Towards an Empirically Informed Account of Phronesis in Medicine

In the field of medical virtue ethics, the concept of 'phronesis' (or practical wisdom) plays a crucial role. Indeed in medical ethics, the good ethical judgement of the medical practitioner is of such importance that Pellegrino and Thomasma (1994) have called phronesis 'medicine's indispensable virtue'. In recent years there has been a flurry of interest in phronesis in medicine and a number of important theoretical questions have been identified regarding phronesis: (1) is phronesis more akin to thinking or theorising or to feeling and intuiting?, (2) can phronesis be communicated and explained or is it individual and personal? and (3) is phronesis needed in all decision-making in medicine or only in the making of decisions that are ethically fraught? In this paper we argue that, while these questions have received attention on the theoretical level, empirical investigation has the potential to shed light on these questions from the perspective of medical practice in the real world. Indeed, because virtue ethics insists that virtuous action can only be understood properly in the context of real decisions (and not in the abstract) there are good grounds for thinking that understanding phronesis must involve attention to real world particulars. In particular, we hold that empirical investigation of phronesis will have to involve in-depth narrative interviewing and analysis along with an arts based approach to presentation of findings.