Modularity, Subjectivity, Intersubjectivity and Normativity: Clinically Applicable Operative Benchmarks

Abstract

In the old tradition of disease management, an abbreviated relation was consistently established between experimental and clinical observations compiled in a reductionist manner and the daily practice of diagnosis and therapy. By now, the gap between medical theory and therapeutic practice has been further operationalized by a formal-pragmatic communication theory that tends to only care for the transparency of basic concepts, i.e., the universality of scientific description and situative systems-immanent validity claims. Because of its ‘multilingualism’, a formal-pragmatic communication theory may uncover unexpected coherencies, for example, between experimentally and clinically detectable normative notions, i.e., normative tumor structures, action norms (rapid displacing growth, the ‘hallmarks’ of cancer, etc.), decision maxims (hubs), and their corresponding established rationalization processes that are concretely responsible for the fail-safe constitution (robustness) of tumor-associated normative notions. The first diagnostic step is to reconstruct the prerequisites for the situative identity and function of the systems objects (cells, pathways, etc.) in a tumor system. The results of these efforts—which constitute evolution-adjusted tumor pathophysiology—may advect in completely new therapeutic approaches. Such approaches may consist of biomodulatory multi-targeted therapies that are directed at hubs of tumor-associated rationalization processes constituting distinct normative notions. The communicative nature of configuring novel tumor pathophysiology may launch and shape discussion levels also from a clinical point of view. Clinically oriented tumor pathophysiology is pragmatically deployed by the inclusion of communication-derived benchmarks, i.e., modularity, subjectivity, intersubjectivity and normativity. Necessarily, the starting points for categorizing rationalization processes are pragmatically selected for their final presentation and therapeutic implementation. Intersystemic comparison of rationalization processes plays a crucial role. The pluralistic procedure indicates the pragmatic function of a communication theory for personalizing tumor therapy.