Medical Knowledge and Medical Action: Competing Visions

  • H. Tristram EngelhardtJr.
Part of the Philosophy and Medicine book series (PHME, volume 36)


Much of the energy of contemporary epistemology has been focused on the interplay of facts, theories, and general views of reality. What is observed is recognized against a field or web of significance. In some sense, one must know for what one is looking before one can see it. Theoretical assumptions guide our gaze and frame our experience. All of this is true about the unapplied sciences of which medicine is not an instance. In the case of medicine, as with all applied sciences, values interact robustly with facts, theories, and visions of reality. In applied sciences some facts are more important than others, not because they help us to know more truly, but because they help us to treat more effectively, whether effectiveness is measured in monetary or non-monetary terms. As Henrik Wulff has argued, physicians are not so much concerned whether classifications are true or false, but whether they are useful [16]. Physicians tend to be pleased with an artificial, instrumental classification even if it does not provide a “true” picture of reality, as long as it maximizes the effectiveness of therapeutic interventions. In the applied sciences, epistemic goals are important, but non-epistemic goals are central. One frames understandings of the world within an applied science such as medicine not in order to know the world truly, but in order to control the world easily and cheaply.


Medical Action Applied Science Medical Knowledge Scientific Revolution Health Care Institution 
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Copyright information

© Kluwer Academic Publishers 1990

Authors and Affiliations

  • H. Tristram EngelhardtJr.
    • 1
  1. 1.Baylor College of MedicineHoustonUSA

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