The work of the French philosopher Georges Canguilhem is introduced here. Medical historiography is not the ultimate aim of Canguilhems work, but rather a tool for the analysis ef epistemological questions. These questions are to be investigated, as well as the art of medical history that Canguilhem considers to be helpful for such investigations. French „epistemology”, a direction of philosophy of science to which Canguilhem belongs, is discussed first. Canguilhem's epistomology does not aim at a rational reconstruction of decontextualized scientific (...) results, but at an historical reconstruction of science. It analyses the functioning of scientific concepts in relation of their historical context. The main themes of Canguilhems work are summarized in a second part of this study. Finally we investigate the importance of Canguilhem for modern research in history of medicine. (shrink)

This article explores Foucault’s two different notions of power: one where the subject is constituted by power–knowledge relations and another that emphasizes how power is a central feature of human action. By drawing out these two conceptualizations of power, Foucault’s work contributes three critical points to the formation of medicalized subjectivities: the issue of medicalization needs to be discussed both in terms of both specific practices and holistically ; we need to think how we as human beings are “disciplined” and (...) “subjectivated” through medicalization, as discourses, practices, and institutions are all crystallizations of power relations; and we need to reflect on how we can “resist” this process of subjectification, since “power comes from below” and patients shape themselves through “technologies of the self.” Ultimately, Foucault’s work does not merely assist us in refining our analysis; rather, it is essential for conceptualizing medicalization in contemporary society. (shrink)

Background Biomedicine, i.e. the application of basic sciences to medicine, has become the cornerstone for the study of etiopathogenesis and treatment of diseases. Biomedicine has enormously contributed to the progress of medicine and healthcare and has become the preferred approach to medical problems in the West. The developments in statistical inference and machine learning techniques have provided the foundation for personalised medicine where clinical management can be fully informed by biomedicine. The deployment of precision medicine may impact the autonomy and (...) self-normativity of the patients. Understanding the relationship between biomedicine and medical practice can help navigate the benefits and challenges offered by precision medicine. Methods Conventional content analysis was applied to “Le Normal and le Pathologique” (Canguilhem G. The Normal and the Pathological. Princeton: Princeton University Press; 1991) and further investigated with respect to its relationship with techne and precision medicine using PubMed and Google Scholar and the Standford Encyclopedia of Philosophy to search for the following keywords singularly or in combination: “Canguilhem”, “techne”, “episteme”, “precision medicine”, “machine learning AND medicine”. Results The Hippocratic concept of techne accounts for many characteristics of medical knowledge and practice. The advances of biomedicine, experimental medicine and, more recently, machine learning offer, in contrast, the model of a medicine based purely on episteme. I argue that Canguilhem medical epistemology establishes a framework where episteme and data-driven medicine is compatible with the promotion of patient’s autonomy and self-normativity. Conclusions Canguilhem’s medical epistemology orders the relationship of applied medicine with experimental sciences, ethics and social sciences. It provides guidance to define the scope of medicine and the boundaries of medicalization of healthy life. Finally, it sets an agenda for a safe implementation of machine learning in medicine. (shrink)