Being and Nothingness (1943)

Summary

Being and Nothingness, published in Paris in 1943 under German occupation, is Jean-Paul Sartre’s systematic account of human existence. Sartre distinguishes two fundamental modes of being: being-in-itself (the dense, self-identical existence of objects) and being-for-itself (the nothingness or self-distance at the heart of consciousness that makes freedom possible). The book argues that human beings are radically free and cannot evade that freedom. We are, as Sartre puts it, condemned to be free. It analyzes how this freedom is concealed through bad faith, how the gaze of another person turns us into objects, and how we inhabit our bodies from three irreducible dimensions. For medicine and psychology, the text provides tools for thinking about the difference between a patient’s lived suffering and the physician’s clinical object, the structure of shame in illness, the incoherence of reducing a person to a diagnosis, and the conditions of authentic rather than coerced medical decision-making.

Context and Publication

Being and Nothingness was published in June 1943 by Gallimard in Paris. Sartre had developed its central ideas during the late 1930s, drawing on his contact with German phenomenology (including a stay in Berlin in the early 1930s where he encountered Husserl and Heidegger) and the concentrated intellectual circumstances of the Occupation.(James Aho, Kevin Aho, 2009)

The book’s title echoes Hegel’s dialectic of being and nothingness, and its subtitle (An Essay in Phenomenological Ontology) announces the double ambition: to describe human experience accurately (phenomenology) and to ground that description in a general account of what there is (ontology). Sartre’s introduction is titled À la recherche de l’être (In Search of Being), probably intending an echo of Proust’s great novel of memory and time.(Sartre, Jean-Paul, 1943)

The English translation by Hazel Barnes appeared in 1956 and shaped the text’s reception in the Anglophone world. A newer translation by Sarah Richmond (2018) adopts different terminological decisions at several points, rendering visqueux as “viscous” rather than Barnes’s “slimy,” with consequences for how Sartre’s existential analysis of bodily disgust has been read.(Sartre, Jean-Paul, 1943)

The Ontological Framework

Being-in-Itself, Being-for-Itself, and Nothingness

Sartre’s starting point is a critique of the classical metaphysical distinction between appearance and reality. The being of a phenomenon, he argues, is nothing other than how it manifests: there is no hidden substance behind appearances to be found.(Sartre, Jean-Paul, 1943) From this move he develops two fundamental ontological categories.

Being-in-itself (l’en-soi) is the mode of existence of objects: opaque, self-identical, without inner distance, massively present. Being-for-itself (le pour-soi) is the mode of existence of consciousness: never simply what it is, always self-distant, capable of negation. The for-itself is not a thing alongside other things; it is the introduction of nothingness into the world.(Sartre, Jean-Paul, 1943) This nothingness is not mere absence or logical negation but a genuine nihilation that the for-itself performs: when consciousness questions, it holds open the possibility that something might not be there, introducing non-being into the fabric of experience.(Sartre, Jean-Paul, 1943)

The for-itself is characterized by self-presence (présence à soi) rather than self-coincidence. There is an infinitesimal internal distance between consciousness and itself, which is what makes self-awareness possible without making consciousness an object to itself.(Sartre, Jean-Paul, 1943) This structural self-distance constitutes the nothingness at the heart of the for-itself and grounds both freedom and temporality. Crucially, Sartre insists that consciousness is its own cause as consciousness — nothing outside consciousness causes it to arise — while remaining fully contingent in its being; this tension between spontaneity and contingency underlies his account of facticity and the experience of anxiety as the disclosure of groundless freedom.(Sartre, Jean-Paul, 1943)

Sartre follows Husserl’s principle of intentionality (that consciousness is always consciousness of something) but radicalizes it: intentionality means consciousness is never a self-contained inner substance but always a “bursting forth” toward the world, born carried upon a being.(Sartre, Jean-Paul, 1943) He further distinguishes pre-reflective from reflective consciousness: at the pre-reflective level, consciousness is non-positionally aware of itself without making itself its own object, grounding a form of selfhood that does not depend on Cartesian ego-substance.(Sartre, Jean-Paul, 1943) Consciousness is thus a “being of distances” — always thrown beyond itself toward possibility — and this transcendence means that the world around us reflects back what we are through our projects: without the upsurge of the for-itself, there would be no structured world but only the brute massiveness of being-in-itself.(Sartre, Jean-Paul, 1943)

