Ingemar Nordin

Expert and non-expert knowledge in medical practice

One problematic aspect of the rationality of medical practice concerns the relation between expert knowledge and non-expert knowledge. In medical practice it is important to match medical knowledge with the self-knowledge of the individual patient. This paper tries to study the problem of such matching by describing a model for technological paradigms and comparing it with an ideal of technological rationality. The professionalised experts tend to base their decisions and actions mostly on medical knowledge while the rationality of medicine also involves just as important elements of the personal evaluation and knowledge of the patients. Since both types of knowledge are necessary for rational decisions, the gap between the expert and the non-expert has to be bridged in some way. A solution to the problem is suggested in terms of pluralism, with the patient as ultimate decision-maker.

The limits of medical practice.

Should medicine be defined as the enterprise in charge of the health problems of society? If so, then any problem (individual, public, social or political) that can be reformulated as a “health problem” could serve as a goal of medicine. If, on the other hand, medicine ⁀ or medicine proper ⁀ is defined in terms of some limited goal and limited means, then some medical professionals would find themselves working in other fields than medicine. It could be of some importance to the patient to know whether the medical professional he meets is engaged in medical practice (aiming at the patients health), research, public health or some other project which involves medical competence. Obviously, some of these enterprises may have conflicting goals. This paper will analyse various candidates for being a model of medicine, discuss some of the consequences, and argue for a limited view of medical practice.

The Role of Science in Medicine

A suitable demarcation between pure science and applied research can be drawn in terms of their goals. This distinction of goals has methodological and cultural consequences. If the demarcation is accepted, what does the connection between the two enterprises look like? What is the role of science in medical practice? The Baconian answer to this question is discussed and criticised as too linear. A second answer may be that pure science has no part at all in medicine. This too can be criticised as too simplistic. A third answer is suggested in which pure science plays the role of being an instrument for interpreting observations and problems, and of being a source of inspiration for technological research programs.

Technology and Goodman’s Paradox*

Goodman’s paradox gives rise to a cluster of problems, problems that are in need of different answers. I will discuss some variants of the grue hypothesis applied to the technological context. One conclusion in this paper is that there is room for rational decisions, and that solutions to the paradoxes in technology can be found in the practical choice situation.