Alternative Ways of Framing Parkinson's Disease: Implications for Priorities in Health Care and Biomedical Research

Abstract

American philosopher Donald Schön provided an account of profes sional problem solving, "reflection in action." An important compo nent of this is "framing experiments"—testing different ways of defin ing (framing) a problem by asking "Can I solve the problem thus set?" and "Would it result in a different solution?" Such questions are an swered by taking recourse to bodies of knowledge, theories, norms, and principles, which together constitute "overarching theories" and "appreciative systems." Such overarching theories and appreciative systems are quite specific for particular professional communities. In this article, Schön's theory is used to describe professional problem solving in a medical context by unraveling the contents of the over arching theories and appreciative systems of various medical subspe cialities. Thus Schön's theory is used to reveal the factors that determine to a large extent patient care and priorities in biomedical research and development. The existence of multiple, sometimes incompatible over arching theories and appreciative systems is used as an argument in favour of interactivity in technology assessment.