3. La proyección metodológica de la Enfermería
3.2. Las competencias enfermeras
3.2.1. La competencia diagnóstica
The concept of beauty (or 'goodness') in art has been debated since antiquity.
Alexander Gottlieb Baumgarten (1714-1762) was the first to define the term aesthetics.
Baumgarten described it as: ―Aesthetics (the theory of the liberal arts, lower gnoseology, the art of thinking beautifully, the art of the analog of reason) is the science of sensitive cognition.‖ 9 In his Aesthetica, Baumgarten suggests that the beauty of a sensory representation lies in its heuristic (harmony/consensus of thoughts), methodological (order and sequence) and semiotic (meaning and expression) content. As put by Paul Guyer, in
―The Origins of Modern Aesthetics,‖ Baumgarten ―provided a conception of the imagination as a cognitive capacity, whose products, moreover, are marked by the richness and density of their contents rather than by logical criteria such as economy and simplicity.‖10
Before Baumgarten, Jean-Baptiste Du Bos (1670-1742), Ashley Cooper-Third Earl of Shaftesbury (1671-1713), Joseph Addison (1672-1719) and Francis Hutcheson (1694-1746), all contributed to aesthetic theory. Du Bos united imagination and emotions through
9 Paul Guyer, ―The Origins of Modern Aesthetics: 1711-1735,‖ in The Blackwell Guide to Aesthetics, ed.
Peter Kivy (Blackwell Publishing, Malden, MA, 2004), 15. (Reference to Metaphysica (1739), 533 and Aesthetica (1750), 1).
10 Ibid., 36.
41 representation. Similarly, Cooper (Shaftesbury) believed that creative intelligence, a cognitive event, allowed beauty to be found not necessarily in the object itself but rather in the order and proportions created in the imagination's representation of it (this recalls our earlier discussion on musical communication taking place through imagination─more to follow in this chapter). Addison also linked imagination to pleasure. Hutcheson, on the other hand, believed that aesthetic response was a sense in itself; as put by Guyer: ―by inferring that this response can only be a sense precisely because of its distinction from any form of either cognition or volition.‖11
The influential German philosopher Immanuel Kant (1724-1804) initially agreed with Hutcheson's division between what is sensory and what is cognitive; however, in his Critique of Judgement (1790), Kant amended his views on aesthetic response to account for cognition and saw it as the interplay (harmony or ―free-play‖) between imagination and understanding. In Critique of Judgement, Kant describes aesthetic response (―judgement of taste‖) as follows:
As the subjective universal communicability of the mode of representation in a judgement of taste is to obtain [i.e. to receive] apart from the presupposition of any determinate concept, it can be nothing else than the state of the mind involved in the free play of imagination and understanding. . . .Now this purely subjective (aesthetic) judging of the object, or of the representation through which it is given, is antecedent to the pleasure in it, and is the basis of this pleasure in the harmony of the cognitive faculties.12
Fifty years prior to Immanuel Kant's Critique of Judgement, a correlation between sensory response to music and cognitive evaluation was proposed by the German composer
11 Guyer, ―The Origins of Modern Aesthetics: 1711-1735,‖ 23.
12 Immanuel Kant, Kritik der Urteilskraft (Frankfurt am Main: Wilhelm Weischedel, 1790), trans. James Creed Meredith as Critique of Judgement (Oxford, UK: Oxford University Press, 1952). Revised, edited and introduced by Nicholas Walker as Critique of Judgement (Oxford, UK: Oxford University Press, 2007), Re-issued 2008, 49.
42 and theorist Johann Mattheson (1681-1764) in his Der vollkommene Kapellmeister (1739).
Peter Kivy in The Corded Shell summarizes Mattheson's theory,
i) Music is not primarily a stimulus; and its emotive expressiveness is not manifested in an emotional response.
ii) Music, in its structure, bears a resemblance to the ―emotive life‖; and the primary aesthetic response is a cognitive response: a recognition of the emotive content present in it.13
Although we need to adapt Mattheson's theory to include content and sensory response other than emotions, its acknowledgment of the role of cognition is key. This ties directly into the notion of subjectivity.
