Summary
Medical science stands accused of providing an incomplete understanding of health because it is supposedly founded on linearity, reductionism, and positivism.
These criticisms misrepresent the scientific method.
The alternatives offered by complexity theory, postmodernism, and qualitative research risk falling into the traps that the scientific method avoids.
The hypotheticodeductive model of science provides both a coherent description of the growth of scientific knowledge and a prescription for the conduct of good science.
MEDICAL science has been frequently characterised as providing an incomplete model of health and health care by critics from several quarters: complexity theory, postmodernism, and qualitative research. In contrast, alternative models are promoted as being more holistic or having better explanatory power of complex phenomena. In explaining the limitations of science, critics identify, in some degree or in combination, three purported characteristics of science: linearity, reductionism, and positivism.
There are two good reasons for challenging these critiques. Firstly, they misrepresent science, setting up what can be described as straw man arguments — false characterisations that are easy to knock down. Secondly, the alternatives they offer fall into the very traps that the scientific method has evolved to avoid.
Linearity
Writing in the British Journal of General Practice, Burton stated:
‘Most ideas behind modern medicine and organisational management are grounded in the paradigm of linear external control … Complex systems thinking, on the other hand, suggests that order and adaptation arise within the system, and secondly that adaptation depends more on the interactions of the parts of the system than the actual parts themselves.’1
This is a straw man argument: most concepts in modern medicine are based on non-linear relationships and on interactions. For example, medical science views HIV infection, like most infections, to be an interaction between …