Phronesis (Practical Wisdom)
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Abstract
Phronesis, classically defined by Aristotle as knowledge of what is good and what is bad for humans, is best understood as practical wisdom, that is, the wisdom of action. The main difficulties in possessing phronesis and acting on it are that both human goods and ills come in degrees (so that it is hard to tell how much of the one is enough and how much of the other is too much) and that the goods frequently compete with each other (so that it is hard to determine which to pursue at the expense of the other). In the end, phronesis amounts to sound judgment and intuition in identifying the specific goods to be pursued and the ills to be combated in a given context. In the context of psychiatric practice, the goods and ills must be preeminently those for the patient, mainly the goods of mental health and the ills of mental disorder. But in addition to facing competing goods and subtly varying degrees of goods and ills, the psychiatrist also faces both nonmedical goods and ills and other persons to be taken into account—family members, translators, and consultants, sometimes embodying cultural attitudes different from those of the psychiatrist, as well as such nonpersons as their clinics or health maintenance organizations, insurance companies, and governmental agencies. A look at several cases of community psychiatric practice reveals the complexities that require seasoned phronesis for successful treatment.