Medicine, postmodernism, and the end of certainty

BMJ 1997; 314 doi: https://doi.org/10.1136/bmj.314.7086.1044a (Published 05 April 1997) Cite this as: BMJ 1997;314:1044

Postmodern philosophy offers a more appropriate system for medicine

  1. Nick Raithatha, General practitionera
  1. a Health Centre, University of East Anglia, Norwich NR4 7TJ
  2. b Chaveley Park Medical Centre, Belmont, Durham DH1 2UW
  3. c Public Health Laboratory, Countess of Chester Health Park, Chester CH2 1UL
  4. d Department of Psychiatry, University College London, Middlesex Hospital, London W1N 8AA

    Editor—Paul Hodgkin equates postmodernism with the death of belief.1 A more appropriate interpretation is that postmodernism argues against universal belief.1 Interpreting postmodernism according to the statement “where one version of truth is as good as another anything goes” is in fact a mistake. Postmodernism is an attack on dogma. It is for openmindedness and about other ideas and views. Postmodern philosophy would argue that there can be a truth which is not based on any particular belief system but on an agreed basis within a society at a particular time.2 As Hodgkin puts it, “To the postmodern eye truth is not out there waiting to be revealed but is something which is constructed by people.”

    I suspect that Karl Popper would argue strongly against evidence based medicine as a sole way forward. After all, the evidence is based only on our current value systems, which can dramatically alter with new advances in our understanding of nature.3 The postmodern philosophy in fact offers us a more appropriate system for medicine. The truth is based on a system agreed by society in terms of current scientific knowledge, cost, and the personal preference of individual patients. We have to question why so many of our patients resort to so called alternative therapy with minimal or no scientific evidence. It is because we try to impose our truth on our patients, who may have their own truth. We have to become more postmodernist if we are going to treat our patients appropriately rather than simply impose our …

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