[Medicine and medical concepts].

Abstract

Any discussion on the future of medicine has to deal with the healer's art based on cultural values and with the individual situation of the patients, their perception and concept of health and disease, their hopes, intentions and life projects. Medicine and health care are of fundamental importance in all societies, so their task goes far beyond the traditional academic discipline. As well as repairing localized damage with the usual technical and chemical instruments one may also use the regulatory measures of complementary medicine to stimulate the system's self-organization. Over and above this, healing means changing the patient's self-concepts, his concepts of health and disease, changing his behavior, and adapting his life projects and targets. The treatment, therefore, should be experienced by the patient as part of his life, and therapeutic interventions as well as the diagnostic interpretation are to be seen as structuring elements of the healing process, besides, of course, being helpful in the overcoming of the disease. Healing does not happen in a void, but within a therapeutic setting, a sort of subcultural unit which includes the therapist, and is based on a common understanding of the illness and a common will to overcome it. The therapeutic setting is an integrative part of regulatory treatment, and evaluation procedure must be designed in a way that the questions asked are consistent with the specific individual reality of the setting and the evaluation has no impact on the setting as such. Therefore, research cannot be done by the therapist since he is part of the setting, but must be undertaken by independent observation of the setting as a whole from outside. The projects of the Nationales Forschungsprogramm 34 (NFP34) provide an overview of adequate and inadequate concepts and methods for future structured evaluation of complementary medicine. Whether or not the results of the NFP34 will be helpful in advancing medicine depends on the possibility of creating an appropriate research mentality in this new field within the medical community and to establish ongoing projects. Some important concepts of approaching complementary medicine have not been evaluated, e. g. historical, ethnological, sociological and pragmatic methods. As some methods of complementary medicine actually have been integrated into the official curricula, ongoing re-evaluation is mandatory to assure the conherence in teaching and practice. Research into complementary medicine which often has its roots in other times and in other cultures must be designed in such a way that it covers the method's specific cultural concepts as well as the thinking patterns of public medicine today.