Prediction, Understanding, and Medicine

Journal of Medicine and Philosophy 43 (3):289-305 (2018)
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Abstract

What is medicine? One obvious answer in the context of the contemporary clinical tradition is that medicine is the process of curing sick people. However, this “curative thesis” is not satisfactory, even when “cure” is defined generously and even when exceptions such as cosmetic surgery are set aside. Historian of medicine Roy Porter argues that the position of medicine in society has had, and still has, little to do with its ability to make people better. Moreover, the efficacy of medicine for improving population health has been famously doubted by historians and epidemiologists. The curative thesis demands that we have mostly been stupid, duped, or staggeringly hopeful, given that medicine has not until recently offered more than a handful of effective cures. I suggest, in this article, that the core medical competence is neither to cure, nor to prevent, disease, but to understand and to predict it. I argue that this approach does a better job than the curative thesis at explaining why not all medicine is concerned with curative efforts and that it enjoys historical support from the ancient entanglement of prophecy and medicine and from the fact that medicine thrived for centuries with almost no effective cures and continues to thrive today in various forms that are mostly without curative efficacy. I suggest that this approach grounds a fairer approach to alternative, traditional, and other medical practices, as well as some fresh lessons for the development of mainstream medicine.

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Alex Broadbent
University of Johannesburg

Citations of this work

Medicine Without Cure?: A Cluster Analysis of the Nature of Medicine.Thaddeus Metz - 2018 - Journal of Medicine and Philosophy 43 (3):306-312.
Bioethics After the Death of God.Mark J. Cherry - 2018 - Journal of Medicine and Philosophy 43 (6):615-630.

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References found in this work

Causal explanation.David Lewis - 1986 - In Philosophical Papers, Volume II. New York, US: Oxford University Press. pp. 214-240.
Précis of Inference to the Best Explanation, 2 nd Edition.Peter Lipton - 2007 - Philosophy and Phenomenological Research 74 (2):421-423.
The philosophy of evidence-based medicine.Jeremy Howick - 2011 - Chichester, West Sussex, UK: Wiley-Blackwell, BMJ Books.
Medical Nihilism.Jacob Stegenga - 2018 - Oxford, United Kingdom: Oxford University Press.
Contrastive causation.Jonathan Schaffer - 2005 - Philosophical Review 114 (3):327-358.

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