Recognizing tacit knowledge in medical epistemology

Theoretical Medicine and Bioethics 27 (3):187--213 (2006)

Authors
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 clinical judgment  medical epistemology  evidence-based medicine  Edmund Pellegrino  Michael Polanyi  tacit knowledge
Categories (categorize this paper)
DOI 10.1007/s11017-006-9005-x
Options
Edit this record
Mark as duplicate
Export citation
Find it on Scholar
Request removal from index
Revision history

Download options

Our Archive


Upload a copy of this paper     Check publisher's policy     Papers currently archived: 46,282
External links

Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
Through your library

References found in this work BETA

The Tacit Dimension. --.Michael Polanyi & Amartya Sen - 1966 - Chicago, IL: University of Chicago.

View all 23 references / Add more references

Citations of this work BETA

Polanyi's Tacit Knowing and the Relevance of Epistemology to Clinical Medicine.Stephen G. Henry - 2010 - Journal of Evaluation in Clinical Practice 16 (2):292-297.
The Challenge of Evidence in Clinical Medicine.Mark R. Tonelli - 2010 - Journal of Evaluation in Clinical Practice 16 (2):384-389.
Defining Quality of Care Persuasively.Maya J. Goldenberg - 2012 - Theoretical Medicine and Bioethics 33 (4):243-261.

View all 26 citations / Add more citations

Similar books and articles

Whither Our Art? Clinical Wisdom and Evidence-Based Medicine.Malcolm Parker - 2002 - Medicine, Health Care and Philosophy 5 (3):273-280.
Clinical Evidence and the Absent Body in Medical Phenomenology.Maya J. Goldenberg - 2010 - International Journal of Feminist Approaches to Bioethiics 3 (1):43-71.
Expert and Non-Expert Knowledge in Medical Practice.Ingemar Nordin - 2000 - Medicine, Health Care and Philosophy 3 (3):295-302.
Steps Towards a Theory of Medical Practice.Peter Hucklenbroich - 1998 - Theoretical Medicine and Bioethics 19 (3):215-228.

Analytics

Added to PP index
2009-01-28

Total views
131 ( #63,307 of 2,285,911 )

Recent downloads (6 months)
5 ( #250,216 of 2,285,911 )

How can I increase my downloads?

Downloads

My notes

Sign in to use this feature