Scientific understanding in medical research and clinical medicine

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Submission Summary
According to a view that is gaining traction in current philosophy of science, what best describes the aim of scientific inquiries is not truth or knowledge about some target phenomenon, but understanding, which is taken to be a distinct cognitive accomplishment. At the same time, scientific inquiry is thought to be characterized by a certain systematicity that sets it apart from everyday inquiries. This permits a gradual progression from prescientific (or nonscientific) to scientific inquiries and grants scientific inquires a higher degree of systematicity without rendering the commonsense counterpart unsystematic. In light of these two views, we may conceptualize scientific medicine as a systematic inquiry that aims at a particular type of (medical) understanding. Due to the significant diversity that characterizes scientific endeavors, we may expect that what qualifies as constituting proper understanding is to a certain degree context-sensitive and can take on different forms depending on the nature of the scientific field and the features of its subject matter. If so, then we have at least some initial reasons for thinking that understanding within the context of medicine might differ in various ways from understanding in physics or chemistry. A better comprehension of the nature of understanding in medicine merits sustained philosophical attention, and this talk is dedicated to clarifying this matter. The talk falls into three parts. The first part describes in more detail what it means to understand something, distinguishes types of understanding, and links a type of understanding (i.e., objectual understanding) to explanations. The second part proceeds to investigate what objectual understanding of a disease (i.e., biomedical understanding) requires by considering the case of scurvy from the history of medicine. The main hypothesis here is that grasping a correct mechanistic explanation of a condition is a necessary condition for biomedical understanding of that condition. The third part of the talk argues that biomedical understanding is necessary, but not sufficient for understanding in a clinical context (i.e., clinical understanding). The hypothesis is that clinical understanding combines biomedical understanding of a disease or pathological condition with a personal understanding of the patient with an illness. It will be shown that in many cases, clinical understanding necessitates adopting a particular second-personal stance and using cognitive resources in addition to those involved in biomedical understanding. The attempt to support this hypothesis will include revisiting the distinction between “understanding” and “explanation” familiar from debates concerning methodological principles in the humanities and social science.
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Aarhus university

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