title: Ex nihilo nihil fit? Medicine rests on solid foundations.
abstract: BACKGROUND
  There seem to be some misunderstandings abroad in the literature about medical epistemology and person-centered medicine concerning the nature of 'modest' or aetiological foundationalism, and some vagueness about 'emergence'.
  
  
  OBJECTIVE
  This paper urges a greater tolerance for a modest, Humean variety of foundationalism, not least because it seems to offer significant support for person-centred medicine. It also suggests a closer examination of emergence as an explanation or justification for medicine, since emergence is a complex concept that does nothing to rule out foundationalism.
  
  
  METHODS
  Reading of relevant literatures relating to foundationalism, emergence and person-centered medicine, and reflection on the arguments they contain.
  
  
  RESULTS
  Foundationalism has been condemned tout court without recognizing that it comes in various styles and degrees. Emergence has been used as a property of medicine to dismiss any need to seek its foundations. But emergence too comes in different forms, not all of them at odds with modest foundationalism. Modest or aetiological foundationalism is far more flexible than Cartesian foundationalism, and is compatible with modern understandings of emergence.
  
  
  CONCLUSIONS
  Modest foundationalism and a particular understanding of emergence support the ontological and epistemological underpinning of person-centered medicine.
authors.affiliation: Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, New South Wales, Australia. miles.little@sydney.edu.au
authors.forename: Miles
authors.initials: M
authors.lastname: Little
mesh_terms: D003695:Delivery of Health Care; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008962:Models, Theoretical; D018802:Patient-Centered Care