As can be seen from the above, Mikhail Mikhaǐlovich Bakhtin's rationalization that even 'objective' thoughts (or 'understanding') can be viewed as 'subjective' (because perception occurs through the mind) was preceded by many doctrines before Kant, by Kant, himself, in Critique of Judgement, and through to the thoughts of the Neo-Kantians of the Marburg School, founded by Hermann Cohen (1842-1918). Michael Holquist, in Dialogism–Bakhtin and his World, describes the impact of the Neo-Kantians,
By 1918, Neo-Kantianism had been the dominant school of philosophy in Germany for almost fifty-years. From roughly the 1870s until the 1920s, most professors of philosophy in Germany defined themselves by taking a position vis-à-vis Kant.14
Mikhail Bakhtin's exposure to the thoughts of the Marburg School came from Matvei Isaevich Kagan (1899-1937). Ironically (and sadly), Kagan went to study in Marburg to escape Russia's anti-Semitism but, when the war erupted in 1914, he was viewed as an enemy alien, confined for four years, and deported back to Russia in 1918.
13 Peter Kivy, Sound Sentiment, An Essay on the Musical Emotions (including the complete text of The Corded Shell) (Temple University Press, Philadelphia, 1989), 39.
14 Michael Holquist, Dialogism: Bakhtin and his World (London, UK: Routledge, 1990), 3.
43 Germany's loss was Russia's gain as Kagan greatly helped Mikhail Bakhtin form his philosophical ideas. Holquist summarizes the influence of the Marburg School on Bakhtin and his distinction from it, as follows:
Two general aspects of Marburg Neo-Kantianism that played an important role in the composition of Bakhtin's early work should be emphasized. The first of these is the Neo-Kantian desire to relate traditional problems in philosophy to the great new discoveries about the world and nature being made in the exact and biological sciences on the cusp of the nineteenth and twentieth centuries. . . . A second aspect of the Marburg School's activity that proved to be important in Bakhtin's development was the emphasis of its founder [Cohen] on unity and oneness. . . . One of the most important ways he [Bakhtin]
demonstrates his independence from Cohen, even at this early stage, is in his resistance to the idea of an all-encompassing oneness, or Allheit. In this, Bakhtin is perhaps best understood as a figure who is trying to get back to the other side of Kant's synthesis, the world, rather than the mind (and in particular the rational mind), the extreme to which Cohen tended.15
Of essence in this last passage: ―the world, rather than the mind.‖ Bakhtin's "world"
extended past the mind to include the inseparable contributions of the 'other', of society and of history. This was a marked difference from Cohen's stance and was closer to Kant's views. As reports Holquist, ―Bakhtin's understanding of perception as an act of authoring brings him closer to Kant himself than to Cohen, in so far as he rethinks the problem of wholeness in terms of what is an essentially aesthetic operation.ˮ16 We will come back to the importance of "perception as an act of authoring" in the closing section of this chapter.
Bakhtin created thinking circles wherever he lived; these are known as Bakhtin Circles. Dialogism's foundations emerged from the thoughts of the very first of these Bakhtin Circles, in 1918, which at the time included not only Bakhtin and Kagan, but Valentin Voloshinov and P.N. Medvedev, who also became influential minds. The members of the Bakhtin Circles attempted to redefine subjectivity as they considered the existing ideologies of Formalism too strict, and Saussure's Structuralism neglectful of the
15 Holquist, Dialogism: Bakhtin and his World, 5;6.
16 Ibid., 7.
44 importance of historical and social relevance; this is explained by Michael Gardiner in The Dialogics of Critique,
[F]or the members of the Bakhtin Circle, consciousness (subjectivity, the ‗psyche‘) is not a self-sufficient, pre-constituted entity, but is formed through the dialogic struggle between contending ‗voices‘ or discourses.17
Holquist, in turn, describes dialogism as ―a philosophy of the trees as opposed to a philosophy of the forest: it conceives society as a simultaneity of uniqueness.ˮ18In his essay
―Discourse in the Novel,‖ Bakhtin, underlines the inseparability of (literary) art from the social:
Form and content in discourse are one, once we understand that verbal discourse is a social phenomenon─social throughout its entire range and in each and every of its factors, from the sound image to the furthest reaches of abstract meaning.19
Having now introduced how dialogism evolved from philosophies concerned with aesthetic response, representation, freedom of the imagination and notions of subjectivity, details of its guiding principles follow.
17 Michael Gardiner, The Dialogics of Critique – M. Bakhtin & the Theory of Ideology (Routledge, London, 1992), 72.
18 Holquist, Dialogism: Bakhtin and his World, 153.
19 Mikhail Mikhaǐlovich Bakhtin [Bachtin, Michail Michajlovič], ―Discourse in the Novel‖ in Voprosy literatury i estetiki: Issledovanija raznych let (first ed., Moscow: Chudožestvennaja literatura, 1975), translated as The Dialogic Imagination: Four Essays by Caryl Emerson and Michael Holquist, ed. Michael Holquist (Austin, TX: University of Texas Press, 1981, re-print 2008), 259.
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