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Abstract
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), onto…
We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.
Abstract
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.
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Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Lisbon, 1649-035, Portugal
Luis Madeira & Cíntia Águas 1.
Hospital CUF Descobertas, Lisbon, Portugal
Luis Madeira
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- Luis Madeira
- Cíntia Águas
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L.M. and C.P. wrote and reviewed the manuscript.
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Correspondence to Luis Madeira.
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Madeira, L., Águas, C. Uncertainty in human suffering: ontic, ontological, and embodied dimensions in clinical care. Discov Psychol (2025). https://doi.org/10.1007/s44202-025-00489-3
Received: 26 June 2025
Accepted: 16 October 2025
Published: 04 December 2025
DOI: https://doi.org/10.1007/s44202-025-00489-3