Strange new lifeworlds

Andrew Papanikitas is Deputy Editor of the BJGP.

The ‘lifeworld’ view was originally coined by philosopher and mathematician Edmund Husserl (1859–1938). Husserl warns us that quantitative measures can forget or ignore qualities of the human experience, and that any human view of the world without subjectivity is fundamentally unfounded. When health care becomes overly focused on decontextualised or superficial goals, this world can be neglected or even forgotten, leaving us open to the risk of dehumanising research and practice.¹

Phenomenological research identifies five core elements: time, space, shared experience, bodily experience, and mood. The concept of ‘lifeworlds’ allows us to express the tension between intimate personal relations and societal structures. They can be (for example) used to improve patient-centred care by understanding patients’ unique, lived experiences. In this issue, we explore some rich and strange lifeworlds.¹

Ben Hoban reflects that boundaries in medical care should not be (and indeed aren’t) primarily a mechanism for creating distance between people, but for making safe the closeness that effective care requires — not just the line separating one entity from another, but also the point of contact.² This boundary is modified in startling ways by advances in technology. Benjamin Titford, for example, writes about the way that artificial intelligence (AI) scribes allow a GP to focus on the conversation with a patient by automatically recording and summarising salient facts in the background. He finds that the absence of this task adversely affects his working memory of patient encounters, an aspect of continuity prized in general practice.³ By contrast, Adam Phillips and Simon Rudland suggest that, rather than seeking imitation relationships, the public could perceive AI as a reliable way of making sense of health experiences, shaping beliefs before clinical opinion is sought.⁴ Both GP and patient in these example defer thinking to machines that might otherwise happen at the clinician–patient interface. Something precious needs to be recognised and recaptured.

While AI looms large there are other existential changes that shape our world. Richard Armitage reports from Gaza on total war and the near annihilation of the local healthcare system. Beyond the visible destruction, there is another catastrophe that receives less attention: the elimination of digital health infrastructure. Electronic medical record systems have been destroyed along with the facilities that housed them, erasing detailed health data for an entire population.⁵

Yusuf and Niha Hussain look at a different kind of armageddon — antibiotic resistance — and use the arrival of a new antibiotic for the treatment of urinary tract infection to examine the relationship between social deprivation and antibiotic use. Social determinants predispose to antimicrobial resistance: patients from socioeconomically disadvantaged communities often face transportation difficulties, work inflexibility, and caring constraints that make attending for parenteral treatments difficult. So can a new antibiotic offer new hope as an antidote to the inverse care law of those most in need being least able to access care?⁶ Or will this too fail without system change?

Alex Burrell offers us a phenomenological banquet as he explores how people talk to a GP about suicide, the involvement of minister networks and spirituality in general practice, managers with a partnership stake in the GP-business, and how Welsh practices address the needs of those whose first language is Welsh (there is no legal obligation to provide bilingual services).⁷

Lucy Steed invites us into her own lifeworld as she shares what she has learned though personal tragedy — the death of her husband at a young age. When someone’s world changes in such an intimate and savage way, it is unimaginative and unreasonable to expect them to be the same person, doing things in the same way as before. Steed discusses the importance of acknowledging a deep personal loss and building something new, ‘You are not failing … You are touring your humanity.’⁸

Husserl articulates our world as textured, embodied, and experienced by us and through us: a world of colours, sparkling stars, memories, happiness, joy, anger, and sadness.¹ This speaks to the mystery of general practice, where narrative and biography are at least as important as biology.⁹ A boundary is not simply a barrier to care but a point of connection, not just between people but between lifeworlds — divided we fail.

References

1. Hemingway A. Lifeworld-led care: is it relevant for well-being and the fifth wave of public health action? Int J Qual Stud Health Well-being 2011; DOI: 10.3402/qhw.v6i4.10364.
2. Hoban B. Barriers and boundaries. Br J Gen Pract 2026; DOI: https://doi.org/10.3399/bjgp26X744849.
3. Titford B. AI scribes, memory, and the future of general practice. Br J Gen Pract 2026; DOI: https://doi.org/10.3399/bjgp26X744825.
4. Phillips A, Rudland S. Post-Turing clinical relationships: how AI is reshaping patient behaviour before the consultation. Br J Gen Pract 2026; DOI: https://doi.org/10.3399/bjgp26X744801.
5. Armitage R. Primary care in a destroyed health system: reflections on a deployment to Gaza. Br J Gen Pract 2026; DOI: https://doi.org/10.3399/bjgp26X744837.
6. Hussain Y, Hussain N. The inequality paradox: how gepotidacin addresses the hidden social gradient of antimicrobial resistance. Br J Gen Pract 2026; DOI: https://doi.org/10.3399/bjgp26X744789.
7. Burrell A. Yonder: Talking to a GP about suicide, GP–minister networks, practice managers as partners, and Welsh as first language. Br J Gen Pract 2026; DOI: https://doi.org/10.3399/bjgp26X744813.
8. Steed L. When life changes everything: a GP’s return to work after bereavement. Br J Gen Pract 2026; DOI: https://doi.org/10.3399/bjgp26X744861.
9. Heath I. The mystery of general practice. 1995. https://www.nuffieldtrust.org.uk/sites/default/files/2017-01/the-mystery-of-general-practice-web-final.pdf (accessed 20 Apr 2026).

 Featured photo by Jeremy Thomas on Unsplash.