The myth of objectivity: Is medicine moving towards a social constructivist medical paradigm?

Abstract

Biomedicine is improperly imbued with a nomothetic methodology, which views 'disease' in a similar way to other 'natural' phenomena. This arises from a 300-year history of a positivist domination of science, meaning that objectivist research (e.g. randomized controlled trials or biochemical research) attracts more funding and is more readily published than 'softer' qualitative research. A brief review of objectivism and subjectivism is followed by a definition of an emerging medical paradigm. Current 'inappropriate' medical practices become understandable in this broader context, and examples are given. A constructivist paradigm can continue to incorporate 'objective' clinical findings and interventions, as well as the recent evidence for the doctor-patient relationship as a major contributor to patient outcomes.