Sartre also identifies the for-itself as constituted by a fundamental lack: it perpetually lacks the coincidence with itself that being-in-itself possesses, and it is this lack that constitutes value. Value is the ideal of a being that would be both in-itself and for-itself simultaneously — the impossible ens causa sui that Sartre identifies with the traditional idea of God — a project necessarily incapable of fulfillment.(Sartre, Jean-Paul, 1943) The world encountered in experience is always organized by the for-itself’s practical concerns and possibilities, following the Heideggerian “for-the-sake-of-which”: objects are not given neutrally but always already encountered within a world constituted by the agent’s project.(Sartre, Jean-Paul, 1943)

Temporality and the Weight of the Past

Sartre’s account of time derives from the structure of the for-itself itself. The for-itself is always its own past (as the facticity it can never simply be), its own present (as the flight from that past), and its own future (as the project that surpasses both). These three ecstases are unified in a single temporal flow, not external containers in which events occur.(Sartre, Jean-Paul, 1943)

The past is the in-itself that I am (my sedimented facticity), but I can never simply be my past in the way an object is what it is. I always relate to my past from a present that surpasses it, which means I am responsible for how I take up my past, not determined by it.(Sartre, Jean-Paul, 1943) This structure of temporal responsibility has direct consequences for how illness history is understood clinically: the past of a patient is never simply a causal chain delivered into the present but is always something the patient is actively taking up in a particular way.

Sartre’s account of impure reflection (réflexion complice) has particular consequences for clinical introspection. Ordinary reflective inspection, he argues, posits psychic states as objects — emotions and desires treated as things — and thereby hypostatizes the fluid activity of consciousness into a false interior substance, producing the illusions of fixed character and personality.(Sartre, Jean-Paul, 1943) Related to this is Sartre’s treatment of the Ego: rather than the inner agent of consciousness, the Ego is a transcendent object constituted retroactively by impure reflection, and identifying with one’s ego is therefore itself a form of bad faith.(Sartre, Jean-Paul, 1943) For phenomenological psychology, these arguments imply that both characterological diagnosis and ego-psychological treatment risk reifying what is in fact open and self-surpassing.

The Body as Lived (Le Corps Vécu)

Sartre’s analysis of the body in Part Three of Being and Nothingness is among the most developed phenomenological treatments of embodiment before Merleau-Ponty’s Phenomenology of Perception (1945). Sartre identifies three irreducible ontological dimensions of the body.(Sartre, Jean-Paul, 1943)

The first dimension is the body-for-itself: the body as the point of view from which I act in the world, the facticity that I am rather than have. At this level the body is not an object experienced but the very medium of experience. Toombs follows this analysis, noting that at the pre-reflective level the body is not thematized as body at all: “one does not have a body but IS one’s body.”(Toombs, 1992)

The second dimension is the body-for-others: the body as object perceived, classified, and categorized by another person. The body acquires a being-outside that is radically not at my disposal; another person can see what I cannot, define me from a perspective I never occupy.

The third dimension is the body as known through another’s perception of me: the body I discover when I try to take up the other’s view of myself, always partially opaque, always trailing a residue of being-for-others that cannot be fully interiorized.(Sartre, Jean-Paul, 1943)

Pain and the Phenomenology of Illness

Sartre’s analysis of pain is central to phenomenological medicine. Pain (la douleur) is not itself an object for consciousness but the mode in which the body is present to consciousness as facticity. Only when I reflect on pain does it become a psychic object (“the ache”), constituting the difference between lived suffering and medicalized symptom.(Sartre, Jean-Paul, 1943) Aho and Aho situate this analysis within the broader phenomenological account of illness breakdown: body parts become conspicuous as obstructions at the very instant their taken-for-granted reliability fails, so that what was previously “lost” in unreflective bodily engagement is suddenly “found” as a recalcitrant thing demanding attention.(James Aho, Kevin Aho, 2009)

