Does medicine need philosophy?

es, doubly so. First of all, in an epistemological sense, and to reflect on the question of what do we know and what do we not know, and why do we think we do or do not know?

Some positions are simply taken for granted, which is not good. Everything should be (and is) subject to revision in the light of new information acquired over time. A grain of an anarchist approach is also not superfluous. Anarchism, as at best a movement that questions institutions as levers of power in society, is necessary for medicine. Medicine as an institutional school of thought demands a monopoly on medical truths by reference to science in medicine.

At the same time, it arrogates to itself the power to decide on questions of health, life and death. As we know, monopolies are dangerous. Because the application of science to medicine is only partially possible because of the multitude of variables involved in the process. Therefore, the results of valid scientific research in medicine are not beyond doubt.

It is only when the findings of medical scientific research are applied in practice that we get the real picture, i.e. insight into "whether a tool is good". Given that practice is much more complex than theory, we clinicians are faced with "dead letters on paper" that are often thrown to the wind!

At the same time, some of the knowledge we gain in our daily work is not present in the literature, and it is difficult to enter it because the editorial filter is not independent, but is influenced by the ruling power structure in the medical world at a global level (industry interests!). Let us not forget that in every school of thought there are dogmas that are nurtured by the professional authority mainly to preserve and justify their own egos!

Why do I think things are going this far? Because of the primacy of interest over cognitive values in medicine. Medicine wants to maintain social power and resorts to all sorts of manipulations (because only the sick need medicine and invest in it), and the consequences are not only convenient. Given that every revolution sacrifices its children, we doctors are often held hostage to our own often unconscious manipulative concepts.

All of the above is not only true of medicine, but of any professional cartel, and the game starts with manipulation in education.  It seems that everyone in society is hatching smaller or bigger conspiracies to keep the money as long and as much as possible and never let it go. Perhaps this approach is logical, because we are all only human. It is just that we do not, at least in front of ourselves, wrap our interests up in all sorts of stories, science being one of them. Some believe that the answer lies in evidence-based medicine. But it is really all the same, and it is just a recycling of knowledge and thinking that has already been seen, precisely because of the nature of the editorial filter that watches over the 'input of ideas' into the relevant medical literature.

Integral medicine is more acceptable because:

1. it takes on interesting cognitive values (because it is not a slave to any school of thought)
2. it integrates good ideas from different systems, which increases its cognitive power and thus places itself in a position of real authority (maintained by competence) rather than false authority (maintained by force)
3. creates free doctors. Free to do their real work. And that creates health!

(The author of this text is in no way against science and medical education. She is already campaigning for its revision.)

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:

1. All conscious actions are driven by values and beliefs, as modern decision theory tells us
2. Therefore, all conscious actions of scientists, including the acceptance or rejection of theories, are motivated by values
3. 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...

1. 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 ...
2. The supposed objectivity of science is nothing but an intersubjective agreement between scientists
3. Science is nothing but a social-psychological process of persuasion, similar to political or religious persuasion, except with more defined standards
4. 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.

Marketing in medicine

Medicine is a specific form of goods and services on the market and, like any other industry, it wants to achieve results. It therefore relies on marketing to be as effective as possible in this respect.

We will examine the basics of marketing in medicine using the example of the drug Lxxxxxxxxx, which is an antidepressant by nature, by comparing the real pharmacological and clinical aspects of this drug with the information in the advertisement itself (immanent critique) and by analysing the codes in the advertisement that facilitate the construction of transferable symbols (semiotic analysis). It is then important to familiarise oneself with the social formation in which the advertisements have been produced and who is perceiving and accepting them.

In a political economic context, drugs are produced to make a profit in a situation where such goods are in demand.

The 20th century saw a huge expansion of the pharmaceutical industry, starting with antibiotics, but psychotropic drugs have also been important. The production of medicines is rooted in the concept of the disease state in terms of the search for a 'magic pill' for a particular condition.

