The evidence-based medicine movement was intended as a methodological revolution. Its proponents suggested the best way to establish the effectiveness of treatment and new criteria to choose between available treatments without bias. Philosophically, however, these changes were not so innocent, at least not ontologically speaking. In bringing itself closer to science, medicine has become less suitable for dealing with complex illnesses, individual variations and, as I will argue, with causation in general. (more…)
Gazing through my window, I’m enriched by a muted but beautiful December twilight-palette. The remains of autumn covered by a thin layer of snow. It’s said that every culture has its own sense of the different hues. I’m reading a beautiful passage in White by Kenya Hara about the traditional Japanese way of naming colours. Contrary to the modern way of categorizing a given spectrum of light, such as greens, magentas or yellows, it’s said that red, blue, white and black were the only basic colour adjectives in 8th century Japan. The tradition was not to classify, but to describe and texturize, capturing the seasons and surroundings. This narrative heritage is beautifully documented in the book The traditional colours of Japan.
I’m imagining a metaphorical link from all this to the difficulties of describing experience—sensations, emotions, pain or pleasure. (more…)
Have you ever thought about whether your regular GP knows more about you than your blood pressure or cholesterol levels? If so, might such knowledge be of any medical relevance?
Most of us visit our regular GP once or twice a year for more or less trivial complaints, and you are probably most interested in the GPs medical skills, and not so concerned about whether the doctor knows you as person or not. However, if you got seriously ill or had a chronic illness, would it still not matter? (more…)
What if one would weave a text by means of threads coloured by the recent topics of the on-going CauseHealth project. One thread would be causality, and how it is understood and applied in current biomedicine. Another would be ontology in the sense of how a human being and the human body is conceptualised in medicine and how this concept underpins the Western health care systems. A third thread would be methodology, and how the predominant methods for knowledge production, group based, randomised trials often including thousands of patients, might be radically challenged by the concept of N=1. A fourth thread would be stories in the sense of biographies before a person fell ill, and stories in the sense of testimonies of being ill – and how these have been systematically avoided as possible source of contamination in medical knowledge production. A fifth thread would then be knowledge condensates as these have grown both in number and normativity in the shape of clinical guidelines in all medical specialties during the latest years. Together, these threads can form quite different pictures, dependent on the frame applied. (more…)