Philosophy in epidemiology
Philosophy in epidemiology
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流行病学哲学
DOI：
10.1007/bf00489610
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发表时间：
1991
期刊：
影响因子：
--
通讯作者：
M. Susser
中科院分区：
文献类型：
--
作者：
M. Susser
致编辑：本期刊最近的文章强调了医学中哲学话语超越伦理话题的必要性[1-3]。在引发讨论的社论[4]中，林达尔意识到了这种论述的不足。他排除了伦理学；对于任何医学期刊的读者来说，近几十年来对这一领域的正式兴趣的迅速增长是显而易见的。他呼吁拓宽“一般医学的哲学和方法论”。Lindahl建议在杂志中解决这些问题，因为它们与医学研究特别相关。医学和相关科学中哲学和理论的缺乏是现代的特征。在很长一段时间里，情况完全相反。在弗朗西斯·培根推动经验主义研究之前的几个世纪里，理论优先于观察：根深蒂固的理论挑战的是观察，而不是相反。然而，一旦经验科学在18世纪和19世纪获得了发展势头，理论和哲学就从它们的首要地位被取代了。随之而来的是，“自然哲学”一词作为对科学的恰当描述也陷入了困境。从林达尔的角度来看，钟摆摆动得太远了。在正式意义上，流行病学无法逃脱这一限制。哲学家对流行病学研究文献的贡献寥寥无几。而且，直到最近，流行病学家很少把有争议的哲学带到他们的论述的中心。尽管如此，哲学的某些方面从一开始就以一种不言而喻的方式渗透到这门学科中，例如，在因果推理中。将流行病学的根源追溯到科学的起源并不是一种幻想。本杰明·法林顿在他关于希腊科学的启发性著作中辩称，希波克拉底医学是原始科学基础的重要组成部分。法林顿强调了希波克拉底著作的经验性，即他们对观察、推理和试验的依赖。从流行病学的角度审视希波克拉底著作[6]会让人认识到他们的概念与过去40年来共识所界定的流行病学领域的亲和力。在目前的定义中，流行病学是研究人群中健康状况的分布和决定因素。人们还可以补充说，流行病学既是一门应用科学，也是一门人类科学。就像医学一样，它被赋予了预防或减轻人类疾病的任务。
To the Editor: A need for philosophical discourse in medicine to go beyond ethical topics has been emphasized in recent articles in this journal [1-3]. In the editorial that provoked the discussion [4], Lindahl perceived a deficiency of such discourse. He excepted ethics; the burgeoning of formal interest in that area in recent decades is apparent to any reader of medical journals. His call is for a broadening of" the philosophy and methodology of medicine in general". Lindahl proposes to address these issues in the journal as they relate to medical research in particular.This dearth of philosophy and theory in medicine and allied sciences characterizes the modem era. For a long stretch of time, the case was quite opposite. During the centuries preceding Francis Bacon's promotion of empirical research, theory took priority over observation: well-entrenched theory challenged the observation, rather than the reverse. Once empirical science gathered momentum in the eighteenth and nineteenth centuries, however, theory and philosophy were displaced from their prime position. Along with that, the term" natural philosophy" went into limbo as an appropriate description of science. From Lindahl's perspective, the pendulum has swung too far. In a formal sense, epidemiology does not escape this stricture. Contributions by philosophers to the epidemiological research literature are few and far between. And, until recently, epidemiologists have seldom brought contending philosophies into the center of their discourse. Nonetheless, in an unstated way, some aspects of philosophy have been pervasive in the discipline from its beginning, for instance, in causal inference. It is not fanciful to trace the roots of epidemiology to the very origins of science. Hippocratic medicine, Benjamin Farrington argued in his illuminating works on Greek science, was an important part of the original scientific foundation [5]. Farrington stressed the empirical nature of the Hippocratic works, their reliance on observation, on inference and on trial. An examination 9f the Hippocratic works from an epidemiological perspective [6] leads one to recognize the affinity of their concepts with the epidemiological territory defined by consensus over the past four decades. In this current definition, epidemiology is the study of the distribution and determinants of health status in populations. One can add too that epidemiology is at once an applied science and a human science. Like medicine, it is endowed with the task of preventing or alleviating human ills.