This article has a threefold intention. 1. It intends to contribute to the clarification of the question in what respect medicine may be called a science and in what respect a practice. 2. It proposes a concept of clinical methodology (including clinical-ethical aspects), as a theory of medical practice that is one component of theoretical medicine. 3. It sketches an approach and some steps towards a systematic analysis of medical-clinical practice. In the first part, the position that medicine is a (...) practical science is criticized. It is shown that the supposed opposition of theoretical and practical sciences is misconstrued. The relevant distinctions are those between knowledge, research, and scientific practice. In the second part, an analysis of the structure and function of descriptive and normative data and of clinical knowledge and principles in clinical practice is given, and a strategy for solving the deep problems of clinical methodology and ethics is sketched. (shrink)

The epistemological status of health science, natural science, and clinical knowledge is explored. It is shown that ‘health science’, a term increasingly used in association with the clinical knowledge of the therapies, nursing, and other health occupations, is not fully a science in the sense of the natural sciences. It is rather a hybrid which relates applications of natural science, behavioral science, and the humanities to problems in health. The same may be said of clinical knowledge which entails, as essentials, (...) humanistic considerations involving the personal concerns of the patient, in addition to the more evident external aspects of diagnosis and treatment. The recent introduction of the term ‘health science’ reflects scientism in its approach to health issues. It also reflects confusion about the nature of clinical knowledge. Keywords: health science, clinical knowledge, natural science, behavioral science, humanism CiteULike Connotea Del.icio.us What's this? (shrink)

In spite of the seminal work A Philosophical Basis of Medical Practice, the debate on the task and goals of philosophy of medicine still continues. From an European perspective it is argued that the main topics dealt with by Pellegrino and Thomasma are still particularly relevant to medical practice as a healing practice, while expressing the need for a philosophy of medicine. Medical practice is a discursive practice which is highly influenced by other discursive practices like science, law and economics. (...) Philosophical analysis of those influences is needed to discern their effect on the goals of medicine and on the ways in which the self-image of man may be changed. The nature of medical practice and discourse itself makes it necessary to include different philosophical disciplines, like philosophy of science, of law, ethics, and epistemology. Possible scenario's of euthanasia and the human genome project in the USA and Europe are used to exemplify how philosopy of medicine can contribute to a realistic understanding of the problems which are related to the goals of medicine and health care. (shrink)

A suitable demarcation between pure science and applied research can be drawn in terms of their goals. This distinction of goals has methodological and cultural consequences. If the demarcation is accepted, what does the connection between the two enterprises look like? What is the role of science in medical practice? The Baconian answer to this question is discussed and criticised as too linear. A second answer may be that pure science has no part at all in medicine. This too can (...) be criticised as too simplistic. A third answer is suggested in which pure science plays the role of being an instrument for interpreting observations and problems, and of being a source of inspiration for technological research programs. (shrink)