Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-05T17:09:45.014Z Has data issue: false hasContentIssue false
  • English
  • Français

Phenomenology of Bodily Integrity in Disfiguring Breast Cancer

Published online by Cambridge University Press:  11 March 2020

Jenny Slatman
Get access Rights & Permissions [Opens in a new window]

Abstract

In this paper, I explore the meaning of bodily integrity in disfiguring breast cancer. Bodily integrity is a normative principle precisely because it does not simply refer to actual physical or functional intactness. It rather indicates what should be regarded and respected as inviolable in vulnerable and damageable bodies. I will argue that this normative inviolability or wholeness can be based upon a person's embodied experience of wholeness. This phenomenological stance differs from the liberal view that identifies respect for integrity with respect for autonomy (resulting in an invalidation of bodily integrity's proper normative meaning), as well as from the view that bodily integrity is based upon ideologies of wholeness (which runs the risk of being disadvantageous to women). I propose that bodily integrity involves a process of identification between the experience of one's body as “Leib” and the experience of one's body as “Körper.” If identification fails or is not possible, one's integrity is threatened. This idea of bodily integrity can support breast cancer patients and survivors in making decisions about possible corrective interventions. To implement this idea in oncology care, empirical‐phenomenological research needs to establish how breast cancer patients express their embodied self‐experiences.

Type
Articles
Information
Hypatia , Volume 27 , Issue 2 , Spring 2012 , pp. 281 - 300
Copyright
Copyright © 2012 by Hypatia, Inc.

