The biomedical disciplines and the structure of biomedical and clinical knowledge

Theoretical Medicine and Bioethics 21 (6):553-566 (2000)

Hubertus Nederbragt
Utrecht University
The relation between biomedical knowledge and clinicalknowledge is discussed by comparing their respectivestructures. The knowledge of a disease as a biologicalphenomenon is constructed by the interaction of factsand theories from the main biomedical disciplines:epidemiology, diagnostics, clinical trial, therapydevelopment and pathogenesis. Although these facts andtheories are based on probabilities andextrapolations, the interaction provides a reliableand coherent structure, comparable to a Kuhnianparadigma. In the structure of clinical knowledge,i.e. knowledge of the patient with the disease, notonly biomedical knowledge contributes to the structurebut also economic and social relations, ethics andpersonal experience. However, the interaction betweeneach of the participating ``knowledges'' in clinicalknowledge is not based on mutual dependency andaccumulation of different arguments from each, as inbiomedical knowledge, but on competition and partialexclusion. Therefore, the structure of biomedicalknowledge is different from that of clinicalknowledge. This difference is used as the basis for adiscussion in which the place of technology,evidence-based medicine and the gap between scientificand clinical knowledge are evaluated.
Keywords biomedical disciplines  biomedical knowledge  clinical knowledge  paradigma  structure of knowledge
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Reprint years 2004
DOI 10.1023/A:1026510723597
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Strategies to Improve the Reliability of a Theory: The Experiment of Bacterial Invasion Into Cultured Epithelial Cells.Hubertus Nederbragt - 2003 - Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences 34 (4):593-614.

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