The Problem with Science—-the Context and Process of Care: An Excerpt from Remodelling Medicine

Abstract

• The goal of science is truth through knowledge. But medicine's truth is not altogether the same as science's truth. • Science works with ideas, imagination and intuition, but essentially has to do with facts. Medicine has also to deal with meaning. • This is not an argument for less science in medicine, but for more and better science; better in the sense of better attuned to 'the rest of life'. • Truthfulness is a core principle of medical practice and medical science. • But a kind of untruthfulness is common in day-to-day clinical practice. • The fundamental untruth is the illusion of certainty. • The inexcusable untruth is to reduce the patient's problem to it to its narrow biomedical parameters and to allow the patient as a person to vanish from our gaze. • Science fails medicine by the narrowness of the scope of things it is willing to investigate. Important areas of medicine have been neglected as a consequence. • The medical research culture must change if it is to promote science for understanding alongside science for manipulation. We need to be unsparingly critical of the distinction between useful science and wasteful science. • “Medical knowledge is not knowledge acquired primarily for its own sake (but) for a specific purpose—-the care of the sick.”1