abandonment of being” in Contributions to Philosophy.
Moving away from Heidegger and tapping into the ancient streams of esoteric understanding in all major spiritual traditions, we can invoke the famous hermetic principle of “As above, so below”. The leap of Contributions to Philosophy needs the ground of Being and Time – these two great moments in Heidegger’s thinking are not separated from, let alone opposed to, each other.
The fundamental phenomenon of care (Pflege) in nursing, in its attunement of the Dasein of the ailing other, provides a link in nursing theory between Being and Time and Contributions to Philosophy. Nursing thus becomes a guiding mode of being that grounds the leap: a total openness to the futurity of being in, say, caring for someone who may not have a full life span on earth. In this care, essential thinking about being awaits recognition and cultivation in the existential openness of aletheia. Being is incarnated in the care that one Dasein has for another – which in nursing is secured, expected and anticipated with no deviation.
Leap (Sprung), according to Heidegger, is leaping from and into the primordiality of being – the making possible of the meaning of being and its understanding and interpretation -, because the primordial is the primary leap in ontological thinking and in hermeneutic saying, which is the projecting open of being itself in the clearing (Lichtung) of aletheia, where Dasein positions itself in the ontological difference between being (Sein) and beings (Seiende) as the most fundamental leap of its being. Indeed the ontological difference is the primordial difference in the question of being – in Dasein‘s posing of its first question that, driven by care, opens up the meaning of its being-in-the-world. Given that being-in-the-world is phenomenologically describable as Dasein‘s Mitsein, in being mindful of the primordial leap of being, what can be gained in understanding the interrelationships that is basic to Dasein‘s existence in the world? In other words, given that being is temporal-spatial in phenomenology, what is the temporality and the spatiality of the interrelatedness of Dasein with one another in the environing of the worldhood of its being-in?
Dasein has its basis in the world through a disclosed mode of being known as care (Sorge), which enables Dasein‘s being-in that it is circumspect about, and which protects Dasein from being cast out into the non-relational spatiality of nothingness. Despite Dasein‘s own being-towards-death (Sein zum Tode), there is never anything nihilistic about the meaning of being qua Dasein. Death, rather than being the culmination of nihilism (nothingness as pure negation), actually is the fulfilment of care, which is also the gathering together (legein) of Dasein in Mitdasein – the logos of phainomenon which is hermeneutically appropriated in the Ereignis that is the coming to itself of understanding as the fundamental ontology of being. Indeed with Ereignis as the ultimate point of reference in ontological thinking, every moving forth is also a coming back – the earth-sky-earth trajectory of the leap. In the situation of care, Dasein always returns to the other (das Andere), thus making self and alterity inseparable. Care is the non-dualistic unity of being – of self and other, of sky and earth, of humans and gods.
Given that hermeneutics is founded upon a hermeneutic circle that occurs primordially to the “movement” of understanding and interpretation, intersubjectivity cannot be avoided.
A 2013 paper by June H Park called Health care design: Potential und Perspektive contains insights that resonate with Heidegger’s ontological reflections on handiness (Zuhandenheit), meaning and the worldhood of the world.
It may be said that Gadamer’s emphasis on phronesis in his philosophical hermeneutics is, in terms of the history of being (Seinsgeschichte) in modern times, a type of fulfilment of Heidegger’s fundamental ontology (Fundamentalontologie) when the latter is commonly faulted for his lack of a theory of ethics in his major work Being and time. Gadamer emphasises that in the Aristotelian tradition, philosophers prove their mettle through phronesis – the wisdom gained from philosophy is put into good action for the benefit of humanity. Aristotle himself came from a medical family – his father Nicomachus was a court physician to the king of Macedonia – and received some training in Greek medicine.
Nursing theory is an exemplary form of phronesis in that its philosophical import is matched with the actual praxis of caring for the sick and the dying. Nurses have a unique form of presence (Anwesen) as the source and the provider of caring (Pflegen). Being caring, a nurse’s presence has the spatial significance of nearness and availableness. A nurse cannot do his or her job by being remote and unavailable. The clearing of being (Lichtung des Seins) of a nurse’s being-there (Dasein) takes place in the disclosive (erschloßende) mode of nearness (Nahe) and availableness (Zuhandenheit) in a hermeneutic circle of caring that involves the patients as well. In essence, caring involves access (Zugang) that is reciprocated in the being-with-one-another (Mitdasein) of nurses and patients in a clinical setting of care. An insightful phenomenological study in this aspect of nursing can be found in McKenzie et al (2008).
Heidegger never used the word Pflegen as a key concept, despite the fame he gained in Being and time by grounding the temporal phenomenon of care (Sorge) as a principal existential feature of what Dasein is as being-in-the-world (In-der-Welt-sein) or thrownness (Geworfenheit) in the world. Coming from the wisdom of nursing theory, it can be argued that Pflege, no less temporal and bound up with the fundamental mode of being that is being-towards-death, is an eminent form of Sorge. Among its many expressions – Heidegger picks Angst in Being and time -, care fulfils the real and metaphysical virtue of phronesis when it is nursing care.
McKenzie, Heather, Maureen Boughton, Lillian Hayes & Sue Forsyth. (2008) Explaining the complexities and value of nursing practice and knowledge. In Ian Morley & Mira Crouch (Eds), Knowledge as value: illumination through critical prisms (pp. 209-222). Amsterdam, the Netherlands: Rodopi.