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<p>Uncertainty in clinical practice is often treated as a remediable epistemic deficit. This article proposes a conceptual reframing: uncertainty is not merely a lack of information, but a constitutive dimension of human suffering. Drawing on phenomenology, psychiatry, psychology, and anthropology, we articulate a tripartite heuristic distinguishing ontic uncertainty (discrete unknowns), ontological uncertainty (disruptions in meaning and worldhood), and embodied uncertainty (felt disarray in rhythm, agency, and spatial orientation). These dimensions frequently cascade into one another across illness trajectories, intensifying distress when unacknowledged. We explore how cultural and institutional mediations—such as rituals, narratives, spatial design, and algorithmic infrastructures—can buffer or exacerbate the experience of uncertainty. Clinical and ethical implications include distinguishing uncertainty types in consultation, pairing risk communication with safety-net strategies, and aligning interventions with dominant modalities (behavioral, narrative, or environmental). At the system level, we propose continuity infrastructures and transparency practices that render uncertainty shareable and revisitable. Rather than seeking its elimination, we argue for a clinical stance that engages uncertainty as a site of relational and ethical responsibility. This reconceptualization supports more humane care, and offers a foundation for implementation-oriented research across clinical and organizational domains.</p>

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Uncertainty in human suffering: ontic, ontological, and embodied dimensions in clinical care

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月4日

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  • Luis Madeira,
  • Cíntia Águas

摘要

Uncertainty in clinical practice is often treated as a remediable epistemic deficit. This article proposes a conceptual reframing: uncertainty is not merely a lack of information, but a constitutive dimension of human suffering. Drawing on phenomenology, psychiatry, psychology, and anthropology, we articulate a tripartite heuristic distinguishing ontic uncertainty (discrete unknowns), ontological uncertainty (disruptions in meaning and worldhood), and embodied uncertainty (felt disarray in rhythm, agency, and spatial orientation). These dimensions frequently cascade into one another across illness trajectories, intensifying distress when unacknowledged. We explore how cultural and institutional mediations—such as rituals, narratives, spatial design, and algorithmic infrastructures—can buffer or exacerbate the experience of uncertainty. Clinical and ethical implications include distinguishing uncertainty types in consultation, pairing risk communication with safety-net strategies, and aligning interventions with dominant modalities (behavioral, narrative, or environmental). At the system level, we propose continuity infrastructures and transparency practices that render uncertainty shareable and revisitable. Rather than seeking its elimination, we argue for a clinical stance that engages uncertainty as a site of relational and ethical responsibility. This reconceptualization supports more humane care, and offers a foundation for implementation-oriented research across clinical and organizational domains.