The Pragmatist roots of scientific medicine: Reassessing Abraham Flexner's report on medical education

Abstract

Abraham Flexner's 1910 report on medical education is widely regarded as a watershed moment in the history of modern medicine in the US and beyond. Most commentators focus on its administrative and managerial impact, despite Flexner dedicating a sizeable portion of his report to a theoretical account of the kind of medicine that he seeks to implement. Close attention to these sections reveals a surprisingly coherent account of medicine that, based on a Deweyan Pragmatist philosophy of science, unites scientific investigator and medical practitioner in a new experimental paradigm of science. Flexner can develop an account that goes beyond a mere epistemic redefinition of medicine, providing the profession with a social, cultural, and ethical identity that avails itself of the extremely wide purview that Dewey granted to modern science. Due to the subsequent narrowing of philosophy of science to a delimited academic subdiscipline, these broad Pragmatist philosophical commitments at the roots of Flexner's scientific medicine remained a largely unexplored intellectual legacy.