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andrade, W. N., Baxter, N., and Semple, J. L. 2001. Clinical determinants of patient satisfaction with breast reconstruction. Plastic and Reconstructive Surgery 107 (1): 46–54.CrossRefGoogle ScholarPubMed
Arora, N. K., Gustafson, D. H., Hawkins, R. P., McTavish, F., Cella, D. F., Pingree, S., Mendenhall, J. H., and Mahvi, D. M. 2001. Impact of surgery and chemotherapy on the quality of life of younger women with breast carcinoma. Cancer 92 (5): 1288–98.3.0.CO;2-E>CrossRefGoogle ScholarPubMed
Ashley, B. M. 1985. Theologies of the body: Humanist and Christian. Braintree, Mass.: The Pope John Center.Google Scholar
Bayne, T., and Levy, N. 2005. Amputees by choice: Body integrity identity disorder and the ethics of amputation. Journal of Applied Philosophy 22 (1): 75–86.CrossRefGoogle ScholarPubMed
Bazell, R. 1998. Her‐2: The making of Herceptin, A revolutionary treatment for breast cancer. New York: Random House.Google Scholar
Beauchamp, T. L. 2007. The “four principles” approach to health care ethics. In Principles of health care ethics, ed. Ashcroft, R. E., Dawson, A., Draper, H. and McMillan, J. R.Chichester, UK: Wiley.Google Scholar
Beauchamp, T. L., and Childress, J. F. 1994. Principles of biomedical ethics. Oxford: Oxford University Press.Google Scholar
Beauvoir, S. de. 1948. The ethics of ambiguity. New York: Citadel Press.Google Scholar
Bergoffen, D. 2009. Exploiting the dignity of the vulnerable body: Rape as a weapon of war. Philosophical Papers 38 (3): 307–25.CrossRefGoogle Scholar
Campbell, C. S. 1998. Religion and the body in medical research. Kennedy Institute of Ethics Journal 8 (3): 275–305.CrossRefGoogle ScholarPubMed
Charles, C. A., Gafni, A., and Whelan, T. 1999. Decision‐making in the physician–patient encounter: Revisiting the shared treatment decision‐making model. Social Science & Medicine 49 (5): 651–61.CrossRefGoogle ScholarPubMed
Charles, C. A., Whelan, T., Gafni, A., Willan, A., and Farrell, S. 2003. Shared treatment decision making: What does it mean to physicians? Journal of Clinical Oncology 21 (5): 932.CrossRefGoogle Scholar
Coetzee, J. M. 2005. Slow man. London: Secker & Warburg.Google Scholar
Cohen, M. Z., Kahn, D. L., and Steeves, R. H. 1998. Beyond body image: The experience of breast cancer. Oncology Nursing Forum 25 (5): 835–41.Google ScholarPubMed
Collins, E. D., Moore, C. P., Clay, K. F., Kearing, S. A., O'Connor, A. M., Llewellyn‐Thomas, H. A., Barth, R. J., and Sepucha, K. R. 2009. Can women with early‐stage breast cancer make an informed decision for mastectomy? Journal of Clinical Oncology 27 (4): 519–25.CrossRefGoogle ScholarPubMed
Dekkers, W., Hoffer, C., and Wils, J. P. 2005. Bodily integrity and male and female circumcision. Medicine, Health Care and Philosophy 8: 179–91.CrossRefGoogle ScholarPubMed
Dekkers, W., Hoffer, C., and Wils, J. P. 2006. Besnijdenis, lichamelijke integriteit en multiculturalisme: Een empirische en normatief‐ethische studie [Circumcision, bodily integrity and multiculturalism. An empirical and normative‐ethical study]. Budel, Netherlands: Damon.Google Scholar
Diprose, R. 1994. The bodies of women: Ethics, embodiment and sexual difference. London and New York: Routledge.Google Scholar
Duncker, P., and Wilson, V., eds. 1996. Cancer through the eyes of ten women. London: HarperCollins.Google Scholar
Figueiredo, M. I., Cullen, J., Hwang, Y. T., Rowland, J. H., and Mandelblatt, J. S. 2004. Breast cancer treatment in older women: Does getting what you want improve your long‐term body image and mental health? Journal of Clinical Oncology 22 (19): 4002–09.CrossRefGoogle ScholarPubMed
Fuss, D. 1989. Essentially speaking: Feminism, nature and difference. New York: Routledge.Google Scholar
Gilbert, M. 2003. Whole. A Documentary. St. Paul, Minn: Frozen Feet Films.Google Scholar
Grosz, E. 1994. Volatile bodies: Toward a corporeal feminism. Bloomington: Indiana University Press.Google Scholar
Hacking, I. 2007. Our neo‐Cartesian bodies in parts. Critical Inquiry 34 (1): 78–105.CrossRefGoogle Scholar
