Medicina e Pós-modernidade

"Within medicine one response to the relativism and uncertainty created by postmodernism has been to emphasise the evidence on which medicine is based. After all, if there are knowable medical truths "out there" then we should get our act together and apply them. Evidence based medicine promises certainty--do enough MEDLINE searches and you will find the answer to your prayers. Read in this way, evidence based medicine is a reaction to the multiple, fragmented versions of the "truth" which the postmodern world offers. It is also a serious attempt to invent a new language that might reunite the Babel of doctors and patients, managers and consumers. However, an evidence based approach will only work for as long as we all view medicine as "modern"--that is, as making statements about an objective, verifiable external reality. To the postmodernist the question is whose "evidence" is this anyway and whose interests does it promote?"

Paul Hodgkin contesta o "tratamento" de Bruce Charlton. E vai além, chama a atenção para a intromissão da tecnocultura no pensamento médico contemporâneo. Abrindo o caminho para Hofmann.

O Castelo Sitiado

Mais do texto de Bruce Charlton (que acertou o diagnóstico mas errou o tratamento! - comentaremos mais sobre o artigo.)

"In a condition of post-modernity there is no progress; merely fashion - there is no purpose, merely change. Society has become a conversation not an argument, a conversation without goal or end-point. Medicine, however, has not abandoned ideas of progress, neither has it abandoned the idea of purpose. Medical progress is seen in the conventional accounts of more effective surgery, powerful antibiotics with minimal side effects, successful prolongation of the life of diabetics, new cures for leukaemia, etc. If the purpose of medicine is to alleviate illness and cure disease, there is also an end point. After that goal has been achieved, the work of medicine is done, and the non-sick can get on with living. Progress towards that goal can be rationally and objectively charted. Medicine is modernity in action.

However, the position of modernist medicine in postmodern culture explains why there is a constant tendency for the boundaries of medicine to breakdown. Medicine tends to become engulfed by the surrounding aesthetic, feel-good, 'life-style' modes of thought which dissolve medical certainties into mere matters of fashion and preference. The plurality of views and lack of a shared moral framework has made cynicism commonplace, and medical 'objectivity' is cynically redescribed in terms of veiled self-interest. On the other hand medicine is inclined to burst its banks and attempt the subjugation of surrounding 'relativistic' territories using such 'objective' weapons as the prestige of science and the professional consensus of doctors."

Dissolver certezas médicas em modismos e preferências... A falta de uma matriz moral comum da medicina com a sociedade e o lugar-comum do cinismo... Como subjugar os territórios relativísticos que a sitiam se não com armas objetivas como o prestígio da ciência e o consenso de médicos? Evidence-Based Medicine!

O Atraso da Medicina

A meta suprema do Esclarecimento é o progresso obtido através da aplicação da racionalidade. No mundo esclarecido ou moderno, a livre investigação de pessoas racionais, com método e honestidade, leva invariavelmente à Verdade. A Verdade é fixa, transparente e, uma vez atingida, todos seres pensantes devem concordar com ela.

A Pós-modernidade é um mundo onde a racionalidade é desconstruída revelando sua base na subjetividade. A Verdade agora é construída e não descoberta. Relativismo mais que objetivismo. Preferência mais que verdade.

Por mais que se discuta o termo, será útil considerarmos, na ausência de uma definição melhor, que o mundo atual é pós-moderno. Vários segmentos culturais têm se comportado assim. O pensamento dominante na Arte, na Literatura, na Política, na Mídia e mesmo em textos filosóficos, é pós-moderno. Apenas um campo de atuação da ciência e cultura humanas continua fortemente influenciado pelo pensamento moderno/esclarecido: a Medicina...

Como disse um autor:

Medicine is(...) an island of rationalistic modernity floating in a shifting sea of subjective post-modernity - a castle of objectivity besieged by the forces of relativistic cynicism ...