共情:哲学修辞与临床张力*余佯洋1王一方2摘要:叙事医学与关怀伦理的兴起,对共情的探讨陡然升温,并呈现不同伦理选择的声音。从哲学修辞的维度出发,对共情的语义范畴进行深入分析,对共情的互文性,即非共情、反共情、伪共情展开充分辨析,进而挖掘了临床境遇中的共情悖论与异化,探讨了叙事医学对共情的拓展与建构,如精细化文学阅读与共情的审美习得,如何开启“共情−反思−医患共同体”的三段论认知,如何杜绝“共情”的孤岛化,以廓清共情在全人医疗模式中临床实践的地位和意义。关键词:共情,语义范畴,互文性,叙事医学中图分类号:R-05文献标识码:A文章编号:1002-0772(2024)05-0001-04DOI:10.12014/j.issn.1002-0772.2024.05.01Empathy:PhilosophicalRhetoricandClinicalTensionYUYangyang1,WANGYifang2.1.MedicalSchool,ShenzhenUniversity,Shenzhen518055,China;2.SchoolofHealthHumanities,PekingUniversity,Beijing100191,ChinaAbstract:Theriseofnarrativemedicineandcaringethicshassparkedasurgeintheexplorationofempathy.Voicesofdifferentethicalchoiceshaveemerged.Startingfromthedimensionofphilosophicalrhetoric,thisarticlemakesanin-depthanalysisofthesemanticcategoryofempathy,andfullydistinguishestheintertextualityofempathy,namelynon-empathy,anti-empathy,andpseudo-empathy.Wefurtherexploretheparadoxandalienationofempathyinclinicalsituations,anddiscusstheexpansionandconstructionofempathyinnarrativemedicine,suchasrefinedclosereadingandaestheticacquisitionofempathy,howtoactivatethesyllogisticcognitionof"empathy-reflection-doctor-patientcommunity",andhowtoeliminatetheisolationof"empathy",soastoclarifythestatusandsignificanceofempathyinclinicalpracticeinthewhole-personmedicalmodel.KeyWords:empathy,semanticcategory,intertextuality,narrativemedicine近十几年来,随着叙事医学的勃兴与关怀伦理的深度拓展,“共情”一词成为临床医学的热词。无疑,共情是一个医−护−患−属关系纽带的考量,而非健康、疾病的本质呈现。这标志着临床医学的价值嬗变,从关注单一的生物医学维度转向高度重视社会、心理投射的关系维度,从单纯的疾病客观性分析转向复调的疾苦境遇中主客间性探究。究其原由,一是全人医学模式与叙事医学的倡导之功,二是慢病时代人们对多轨临床疗愈的...