An Analysis of Medical Knowledge and Reasoning

Until relatively recently, the human organism was always considered as an entity that was extremely complex, difficult to comprehend (if intelligible at all) and not subject to deterministic laws. At the turn of the nineteenth and twentieth centuries, thanks to the progress of science, a hope appeared that things were not so bad, that we could understand the human organism, which started to be seen as a precise, if not quite regularly working, mechanism. In the second half of the twentieth century, however, it has become evident that the living organism cannot be viewed in this way, and thus certain aspects of the previous, traditional way of looking at the organism have started to attract interest once again. This time, nonetheless, its complexity and indeterminacy have appeared in a new light, and it is the very same scientific progress that has now started to suggest how the components of the organism (and the way they work) may be perceived. In order to deal with the complexity and uncertainty, new sciences have appeared, such as systems theory, cybernetics and others (including the youngest of them, the theory of chaos). Research in the field of goal-directed human behaviour and efficient action (decision theory, praxiology and theories of management) is also beginning to bring results that are relevant to medical theory and practice. As regards medicine, perhaps even more crucial is the fact that the same disciplines in which a few score years ago reductionist, over-simplified tendencies dominated (e.g., physiology, biochemistry, pharmacology) are now becoming more mature — and seem to be ready to produce ideas that are sufficiently deep and broad to adequately describe extremely complex phenomena. A prerequisite, however, for the fulfilment of such a possibility is the development of a general methodological theory of these sciences.