Toombs, drawing on Sartre’s four-level analysis, identifies the same structure: at the pre-reflective level, pain in the eyes is not experienced as an object located in the eyes. It is the eyes-as-pain, vision-as-pain, manifested as the inability to concentrate on reading rather than as an identifiable object.(Toombs, 1992) Sartre himself identifies four levels at which illness acquires meaning: pre-reflective sensory experiencing, suffered illness, disease as the patient’s own objectification, and the disease state as the physician’s scientific conceptualization (bacteria or lesions in tissue).(Toombs, 1992)

Svenaeus reads Sartre’s description of pain as “a melody which has a life of its own that influences, and in some cases becomes the dominating melody of, a person’s life” as particularly apt for understanding chronic pain: “Sartre’s analysis makes lucid the way pain is primarily suffered rather than known, and this is a very important insight for health-care professionals and bioethicists.”(Svenaeus, 2018)

Bad Faith and Self-Deception (Mauvaise Foi)

The Structure of Bad Faith

Sartre defines bad faith (mauvaise foi) as a structure of self-deception in which consciousness denies its own freedom by pretending to be a fixed thing, treating itself as determined by its situation, role, or past, while simultaneously relying on its freedom to maintain that pretense.(Sartre, Jean-Paul, 1943) Bad faith is not simple lying to oneself; it involves a paradoxical simultaneous awareness and denial of one’s freedom. The consciousness that lies to itself must know the truth it is concealing in order to conceal it.

The paradigmatic illustration is the waiter who plays at being a waiter, performing his role with excessive precision, treating his function as his essence and thereby denying that he freely chooses to be a waiter and could always choose otherwise.(Sartre, Jean-Paul, 1943) The waiter inhabits the being-in-itself of a social object while being, as consciousness, always already beyond it. For medicine, this analysis reaches its force in the figure of the patient or clinician who identifies entirely with a role (“I am a diabetic,” “I am a doctor”), treating that identification as though it settled what they are rather than as a project they are enacting.

Bad Faith and Freudian Psychoanalysis

Sartre mounts a sustained critique of Freudian psychoanalysis in Part One. The concept of the unconscious is incoherent, he argues: the censor that represses must know what it is repressing, and thus must be conscious of the very thing it is hiding from consciousness. The censor is not an unconscious mechanism but an instance of bad faith.(Sartre, Jean-Paul, 1943) This critique directly influenced R. D. Laing, who extended the Sartrean analysis into his account of how defence mechanisms, phenomenologically understood, are not impersonal processes undergone by the patient but “actions the person takes upon his own experience,” and that recognizing this converts process back into praxis: the patient becomes an agent.(Laing, R. D., 1967)

Authenticity

Anxiety (angoisse) is the specific attunement in which freedom discloses itself: the free consciousness, suspended without any prior determination settling what it will do, apprehends itself as the groundless source of its choices.(Sartre, Jean-Paul, 1943) Bad faith can be understood as the habitual flight from this anxiety. The escape from bad faith requires what Sartre calls a radical conversion, which he names authenticity, but he defers its full treatment in Being and Nothingness with a footnote: “Its description does not belong here.”(Sartre, Jean-Paul, 1943) His Conclusion returns to this, suggesting that a consciousness which in purifying reflection turns back upon its own freedom and value-positing could “will itself.” The thought is gestured at, not developed.(Sartre, Jean-Paul, 1943) The Notebooks for an Ethics, published posthumously in 1992, represents Sartre’s uncompleted attempt to work it out.

The Look (Le Regard) and the Body-for-Others

Shame and the Clinical Encounter

The Look (le regard) is Sartre’s account of how other persons are given to experience. The Other’s existence is not an inference from analogy but is disclosed in the experience of shame: when I am looked at, I directly apprehend my own being as an object for another subject.(Sartre, Jean-Paul, 1943) The Look arrests my freedom temporarily; I find myself fixed, characterized, and defined from outside.(Sartre, Jean-Paul, 1943) This produces the primary emotions of shame, pride, and embarrassment, all of which turn on the discovery that I have a being-outside that is not at my disposal: “The Other holds a secret — the secret of what I am.”(James Aho, Kevin Aho, 2009)

When the clinical encounter is read through the Look, the asymmetry of the medical gaze becomes visible as an ontological structure rather than merely a social arrangement. Toombs notes, following Foucault and Zaner, that under the medical gaze the body is transformed from lived body to anatomical body: the live body becomes explicable in terms of the dead body, and clinical observation becomes autopsy-in-advance.(Toombs, 1992)

