Medicine, ideology and social power
The main aim of this text is to draw the reader's attention to medicine as a social, not only a scientific phenomenon, and to make him aware of the ideological connotations of a medical doctrine that has at its core the aim of maintaining and even increasing the social power of medicine as a national and international system.
It follows that the theses taught at medical school are not only and necessarily scientific theses, but ideological theses, and that evidence-based medicine is not, because it does not take into account all possible evidence. Both are a function of social power for a certain group of people.
Medicine, ideology and social power Classical medicine, whose doctrine is systematised in medical textbooks, denotatively claims to be true. The truth of its claims is based on the assumptions that these claims have been postulated on the basis of scientific research, i.e. logical reasoning. In other words, it is based solely on cognitive values, i.e. whether something is logical or not (and not whether it is profitable or not, beautiful or not, moral or not, modern or not, etc.).
A value judgement labels objects as good or bad. The very fact that something is good or bad indicates the subjectivity of the person making the claim, i.e. whether something is good or bad for the person making the claim.
Thesis 1:
Science is a source of objective facts about the world. Science has nothing to do with values, either in the claims made or in the methods used to derive theories.
Appeal:
- All conscious actions are driven by values and beliefs, as modern decision theory tells us
- Therefore, all conscious actions of scientists, including the acceptance or rejection of theories, are motivated by values
- That is why everything in science is valuable
In the light of this objection, perhaps we could soften our thesis a little to make it acceptable ... Perhaps we could make a distinction between objective and subjective values and argue that science is free from subjective values.
Definition 1:
Values such as truth, unification, explanatory power are constitutive values for science. These are also cognitive values. Cognitive values are taken as indicators of truth.
Definition 2:
Norms, preferences, beliefs, interests that do not correlate with cognitive values are non-cognitive or contextual values. Unlike cognitive values, which are constant because they are derived from principles of mathematical logic, contextual values change from one context to another. For example, the director of an institute prefers to stick to a theory devised by his scientist friend rather than a competing theory devised by a woman from another country and of a different race...even though both are equally acceptable or unacceptable... .
Thesis 2:
Science is a source of objective facts about the world and is not influenced by contextual values.
Objection: No scientist is insensitive to non-epistemological values such as loyalty to teachers and colleagues, acceptance by the wider community, etc., because, after all, he is only human. Since there is no science without scientists, we conclude that science is not free from the influence of non-commons values, since scientists themselves are not. When contextual values influence science, their influence is always detrimental, because they interfere with the process of logical reasoning, i.e. independent inference.
Although science should be based solely on cognitive values, realistically this is not the case and we should take this into account.
We can therefore conclude that...
- The scientific community will decide which science is good and which is bad, just as in political revolutions the standards are dictated by the relevant community ...
- The supposed objectivity of science is nothing but an intersubjective agreement between scientists
- Science is nothing but a social-psychological process of persuasion, similar to political or religious persuasion, except with more defined standards
- Truth is (only) what the scientific community thinks it is
This conclusion is called the sociological turn in the philosophy of science.
If we accept ignorance, we need to rethink the knowledge we acquire at the dictates of the scientific community. Today, because of the easier flow of information in medicine, there is more and more consensus on certain problems at a global level, so the scientific community exists at a global level. This knowledge is systematised in reference textbooks from which students around the world learn.
It follows that there is other knowledge that is not taken into account by the scientific community, even if it is not based on cognitive values. This knowledge is systematised outside the school system and in a sense constitutes a scientific subculture. Given that the state is linked to the school medical system, it is directly involved and dictates to citizens what is true and what is false in medicine. In this sense, to know something is to be subject to information obtained from publicly promoted sources of information, i.e. schools. According to Plato's definition, to know something is to have a conviction about something that is really true, and that person is justified in believing that it is also true. Knowledge is therefore a benevolent belief ...
This brings us to the problem of ideology in medicine.
Ideology is defined as a closed system of thought based on certain assumptions, true or not, and based on subjective choice, which always serves something or someone. Every ideology categorises the world in a certain way, always according to some need, and the unrealistic need to fully justify every ideology creates fundamentalists, in politics, religion and elsewhere. Every ideology wants to prove itself right at all costs and does not stand up to criticism and revision precisely because it serves someone or something at a particular moment in time exactly as it is, materially and/or psychologically. This is why we say that ideology is a normative thought process. It creates mental norms in understanding the world. Exceptions to these norms are not welcome.
What is education, including medicine, other than a normative thought process? The education system will reward us if we accept the mental norms it postulates as truth.
In other words, it is an epistemological ideology. It prevents science from challenging the dominant paradigm. Although the definition of science says that it encourages the verification of existing beliefs, the dominant paradigm may prevent it from doing so (again because of the power issue). As we can see, scientific truth is only what the established scientific community claims. Should there be, and are there, corrections for this situation where human contextual values largely dominate this community as well as every community?
We now turn to social power in medicine. Social power is a measure of the ability of a system to control resources in a particular context.
Ideology in medicine always serves as an ideology to maintain social power. Medicine controls its environment and resources by selling its products as the best on the market. That they are the best, says medical science (or 'science'). Medicine, like any social group, wants to control resources better and more in order to maintain and strengthen its social power. It therefore needs an ideology. That is why the textbook says what it says and excludes anything different.
In view of the above, I do not think it is best for a patient to be treated within the system of any medical ideology, because he simply will not receive the therapeutic optimum.
This is why Integrative Medicine is currently the best treatment concept, as it takes into account all (established and subcultural), not just some (established) modalities that can be used to restore health. A greater number of therapeutic modalities creates a synergistic effect and accelerates the achievement of the desired goal - HEALTH.