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Making Medical Knowledge (Paperback)
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Making Medical Knowledge (Paperback)
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How is medical knowledge made? New methods for research and
clinical care have reshaped the practices of medical knowledge
production over the last forty years. Consensus conferences,
evidence-based medicine, translational medicine, and narrative
medicine are among the most prominent new methods. Making Medical
Knowledge explores their origins and aims, their epistemic
strengths, and their epistemic weaknesses. Miriam Solomon argues
that the familiar dichotomy between the art and the science of
medicine is not adequate for understanding this plurality of
methods. The book begins by tracing the development of medical
consensus conferences, from their beginning at the United States'
National Institutes of Health in 1977, to their widespread adoption
in national and international contexts. It discusses consensus
conferences as social epistemic institutions designed to embody
democracy and achieve objectivity. Evidence-based medicine, which
developed next, ranks expert consensus at the bottom of the
evidence hierarchy, thus challenging the authority of consensus
conferences. Evidence-based medicine has transformed both medical
research and clinical medicine in many positive ways, but it has
also been accused of creating an intellectual hegemony that has
marginalized crucial stages of scientific research, particularly
scientific discovery. Translational medicine is understood as a
response to the shortfalls of both consensus conferences and
evidence-based medicine. Narrative medicine is the most prominent
recent development in the medical humanities. Its central claim is
that attention to narrative is essential for patient care. Solomon
argues that the differences between narrative medicine and the
other methods have been exaggerated, and offers a pluralistic
account of how the all the methods interact and sometimes conflict.
The result is both practical and theoretical suggestions for how to
improve medical knowledge and understand medical controversies.
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