Sartre’s treatment of ereutophobia (pathological fear of blushing) shows how this ontological structure generates clinical phenomena. The blush exposes the body as an uncontrollable signifier for the other’s gaze, making visible the vulnerability of embodied intersubjectivity.(Sartre, Jean-Paul, 1943) Aho, following Sartre, notes that in illness the power of the other’s look is magnified: the patient is repeatedly reminded of being damaged, disfigured, immobile, and slow, as Goffman’s concept of stigma makes sociologically explicit.(James Aho, Kevin Aho, 2009)

Conflict in Concrete Relations

Sartre argues that all concrete relations with others (love, desire, hate, indifference) are characterized by irreducible conflict: each consciousness attempts to capture the other’s freedom while preserving its own, but this project is necessarily self-defeating.(Sartre, Jean-Paul, 1943) Sexual desire is his central illustration of this structure: desire is not primarily directed toward an organ or an act but is a project to incarnate the Other’s consciousness — to make the Other’s freedom appear as mere flesh — while simultaneously allowing one’s own consciousness to be captured in bodily facticity, making desire a mutual enslavement rather than a meeting of subjects.(Sartre, Jean-Paul, 1943) This ontological pessimism about intersubjectivity is one of the sharpest points of divergence between Sartre and the bioethical tradition, which requires some form of genuine therapeutic alliance. Svenaeus’s phenomenological bioethics addresses this directly: while Sartre’s framework exposes the objectifying structure of clinical encounters, it requires supplementation by Levinas’s ethics of the face, a radical asymmetry in which the other’s vulnerability forbids violence and grounds clinical obligation.(Svenaeus, 2018)

Freedom, Situation, and the Condemned-to-Be-Free

Sartre’s most famous formulation appears in Part Four: we are “condemned to be free.”(Sartre, Jean-Paul, 1943) Freedom is not a property consciousness happens to have; it is the very being of consciousness. We cannot choose not to choose, and we are fully responsible for what we make of our situation even if we did not choose the situation itself.

This does not mean situation is irrelevant. Sartre’s concept of the situation (the facticity-plus-freedom complex) holds that we are always already in a world we did not choose, yet we cannot be determined by it.(Sartre, Jean-Paul, 1943) The same objective situation (grinding poverty, chronic illness, disability) can be lived as intolerable injustice prompting action or as simply “how things are,” depending on whether the person chooses to see themselves as a free subject who can surpass their condition. This structure is directly relevant to clinical questions about how suffering is lived from within constraint, and to debates about patient autonomy that assume free choice as a given rather than as an achievement.

Sartre also argues that motives and drives do not cause action from within the psyche but are constituted by the free project itself: the agent retrospectively posits what counted as a reason for acting, meaning there is no psychological determinism that precedes choice.(Sartre, Jean-Paul, 1943) This anti-determinism places Sartre in explicit dialogue with Jaspers’s General Psychopathology, which he cites for its use of Verstehen (understanding, comprehensible connections between mental states), while departing from Jaspers by denying that these connections have any causal force.(Sartre, Jean-Paul, 1943)

Sartre’s Critique of Being-toward-Death

Sartre diverges sharply from Heidegger on death. He argues that “Being-toward-death” (Sein-zum-Tode), the Heideggerian claim that death is my ownmost possibility and gives life its authentic structure, is mistaken: death is not my ownmost possibility because it is precisely what deprives me of all possibility. Death arrives from outside as an absurd facticity and cannot be anticipated or owned; it simply interrupts my projects.(Sartre, Jean-Paul, 1943) For medicine, this matters: Sartre’s analysis supports the view that the anticipation of mortality does not straightforwardly structure authentic choice in the Heideggerian sense, but is experienced as a threat from without that may equally produce despair as resolution.

