ABSTRACT
TIME In this chapter I will use the freedom invited by writing to focus on time as a decisive element of prognosis, and in fact as an essential element of the doctorpatient relationship itself. As we have seen in these stories, when the doctor senses the future of, not only the disease, but of the patient having the disease, prognostic judgement and care become inseparable. This relation between time and moral commitment is the theme of this chapter. To try to bring the reader on track, we need to begin with some points on the subject of time itself. This should make it easier to see how and when the future becomes the main issue of the present of consultations. We will also see more clearly the distinction between prognosis as science-based and probabilistic reasoning and prognosis as a disclosure of time that morally frames the doctor-patient relationship. In the latter part of the chapter I deal more extensively with the stories of Anne Macleod, as they develop through the whole series of four books. It has given me the opportunity to apply the idea of ‘personal prognosis’ as a relational concept in different situations. It lies in contrast to the observational and probabilistic connotations of prognosis. The stories have provided many open ends for the reader’s imagination to expand, and I fully admit that my reading has been flavoured by my aims in the chapter. Time is not easy to grasp, and the ideas that I offer in this first section may therefore likewise be difficult to grasp. I present them to suggest how the daily practice of the physician can be illuminated within the context of some philosophical ideas, in the hope that you may be inspired to follow them up.