Harcourt, D. M., Rumsey, N. J., Ambler, N. R., Cawthorn, S. J., Reid, C. D., Maddox, P. R., Kenealy, J. M., Rainsbury, R. M., and Umpleby, H. C. 2003. The psychological effect of mastectomy with or without breast reconstruction: A prospective, multicenter study. Plastic and Reconstructive Surgery 111 (3): 106–15.CrossRefGoogle ScholarPubMed
Hilhorst, M. 2002. Physical beauty: Only skin deep? Medicine, Health Care and Philosophy 5 (1): 11–21.CrossRefGoogle ScholarPubMed
Husserl, E. 1931/1970. Cartesian meditations. Trans. D. Cairns. The Hague: Martinus Nijhoff.Google Scholar
Husserl, E. 1952/1989. Ideas pertaining to a pure phenomenology and to a phenomenological philosophy, Second book. Trans. R. Rojcewicz and A. Schuwer. Dordrecht, Boston, and London: Kluwer Academic Publishers.Google Scholar
Kendrick, K. 2008. “Normalizing” female cancer patients: Look good, feel better and other image programs. Disability & Society 23 (3): 259–69.CrossRefGoogle Scholar
Kopelman, L. M. 2006. Clinical trials for breast cancer and informed consent: How women helped make research a cooperative venture. In The voice of breast cancer in medicine and bioethics, ed. Rawlinson, M. C. and Lundeen, S.Dordrecht: Springer.Google Scholar
Lansdown, R., Rumsey, N., Bradbury, E., and Carr, T. 1997. Visibly different. Coping with disfigurement. London: Butterworth‐Heineman.Google Scholar
Leder, D. 1999. Whose body? What body? The metaphysics of organ donation. In Persons and their bodies: Rights, responsibilities, relationships, ed. Cherry, M. J.Dordrecht: Kluwer Academic Publishers.Google Scholar
Lerner, B. 2006. Power, gender, and pizzazz: The early years of breast cancer activism. In The voice of breast cancer in medicine and bioethics, ed. Rawlinson, M. C. and Lundeen, S.Dordrecht: Springer.Google Scholar
Lorde, A. 1980. The cancer journals. New York: Spinsters Ink.Google Scholar
Mackenzie, C., and Scully, J. L. 2007. Moral imagination, disability and embodiment. Journal of Applied Philosophy 24 (4): 335–51.CrossRefGoogle Scholar
Merleau‐Ponty, M. 1945/1962. Phenomenology of perception. Trans. C. Smith. London/New York: Routledge.Google Scholar
Moser, I. 2009. A body that matters? The role of embodiment in the recomposition of life after a road traffic accident. Scandinavian Journal of Disability Research 11 (2): 83–99.CrossRefGoogle Scholar
Nancy, J.‐L. 1993. Le sens du monde. Paris: Galilée.Google Scholar
Nancy, J.‐L. 2000. L'intrus. Trans. S. Hanson. The New Centennial Review 2 (3): 1–13.CrossRefGoogle Scholar
Oliver, M. 1996. Understanding disability: From theory to practice. Basingstoke, UK: Macmillan.CrossRefGoogle Scholar
Perpich, D. 2005. Corpus Meum: Disintegrating bodies and the ideal of integrity. Hypatia 20 (3): 75–91.CrossRefGoogle Scholar
Pruzinsky, T., and Cash, T. F. 2002a. Understanding body images. Historical and contemporary perspectives. In Body image: A handbook of theory, research, and clinical practice, ed. Cash, T. F. and Pruzinsky, T.New York: The Guilford Press.Google Scholar
Pruzinsky, T., and Cash, T. F. 2002b. Assessing body image and quality of life in medical settings. In Body image: A handbook of theory, research, and clinical practice, ed. Cash, T. F. and Pruzinsky, T.New York: The Guilford Press.Google Scholar
Rendtorff, J. D. 2002. Basic ethical principles in European bioethics and biolaw: Autonomy, dignity, integrity and vulnerability–Towards a foundation of bioethics and biolaw. Medicine, health care and philosophy 5 (3): 235–44.CrossRefGoogle ScholarPubMed
Rendtorff, J. D., and Kemp, P. 2000. Basic ethical principles in European bioethics and biolaw. Vol. I. Autonomy, dignity, integrity and vulnerability. Copenhagen: Centre for Ethics and Law.Google Scholar
Ricoeur, P. 1991. Life in quest of narrative. In On Paul Ricoeur: Narrative and interpretation, ed. Wood, D.London: Routledge.Google Scholar
Scully, J. L. 2008. Disability bioethics: Moral bodies, moral difference. Lanham, Md.: Rowman & Littlefield Publishers.Google Scholar
Shakespeare, T. 2006. Disability rights and wrongs. London: Routledge.CrossRefGoogle Scholar