Existential Psychoanalysis

Sartre proposes existential psychoanalysis as an alternative to Freudian analysis. Rather than seeking repressed drives in a causal-mechanistic unconscious, existential psychoanalysis seeks the “original project”: the fundamental free choice of being that gives unity and meaning to all of a person’s specific choices and behaviors.(Sartre, Jean-Paul, 1943) Sartre illustrates this with the case of Flaubert, whose literary style and neurotic symptoms can be unified under a single fundamental choice of being: to be both active (writing) and passive (yielding).(Sartre, Jean-Paul, 1943)

The method extends to the analysis of possession and material qualities. Possession (avoir) represents an attempt by the for-itself to appropriate the solidity of being-in-itself by making an object “part of itself,” but this project is inherently futile: the possessed object remains irreducibly in-itself and the identity sought is never achieved, revealing the for-itself’s perpetual lack.(Sartre, Jean-Paul, 1943) Sartre’s analysis of the viscous (le visqueux) further demonstrates this method: the viscous is experienced pre-reflectively as threatening because it symbolizes a mode of being intermediate between solid and liquid, one that clings and absorbs, threatening to engulf the for-itself’s freedom in a way pure solidity does not.(Sartre, Jean-Paul, 1943) Both analyses show that material qualities encountered in the world are always already laden with existential significance corresponding to structures of the for-itself’s mode of being. This method influenced Sartre’s monumental late work, The Family Idiot (1971–72), a three-volume existential biography of Flaubert.

For clinical practice, existential psychoanalysis places the question of meaning (the original project) at the center of therapeutic inquiry. Rather than asking what caused the symptom, it asks what the symptom means in the context of the patient’s fundamental orientation toward being. This framing directly influenced Laing, who cites Sartre’s preface to André Gorz’s The Traitor (“long before our birth, even before we are conceived, our parents have decided who we will be”) as central to his account of how identity is imposed before choice is possible.(Laing, R. D., 1967)

Merleau-Ponty’s Critique and Extension

Merleau-Ponty, Sartre’s contemporary, offered the most systematic philosophical engagement with Being and Nothingness. In The Visible and the Invisible (1968, posthumous), he mounted a sustained critique of Sartre’s “philosophy of negativity.”

Merleau-Ponty argues that by making the seer pure nothingness and the visible absolute positivity, Sartre destroys the horizon-structure and depth that constitute genuine openness to being: “if the seer is nothingness, the visible forthwith occupies this void with absolute plenitude and positivity.”(Merleau-Ponty, Maurice, 1968) The result is that the world collapses into absolute presence to nothingness rather than the exploratory depth and field-structure that perception actually discloses. Merleau-Ponty also argues that absolute negativity and absolute positivity are ultimately the same thought seen from opposing directions, each demanding the other.(Merleau-Ponty, Maurice, 1968)

On intersubjectivity, Merleau-Ponty finds that the philosophy of pure negativity cannot account for how other perspectives genuinely encounter the same world: it reduces the other to an inhabitant of my own universe, producing a transcendental solipsism.(Merleau-Ponty, Maurice, 1968) Sartre’s Look discloses the other’s existence through shame, but this remains a structure of conflict and threat rather than the intercorporeity and mutual flesh that Merleau-Ponty’s later ontology tries to articulate.

Despite these critiques, Merleau-Ponty explicitly confirms that shame and being-seen-by-the-other do reveal that my factical existence exceeds my own self-comprehension: “there is an experience of my total being as compromised in the visible part of myself.”(Merleau-Ponty, Maurice, 1968) The critique is thus a deepening extension rather than a repudiation.

Foucault, in his introduction to Canguilhem’s The Normal and the Pathological, identified two divergent strands of twentieth-century French philosophy that both stemmed from phenomenology: a philosophy of experience, sense, and subject (Sartre and Merleau-Ponty) versus a philosophy of knowledge, rationality, and concept (Cavaillès, Bachelard, Canguilhem).(Canguilhem, 1966) Being and Nothingness stands at the head of the first strand.

Reception in Medical Philosophy

Toombs and Phenomenology of Illness

S. Kay Toombs’s The Meaning of Illness (1992) makes extensive use of Being and Nothingness to analyze the structure of illness experience. Toombs directly applies Sartre’s four levels of illness constitution (pre-reflective sensory experiencing, suffered illness, disease as patient’s objectification, and disease state as physician’s conceptualization) to argue that medicine systematically privileges the last level at the expense of the first three.(Toombs, 1992) At the pre-reflective level, suffering is experienced by persons, not merely by bodies, and occurs at the reflective level where it is intimately related to the meanings the patient assigns to pre-reflective sensory experience.(Toombs, 1992)

