Uffe Juul Jensen

The Struggle for Clinical Authority: Shifting Ontologies and the Politics of Evidence

Evidence-based medicine emerged in connection with struggles for clinical authority in the second half of the twentieth century, as patient-centred medicine and community-oriented medicine presented challenges to laboratory-oriented medicine. The renowned medical researchers Alvan Feinstein and Archie Cochrane helped to develop the new models of patient-centred and community-oriented medicine respectively. They made important contributions to methodological reflections in medicine, and also contributed to social theories about clinical medicine and health care, challenging and criticizing in different ways dominant ontological medical understandings (such as essentialist conceptions of disease and illness). The medical ontologies of patient-centred and community-oriented medicine comprise different (partly incompatible) perspectives on what constitutes standards of evidence, something reflected, for example, in Feinstein and Cochranes contrary views on the importance of controlled trials. The analysis of their work in this article illuminates the connection between medical ontologies, standards of evidence and the political in general, reminding us of the need to explore the role of politics in discussions of evidence-based medicine.

A Critique of Essentialism in Medicine

Modern clinical theory has inherited a philosophical vocabulary shared in the past by empiricists and rationalists. ‘Necessary’ and ‘sufficient’ are the key terms of this vocabulary. Use of these terms is unavoidable in two crucial contexts: when specifying conditions for referring in a clear and exact way to entities in the world, and when specifying the causal conditions for the occurrence of entities in the world.

Property, Rights, and the Body: The Danish Context

Some years ago a clergyman tried during a discussion on medical ethics to focus on some main problems in the Danish health care system by offering the following comment: ‘If the doctor takes even the smallest of the patient’s personal belongings when he or she is dead, the doctor will immediately lose his job. If the doctor, however, takes the patient’s body or parts of it for his research nothing at all happens. On the contrary, this is accepted as the most natural thing in the world, and this in spite of the fact that our body belongs to us in a much more essential way than (let us say) a watch’.

Bio-security after 9/11: public health or a threat to public health?

AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH 2011 vol. 35 no. 4

Values and the Growth of Medical Knowledge

Does the growth of medical knowledge lead to a gradual overcoming of our vulnerability and infirmity, or has ‘scientific’ medicine obtained resources for its own development and secured its own power and authority in modern society by spreading the myth that it could make us transcend human weakness and pave the way to human immortality? Advocates of modern medicine take the first approach. Critics, however, consider medicine as one of the most ideology-producing enterprises of modern society.