Will our health system fall apart? The need for a new paradigm.

Abstract

It is a truism that medicine is in a crisis but the truism is right. This paper sets out the symptoms of the crisis. The effectiveness of modern medicine has been questioned by many. Doctors use too many tests and do not always understand the results. This is the practice of 'decerebrate medicine'. The alleged triumphs of modern medicine have made only a modest impact on mortality rates and death from iatrogenic causes is real. Modern medicine is allied to the industrial society with its hierarchies and division of work. This leads to tensions between doctors and between doctors and their patients. Administrators fear the progressive rise in health costs and ask whether more really means better. Economists demand evaluation of medical procedures and there is a growing demand for real preventive medicine. Health is a problem for the whole of society. This paper then sets out the epistemological aspects of the crisis in medicine. It suggests that a new paradigm must be constructed in the light of the scientific revolution. The concept of medicine based on analytical science with its reductionism and disjunctivism is not enough to cover the complexity of man. The new paradigm needs to embrace all the sciences, both of nature and of man. A view is given of how this process of comprehending an exceedingly complex problem should be tackled and the role to be played by information sciences.