Sheehan, J., Sherman, K. A., Lam, T., and Boyages, J. 2008. Regret associated with the decision for breast reconstruction: The association of negative body image, distress and surgery characteristics with decision regret. Psychology and Health 23 (2): 207–19.CrossRefGoogle ScholarPubMed
Sherwin, S. 2006. Personalizing the political: Negotiating the feminist, medical, scientific and commercial discourses surrounding breast cancer. In The voice of breast cancer in medicine and bioethics, ed. Rawlinson, M. C. and Lundeen, S.Dordrecht: Springer.Google Scholar
Shildrick, M. 1999. This body which is not one: Dealing with differences. Body & Society 5 (2‐3): 77–92.CrossRefGoogle Scholar
Slatman, J. 2005. The sense of life: Husserl and Merleau‐Ponty on touching and being touched. Chiasmi International 7: 305–25.CrossRefGoogle Scholar
Slatman, J. 2007. Recognition beyond narcissism. Imaging the body's ownness and strangeness. In The Other: Feminist reflections in ethics, ed. Fielding, H., Hiltmann, G., Olkowski, D. and Reichold, A.London: Palgrave.Google Scholar
Slatman, J. 2008. Vreemd Lichaam. Over medisch ingrijpen en persoonlijke identiteit [Strange body. On medical interventions and personal identity]. Amsterdam: Ambo.Google Scholar
Slatman, J. 2009a. A strange hand: On self‐recognition and recognition of another. Phenomenology and the Cognitive Sciences 8 (3): 321–42.CrossRefGoogle Scholar
Slatman, J. 2009b. Transparent bodies: Revealing the myth of interiority. In The body within: Art, medicine and visualization, ed. Van de Vall, R. and Zwijnenberg, R.Leiden: Brill.Google Scholar
Slatman, J. 2011. The meaning of body experience evaluation in oncology. Health Care Analysis. 19 (4): 295–311.CrossRefGoogle Scholar
Slatman, J., and Widdershoven, G. 2009. Being whole after amputation. American Journal of Bioethics 9 (1): 48–49.CrossRefGoogle ScholarPubMed
Slatman, J., and Widdershoven, G. 2010. Hand transplants and bodily integrity. Body & Society 16 (3): 69–92.CrossRefGoogle Scholar
Sorene, E. D., Heras‐Palou, C., and Burke, F. D. 2006. Self‐amputation of a healthy hand: A case of body integrity identity disorder. Journal of Hand Surgery 31 (6): 593–95.CrossRefGoogle ScholarPubMed
Tong, R. 2006. Negotiating personal and political settlements with breast cancer. In The voice of breast cancer in medicine and bioethics, ed. Rawlinson, M. C. and Lundeen, S.Dordrecht: Springer.Google Scholar
Toombs, S. K. 1999. What does it mean to be somebody? Phenomenological reflections and ethical quandries. In Persons and their bodies: Rights, responsibilities, relationships, ed. Cherry, M. J.Dordrecht: Kluwer Academic Publishers.Google Scholar
Waldenfels, B. 2004. Bodily experience between selfhood and otherness. Phenomenology and the Cognitive Sciences 3 (3): 235–48.CrossRefGoogle Scholar
Weiss, G. 1999. Body images. Embodiment as intercorporeality. New York: Routledge.Google Scholar
Weiss, G. 2006. Death and the Other: Rethinking authenticity. In The voice of breast cancer in medicine and bioethics, ed. Rawlinson, M. C. and Lundeen, S.Dordrecht: Springer: 103–116.CrossRefGoogle Scholar
Weiss, J. R., Moysich, K. B., and Swede, H. 2005. Epidemiology of male breast cancer. Cancer Epidemiology Biomarkers & Prevention 14 (1): 20–26.Google ScholarPubMed
Widdershoven, G. 1993. The story of life: Hermeneutic perspectives on the relationship between narrative and lifes history. In The narrative study of lives, ed. Josselson, R. and Lieblich, A.London: Sage.Google Scholar
Woerdeman, L. 2005. Surgical risk factors of breast reconstruction and their clinical implication. PhD diss., University of Amsterdam.Google Scholar
Zeiler, K. 2009. Ethics and organ transfer: A Merleau‐Pontean perspective. Health Care Analysis 17 (2): 110–22.CrossRefGoogle ScholarPubMed
Zwart, H. 2000. From circle to square: Integrity, vulnerability and digitalization. In Bioethics and biolaw. Vol. II. Four ethical principles, ed. Kemp, P., Rendtorff, J. D. and Johansen, N. M.Copenhagen: Centre for Ethics and Law.Google Scholar
Zwart, H. 2007. Integriteit. In Lexicon van de Ethiek, ed. Becker, M., Van Stokkom, B., Van Tongeren, P. and Wils, J. P.Assen, Netherlands: Van Gorcum.Google Scholar