title: Medicine's perception of reality - a split picture: critical reflections on apparent anomalies within the biomedical theory of science.
abstract: Escalating costs, increasing multi-morbidity, medically unexplained health problems, complex risk, poly-pharmacy and antibiotic resistance can be regarded as artefacts of the traditional knowledge production in Western medicine, arising from its particular worldview. Our paper presents a historically grounded critical analysis of this view. The materialistic shift of Enlightenment philosophy, separating subjectivity from bodily matter, became normative for modern medicine and yielded astonishing results. The traditional dichotomies of mind/body and subjective/objective are, however, incompatible with modern biological theory. Medical knowledge ignores central tenets of human existence, notably the physiological impact of subjective experience, relationships, history and sociocultural contexts. Biomedicine will not succeed in resolving today's poorly understood health problems by doing 'more of the same'. We must acknowledge that health, sickness and bodily functioning are interwoven with human meaning-production, fundamentally personal and biographical. This implies that the biomedical framework, although having engendered 'success stories' like the era of antibiotics, needs to be radically revised.
authors.affiliation: General Practice Research Unit, Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway.|Department of Community Medicine, The Arctic University Tromsø, Tromsø, Norway.
authors.forename: Anna Luise
authors.initials: AL
authors.lastname: Kirkengen
authors.affiliation: Faculty of Social Science and History, Volda University College, Volda, Norway.
authors.forename: Tor-Johan
authors.initials: TJ
authors.lastname: Ekeland
authors.affiliation: General Practice Research Unit, Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Linn
authors.initials: L
authors.lastname: Getz
authors.affiliation: General Practice Research Unit, Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Irene
authors.initials: I
authors.lastname: Hetlevik
authors.affiliation: Department of Community Medicine, The Arctic University Tromsø, Tromsø, Norway.|Department of Community Medicine, University of Bergen, Bergen, Norway.
authors.forename: Edvin
authors.initials: E
authors.lastname: Schei
authors.affiliation: Department of Microbiology, Haukeland University Hospital, Bergen, Norway.|Department of Clinical Science, University of Bergen, Bergen, Norway.
authors.forename: Elling
authors.initials: E
authors.lastname: Ulvestad
authors.affiliation: Department of Philosophy, University of Oslo, Oslo, Norway.
authors.forename: Arne Johan
authors.initials: AJ
authors.lastname: Vetlesen
mesh_terms: D015897:Comorbidity / Q000639:trends; D004992:Ethics, Medical; D019317:Evidence-Based Medicine; D006304:Health Status; D006801:Humans; D000069342:Medical Overuse / Q000639:trends; D062528:Medicalization / Q000639:trends; D008511:Medicine / Q000458:organization & administration*; D010465:Perception; D010686:Philosophy, Medical; D019338:Polypharmacy; D012307:Risk Factors; D064890:Social Determinants of Health / Q000639:trends
keywords: dichotomies; general practice; lived body; medical anomalies; phenomenology