Theoretical Medicine and Bioethics 27 (3):187--213 (2006)
|Abstract||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.|
|Keywords||No keywords specified (fix it)|
|Through your library||Configure|
Similar books and articles
Malcolm Parker (2002). Whither Our Art? Clinical Wisdom and Evidence-Based Medicine. Medicine, Health Care and Philosophy 5 (3):273-280.
Peter Hucklenbroich (1998). Steps Towards a Theory of Medical Practice. Theoretical Medicine and Bioethics 19 (3).
Ingemar Nordin (2000). Expert and Non-Expert Knowledge in Medical Practice. Medicine, Health Care and Philosophy 3 (3):295-302.
S. R. Jha (1998). The Tacit–Explicit Connection: Polanyian Integrative Philosophy and a Neo-Polanyian Medical Epistemology. Theoretical Medicine and Bioethics 19 (6).
Norbert Paul (1998). Incurable Suffering From the “Hiatus Theoreticus”? Some Epistemological Problems in Modern Medicine and the Clinical Relevance of Philosophy of Medicine. Theoretical Medicine and Bioethics 19 (3).
Stephen G. Henry (2011). A Clinical Perspective on Tacit Knowledge and Its Varieties. Tradition and Discovery 38 (1):13-17.
Peter C. Gøtzsche (2007). Rational Diagnosis and Treatment: Evidence-Based Clinical Decision-Making. J. Wiley.
Maya J. Goldenberg (2010). Clinical Evidence and the Absent Body in Medical Phenomenology. International Journal of Feminist Approaches to Bioethiics 3 (1):43-71.
Kirsti Malterud (1995). The Legitimacy of Clinical Knowledge: Towards a Medical Epistemology Embracing the Art of Medicine. Theoretical Medicine and Bioethics 16 (2).
Hillel D. Braude (2009). Clinical Intuition Versus Statistics: Different Modes of Tacit Knowledge in Clinical Epidemiology and Evidence-Based Medicine. Theoretical Medicine and Bioethics 30 (3):181-198.
Added to index2009-01-28
Total downloads24 ( #51,701 of 549,198 )
Recent downloads (6 months)1 ( #63,397 of 549,198 )
How can I increase my downloads?