O “programa fiduciário” de Polanyi desafia o ideal da racionalidade moderna de alcançar uma completa justificação de todas as crenças, submetendo-as a uma crítica prévia à sua aceitação. Este requisito é um dos malefícios que está na raiz de preconceitos filosóficos e científicos que Polanyi se propõe superar. Este artigo apresenta o confronto entre o “modelo linear” da justificação do conhecimento, a partir de um princípio absoluto, com a alternativa do “modelo circular” proposto por Polanyi. Não se trata de uma (...) circularidade viciosa, mas do reconhecimento de que os fundamentos do conhecimento radicam no compromisso pessoal e na atitude fiduciária, alicerces inegáveis de qualquer forma de conhecer. A alternativa proposta por Polanyi, de longa tradição filosófica, é, nos nossos dias, uma fonte de inspiração também para a hermenêutica contemporânea, com as suas noções de compreensão e interpretação. (shrink)

Continuously from the 1940s, Michael Polanyi comments on topics that have resonated later since the 1960s in the works of his fellow theorists of science, philosophers of natural sciences, and epistemologists. First part of this article provides a brief reconstruction of Polanyi’s concept of „personal knowledge“ which focuses mainly on the interconnection of the individual level of scientific research with its social dimension. My aim is to evaluate the potential of this concept for the interpretation of research fields where sciences (...) are in close contact with other disciplines. I am convinced that Polanyi’s original approach to the problem of reality should be read as an advocacy of diversity of thought. In my interpretation, Polanyi carries out some form of philosophical therapy of science and its self-concept, which, like the whole of Western society, has undergone dramatic changes over the last century. (shrink)

In this paper, we outline a framework for understanding the different kinds of knowledge required for medical practice and use this framework to show how scientism undermines aspects of this knowledge. The framework is based on Michael Polanyi’s claim that knowledge is primarily the product of the contemplations and convictions of persons and yet at the same time carries a sense of universality because it grasps at reality. Building on Polanyi’s ideas, we propose that knowledge can be described along two (...) intersecting “dimensions”: the tacit–explicit and the particular–general. These dimensions supersede the familiar “objective−subjective” dichotomy, as they more accurately describe the relationship between medical science and medical practice. Scientism, we argue, excludes tacit and particular knowledge and thereby distorts “clinical reality” and impairs medical practice and medical ethics. (shrink)

The evidence-based medicine movement advocates basing all medical decisions on certain types of quantitative research data and has stimulated protracted controversy and debate since its inception. Evidence-based medicine presupposes an inaccurate and deficient view of medical knowledge. Michael Polanyi’s theory of tacit knowledge both explains this deficiency and suggests remedies for it. Polanyi shows how all explicit human knowledge depends on a wealth of tacit knowledge which accrues from experience and is essential for problem solving. Edmund Pellegrino’s classic treatment of (...) clinical judgment is examined, and a Polanyian critique of this position demonstrates that tacit knowledge is necessary for understanding how clinical judgment and medical decisions involve persons. An adequate medical epistemology requires much more qualitative research relevant to the clinical encounter and medical decision making than is currently being done. This research is necessary for preventing an uncritical application of evidence-based medicine by health care managers that erodes good clinical practice. Polanyi’s epistemology shows the need for this work and provides the structural core for building an adequate and robust medical epistemology that moves beyond evidence-based medicine. (shrink)

Most clinicians take for granted a simple, reductionist understanding of medical knowledge that is at odds with how they actually practice medicine; routine medical decisions incorporate more complicated kinds of information than most standard accounts of medical reasoning suggest. A better understanding of the structure and function of knowledge in medicine can lead to practical improvements in clinical medicine. This understanding requires some familiarity with epistemology, the study of knowledge and its structure, in medicine. Michael Polanyi's theory of tacit knowing (...) is advanced as the basis for developing a more accurate understanding of medical knowledge. Tacit knowing, which explores the taken-for-granted background knowledge that underlies all human knowing, is explained in detail with a focus on its relevance for clinical medicine. The implications of recognizing tacit knowing in medicine and medical decisions are discussed. These include the ability to explain the importance of the clinical encounter in medical practice, mechanisms for analysing patient and doctor as persons, and the need for humility given the uncertainty that the tacit dimension injects into all medical decisions. This more robust medical epistemology allows clinicians to better articulate the nature and importance of patient-centred care, to avoid pitfalls inherent in reductionist approaches to medical knowledge, and to think more clearly about the relationships between medicine and health care at the individual and population levels. (shrink)