Svenaeus and Phenomenological Bioethics

Fredrik Svenaeus places Sartre, alongside Husserl, Heidegger, and Merleau-Ponty, within the phenomenological tradition that Svenaeus’s Phenomenological Bioethics (2018) attempts to bring to bear directly on medical ethics.(Svenaeus, 2018) Svenaeus reads Sartre’s pain-as-melody analysis as a core contribution to understanding chronic illness suffering.(Svenaeus, 2018) He also draws on the objectifying dimension of Sartre’s Look to analyze the anorexia case: the objectification by way of the gaze in anorexia “is not primarily a battle between consciousnesses à la Sartre, but a finding oneself in a cultural pattern of norms regarding the feminine, the beautiful, and the successful. The gazes of others are soon made by the anorexic girl into a self-surveying gaze.”(Svenaeus, 2018) This extension of Sartre’s Look into the cultural field both applies and limits the purely ontological account.

Svenaeus situates the continental philosophical tradition, including existentialism, as having been “strangely absent in bioethics so far,” suggesting that the application of Sartrean concepts to medical ethics remains substantially underdeveloped.(Svenaeus, 2018)

Aho and Aho

Kevin and Jacoby Aho, in Body Matters (2009), use Sartre’s Look as a lens for the stigma attached to illness: “The Other’s look fashions my body in its nakedness, causes it to be born, sculptures it, produces it as it is. The Other holds a secret — the secret of what I am.”(James Aho, Kevin Aho, 2009) They situate Sartre within the phenomenological response to mechanistic biomedicine, noting that following his stay in Berlin in the early 1930s, Sartre popularized Heidegger’s Being and Time in his own Being and Nothingness, thereby transmitting the phenomenological critique of objectivism to France and eventually to the Anglophone world.(James Aho, Kevin Aho, 2009)

Influence on Anti-Psychiatry

Laing explicitly names Sartre alongside Marx, Kierkegaard, Nietzsche, Freud, Heidegger, and Tillich as the thinkers who identify alienation as the fundamental condition of modernity.(Laing, R. D., 1967) The Politics of Experience (1967) is saturated with Sartrean concepts: the primacy of first-person experience, the structure of bad faith (as the conversion of praxis back into process), and the refusal to reduce the patient to a fixed nature.

Laing’s translation of Sartrean praxis into clinical practice turns on the distinction between process and agency: defence mechanisms, phenomenologically understood, are not impersonal processes undergone by the patient but actions the person takes upon their own experience. “As he becomes de-alienated he is able first of all to become aware of them, if he has not already done so, and then to take the second, even more crucial, step of progressively realizing that these are things he does or has done to himself. Process becomes converted back to praxis, the patient becomes an agent.”(Laing, R. D., 1967)

From the object-relations side, Guntrip offered a pointed counter-reading: in Schizoid Phenomena, Object Relations and the Self (1969), he read the existentialist “emphasis on anxiety and meaninglessness from Heidegger and Sartre” as reflecting “the schizoid state’s cultural expression — a rationalized philosophy of despair.”(Guntrip, Harry, 1969) Guntrip’s clinical colleague Winnicott similarly held that the capacity to believe, grounded in trust in human love, is what the schizoid person lacks, and that existentialism’s celebration of anxiety represents schizoid despair elevated to a philosophy.(Guntrip, Harry, 1969) These critiques do not engage the detail of Being and Nothingness but stand as markers of the limits that object-relations theory perceived in Sartrean ontology.

Reception History

In the Anglophone world, British philosophers initially received Sartre’s existential phenomenology through empiricism and logical positivism, both of which distorted his original project.(Sartre, Jean-Paul, 1943) Herbert Marcuse published an unfavorable review in 1947, situating BN within competing Marxist frameworks.(Sartre, Jean-Paul, 1943) Isaiah Berlin, in a 1955 letter, moved from dismissal to qualified admiration: “It is most imaginative and bold and important.”(Sartre, Jean-Paul, 1943)

Post-structuralist philosophers including Foucault and Derrida explicitly positioned themselves against Sartre’s existentialism and its emphasis on the subject, declaring the “death of man” as a rejoinder to Sartrean humanism.(Sartre, Jean-Paul, 1943) This generational repudiation meant that Being and Nothingness received sustained attention in Anglo-American philosophy and medical humanities only after the structuralist moment had partly spent itself. Feminist philosophers found other elements useful, particularly the account of the objectifying gaze, and the text has been cited as relevant to understanding the clinical encounter and social relations of embodiment.(Sartre, Jean-Paul, 1943)

Sartre’s political turn after Being and Nothingness, moving toward Marxism and abandoning his planned work on morality, was driven in part by the felt priority of collective political action over existential ethics.(Sartre, Jean-Paul, 1943) The Critique of Dialectical Reason (1960) extended the analysis of freedom-in-situation into a theory of social groups, seriality, and class, work that fed directly into Laing’s social psychiatry.

