Journal of evaluation in clinical practice · 2026
Metapersonal Care as Philosophical Health.
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de Miranda Luis
Аннотация
RATIONALE: This paper addresses the aims of the present journal concerning health philosophy and person-centred healthcare. Person-centred care corrected the reduction of patients to bodies and pathologies, yet its interpretation and application remain somewhat inconsistent. This article locates the inconsistency in an unresolved philosophical question: which self is the person on whom care is centred. Under pressure, a person tends to default to an inherited self rather than explore their own philosophy of life, so that an expressed preference may record the default self rather than the thinking person.
AIMS AND OBJECTIVES: To diagnose the root of the inconsistency and to articulate metapersonal care as a necessary criterion distinguishing philosophical from naive person-centred care.
METHODS: Conceptual and philosophical analysis, in dialogue with the person-centred care and capabilities literatures, relational conceptions of autonomy, and psychological accounts of decentring, drawing on Spinoza, Murdoch, and Foucault for the theory of self-relation.
RESULTS: What care records when it asks what the patient wants is often not the person but the epochal default self: the inherited configuration that presents itself as authentic precisely because it is immediate. Hence the paradox: the more immediately personal an expression, the more generic it may be. Between identifying with that configuration and bracketing it in the name of detachment, I develop a third position, metapersonality, the capacity to inhabit one's historically constituted personality without granting it sovereignty. Applied to care, this yields metapersonal care, helping the person to become capable of exploring the lived philosophy from which their preferences arise, and of reaffirming or revising them.
CONCLUSION: Metapersonal care names a necessary criterion of adequate person-centred care, one that philosophical health practices are designed to serve. Its horizon is eudynamia, in which cultivation of the self and composition of a shared world are no longer separable ends.
AIMS AND OBJECTIVES: To diagnose the root of the inconsistency and to articulate metapersonal care as a necessary criterion distinguishing philosophical from naive person-centred care.
METHODS: Conceptual and philosophical analysis, in dialogue with the person-centred care and capabilities literatures, relational conceptions of autonomy, and psychological accounts of decentring, drawing on Spinoza, Murdoch, and Foucault for the theory of self-relation.
RESULTS: What care records when it asks what the patient wants is often not the person but the epochal default self: the inherited configuration that presents itself as authentic precisely because it is immediate. Hence the paradox: the more immediately personal an expression, the more generic it may be. Between identifying with that configuration and bracketing it in the name of detachment, I develop a third position, metapersonality, the capacity to inhabit one's historically constituted personality without granting it sovereignty. Applied to care, this yields metapersonal care, helping the person to become capable of exploring the lived philosophy from which their preferences arise, and of reaffirming or revising them.
CONCLUSION: Metapersonal care names a necessary criterion of adequate person-centred care, one that philosophical health practices are designed to serve. Its horizon is eudynamia, in which cultivation of the self and composition of a shared world are no longer separable ends.