We are exhorted to make our medicine rigorously evidence based and yet robustly patient centred. We find ourselves having to square a circle. Why is it that these two aspects of medicine seem so determined to pull apart? And why is it that the scientific picture of evidence-based medicine always gets to play front of stage?
The US Philosopher Wilfrid Sellars describes two images or pictures of man. The scientific image of man is familiar to medics; it’s all about body tissues, genes, and biochemistry. But what if science is not the only valid way of knowing? Sellars sees the ‘manifest image’ of man as ‘the framework in terms of which, to use an existentialist turn of phrase, man first encountered himself’. The manifest image is connected to personhood and self-awareness, it is how I think of myself every day. Pascal said, ‘Man is but a reed, the most feeble thing in nature; but he is a thinking reed … …