Pharmaceutical companies compete with each other to win as much of the market as possible. Given the relatively small number of chemical substances used in medical treatments, every company wants and needs to differentiate its product from the competition in order to win as much of the market as possible. Therefore, good quality advertising to promote a particular product is actually the most important factor for your marketing success.

The basic differentiation between these products is done through the signs attached to them in the advertisement. There is, however, a peculiarity in the case of medicines, namely the legal restriction on advertising because they are prescription medicines.  Therefore, the target audience for advertising is the medical population, which reads professional medical literature, while the means of public communication are excluded from the range of media used to advertise medicines.

Doctors, influenced by the advertisements that medical journals are full of, pass on their decisions to patients, and in this way some products and related companies gain commercial results, since it is precisely because of the advertising that this medicine sells better than others.

The basic principles of marketing also apply to the advertising of medicines. Given that every medicine ultimately wants to be presented in a better light than it is (which is the whole point of marketing), visual symbols are added to the name and description in the advertisement.

In the case of the real drug Lxxxxxx, the advertising objective is to associate the name of the drug with the symbolism of the rose flower, so that the rose symbolises the fullness of life that the alleged drug Lxxxxxx provides to users. The rose flower stands in metaphorical contrast to the metaphor of desolation and pallor that is associated with depression and is therefore associated with the cure of depression. Thus, the rose flower becomes a portable symbol for the drug Lxxxxxxxxx. The obvious objective of the marketing activity is to make the end-user associate Lxxxxxxxxx with the rose symbol and to associate this symbol with the cure for depression.

By subtly manipulating the target audience, the advert also seeks to associate with the product characteristics that do not necessarily make it a 'magic pill' for a particular problem. The same is directly linked to the patients' need for a quick and inexpensive solution to their health problems, which is why this type of advertising falls on deaf ears. In this way, lies and half-truths about medicines and their possibilities are conveyed.

Awareness of marketing tricks is important in all segments of life, but especially in medicine, so that we remain critical and not disillusioned with the products that are offered to us.

Paradigma

A paradigm is a set of basic assumptions or rules that we take for granted in order to understand reality and its phenomena. In this sense, a personal paradigm is the essential thing we impose on ourselves when interpreting things and phenomena around us. People have different paradigms as individuals, families, groups, nations, professions, etc.

A paradigm creates a mental filter through which the mind passes only the information that corresponds to its existing picture of the world. A paradigm can be compared to coloured glasses. For example, if the paradigm has a green colour, those who look through green glasses will see the world coloured in shades of green, and until they take off the green glasses, everything will appear green to them, and they will set their eyes on fire for it. It is only when they take off the "green glasses" that they will understand that things are not necessarily in shades of green, but take on different shades depending on the new glasses they put on.

The paradigm is created by information and experience in early childhood and later in life. It is power that imposes paradigms. Medicine is currently dominated by the biochemical paradigm, which explains everything that happens in disease and health through biochemical processes, and then there are electromagnetic, energetic, quantum, spiritual and many other things that we do not learn in school or college. For example, the biological effects of homeopathy are largely written off because there is no concentrated substance in the homeopathic preparation, which is a thorn in the side of the biochemical paradigm, and therefore homeopathy is considered a fraud.

The need for a paradigm shift arises when some phenomena cannot be explained by the existing paradigm. People with closed minds often refuse to give up their paradigm, even if the actions demand it, mainly because it requires effort but arouses fear, so they deny phenomena that do not fit the worldview they represent, but treat them as impossible. After all, the ego is perceived through its external identity and value system, so the shaking of the personal paradigm is a threat to the ego.

An interesting example is that of one of my colleagues who told me that patients complain about the side effects of medicines because they read the instructions! In fact, the threat to her ego is the assumption that the drugs we use in conventional medicine are not as good as we think, or that she is not as good as she wants to think of herself!

Paradigms are changing, especially in physics. The radical paradigm challenger in physics is Prof. Amit Goswami, who derives transcendence as a necessary phenomenon from analyses of the behaviour of subatomic particles. If we walk around with our eyes open, we have to revise our views very often, because actions demand it. After all, why not? Life has no other purpose than learning, in the narrow and broad sense of the word.