Roy Bhaskar was a prominent philosopher of science from 1975, holding, among other posts, World Scholar at the University of London. After 30 years of medical practice, this book helped to explain much of what medical school science failed to, in particular how patients might be understood as an inseparable symphony of mind and matter.
Bhaskar shows that we cannot explain the universe solely in terms of molecules and physical laws, and launches a detailed attack on the philosophical and practical problems of this view. He is keen to restore a dynamic dialogue between philosophy and science, which he feels has broken down over the last 300 years. Bhaskar spends much of the book building a new version of science rooted in a central position between these great paradigms. This position — where science observes an objective material reality, but only fallibly — is one where ideas and experiments find equal footing.
Bhaskar uses a key question: Are there any pre-conditions of science being possible, and what are these?
This leads to the argument that the molecular order and structure in the universe pre-dates and is independent of humans, but that humans must have independently thinking conscious minds with which to investigate this structure. Without these preconditions, no science is possible. Much of the rest of the book describes an updated version of science, now often referred to as ‘critical realism’. This includes key ideas such as emergence — that complex things, including the conscious mind, are more than their component parts.
Bhaskar’s book is written in difficult language, which many readers will find challenging, but those who persist will find that he describes a scientific world that is invigoratingly in tune with general practice. His arguments demolish simplified linear and atomistic accounts of science that still arguably dominate medical science. This new philosophy of science, if correctly understood as a modified account of reality, should revolutionise medical thinking in the decades to come.
By offering an integrated and complex science, where clinical outcomes arise in contextual and non-linear ways, and where ethics and biology do not have to vie for truth, this is a real science of humanity for the real world of general practice.
- © British Journal of General Practice 2018