Relational clinical practice: A hermeneutic, enactive, intersubjective model of osteopathy

This commentary proposes a framework for considering the philosophical foundations that support osteopathic practice, using the metaphor of ‘tectonic plates’. It is argued that reflective osteopathic practitioners, and the organisations they make up, would benefit from engaging with the differing ontological and epistemological traditions that underpin healthcare theory, evidence and practice. It is proposed that having more insight into the philosophical traditions of reality (ontologies) and forms of knowledge (epistemologies), that underpin medicine and healthcare, will support ethical, reflective practice, informed by the concepts of ontic integrity and epistemic humility. We focus particularly on phenomenological ontology and epistemology, which we propose underpins the relational and embodied concept of osteopathy as hermeneutic, enactive, intersubjective healthcare, locating it within the sphere of phenomenological and enactivist theory and research.