The myth of objectivity: is medicine moving towards a social constructivist medical paradigm?
Biomedicine is improperly imbued with a nomothetic methodology, which views 'disease' in a similar way to other 'natural' phenomena. This arises from a 300-year history of a positivist domination of science, meaning that objectivist research (e.g. randomized controlled trials or biochemical research) attracts more funding and is more readily published than 'softer' qualitative research. A brief review of objectivism and subjectivism is followed by a definition of an emerging medical paradigm. Current 'inappropriate' medical practices become understandable in this broader context, and examples are given. A constructivist paradigm can continue to incorporate 'objective' clinical findings and interventions, as well as the recent evidence for the doctor-patient relationship as a major contributor to patient outcomes.
Wilson
H J
HJ
Department of General Practice, Dunedin School of Medicine, PO Box 913, Dunedin, New Zealand.
D001154:Art; D019317:Evidence-Based Medicine / Q000639:trends*; D006694:Holistic Health; D006801:Humans; D019359:Knowledge; D010686:Philosophy, Medical; D010819:Physician's Role; D010817:Physician-Patient Relations; D012106:Research / Q000639:trends*; D012586:Science / Q000639:trends*; D012951:Socialization; D013337:Students, Medical / Q000523:psychology