Wider Significance

Being and Nothingness matters for medicine because it provided the first fully worked-out phenomenological ontology in which the body occupies a genuinely central position. Where Husserl’s transcendental phenomenology tended to bracket the body or treat it as an object of constitution, Sartre showed the body to be the very medium of the for-itself’s engagement with the world, irreducibly first-personal in its first dimension, irreducibly social in its second and third dimensions.

The Conclusion of Being and Nothingness synthesizes the ontological project by showing that being-in-itself, being-for-itself, and nothingness form an irreducible triad: nothingness is not a third thing alongside being but a nihilation performed by the for-itself upon the in-itself, making the world appear as a structured totality rather than undifferentiated brute being.(Sartre, Jean-Paul, 1943) Sartre then identifies the fundamental human project — to be the cause of oneself, the ens causa sui — as necessarily impossible: humans desire to be God (the being that would be both in-itself and for-itself), but this project founders on the ontological incompatibility of the two modes.(Sartre, Jean-Paul, 1943) Drawing on Plato’s Sophist, the Conclusion also reconceives the Other not as a being alongside the for-itself but as “otherness” as a negative determination entering being through consciousness’s self-surpassing, distinguishing Sartre’s account from Hegelian mutual recognition.(Sartre, Jean-Paul, 1943) The Conclusion consolidates the anti-determinist thesis: the for-itself is always already beyond its facticity — class, body, past — so the concept of psychological or social determination is ontologically groundless, even as the situation remains the necessary starting point that freedom must surpass.(Sartre, Jean-Paul, 1943)

The text also established a framework for critiquing the reduction of the patient to a clinical object. Bad faith, the Look, and the three dimensions of the body are all ways of tracking the gap between the patient as lived subject and the patient as presented to medical knowledge. These tools anticipated the concerns that Foucault would develop as the medical gaze, that Toombs would develop as the illness/disease distinction, and that Svenaeus would develop as phenomenological bioethics. Svenaeus’s Phenomenological Bioethics (2018) is, in his own account, the first single-authored monograph to offer a sustained phenomenological approach to biomedical ethics, bringing the Sartrean tradition to bear directly on questions of medical ethics that had previously been dominated by analytic principlism.(Svenaeus, 2018)

Scholarly Assessment

The philosophical literature broadly accepts the importance of Sartre’s account of the body and the Look while identifying two structural limitations for medical application.

First, Sartre’s ontology of conflict in intersubjective relations, where the other’s gaze necessarily threatens and objectifies, generates a description of the clinical encounter as intrinsically adversarial. Svenaeus argues that a viable phenomenological medical ethics requires supplementation by Levinas’s asymmetrical structure of care, which transforms the other’s vulnerability from a threat into an obligation.(Svenaeus, 2018)

Second, Merleau-Ponty’s critique shows that Sartre’s sharp opposition between nothingness and being prevents him from articulating the depth, horizon-structure, and intercorporeity that a full phenomenology of perception and embodiment requires.(Merleau-Ponty, Maurice, 1968) The body as lived-in-the-world is more deeply intertwined with its surroundings than Sartre’s ontology allows.

Both limitations are recognized without displacing the value of Sartre’s contributions to the philosophy of medicine. Toombs, Svenaeus, and Aho all draw substantially on Being and Nothingness precisely because the distinctions it introduces (pre-reflective pain versus thematized symptom, lived body versus body-for-others, bad faith versus authentic self-presentation) are not available in equivalent form elsewhere in the tradition.

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Editorial Notes

Gaps the encyclopaedia compiler flagged for future evidence work, collected from inline markers in the body and frontmatter.

Shame and the Clinical Encounter

Scholarly Assessment