Growing Evidence For The Decline of Bio-Medicine's Obsession with Reductionism
Also in 1985 I published a statement I called "Reductionism's Last Hurrah" in my field of Occupational and Environmental Medicine (OEM) stating that the complexity factor alone renders scientific analysis of all exposures unfathomable.
Well since my January essay two important events occurred in my professional life that confirmed my belief that the excesses of a reductionistic model were causing contemporary bio-medicine to fail.
The first was a remarkable paper which was sent to me entitled "Beyond Reductionism-Reinventing The Sacred" by Stuart A. Kauffman,Professor at the University of Calgary, with shared academic appointments between biological sciences, physics and astronomy.(Wow- Talk about a "Neo-Renaissance Man"!).In this remarkable paper Kauffman,(formally from the University of Pennsylvania-my own home state), frames a new scientific world view of emergence and ceaseless creativity, which, he notes, is "awesome in what has come to pass in reality, and God enough for me and many, where God is the creativity of the universe, yielding a global ethics of respect for all life, the planet, awe, wonder and spirituality cut free from a transcendent God." I promise you, this is an essay -published by "EDGE"- worth reading many times.
The other event (less spiritual than the stunning Kuaffman essay but none the less important) in my life was listening to the Keynote Address at the 2007 American Occupational Health Conference(AOHC), my own medical specialty's most important annual conference, this year held during the first week in May in New Orleans, Louisiana. Professor Laura Punnett (Sc.D) from the Department of Work Environment,University of Massachusetts,Lowell- an institution with a long history of outstanding research on the subject of human work with a strong tradition of social conscience and progressive values, delivered the landmark address. I could almost not believe the words I was listening to or the data presented on the slides. It was as if I had waited 30 years to hear this keynote address at a major traditional US allopathic medical specialty conference. For more on Dr. Laura Punnett click here.
In the address Dr. Punnett literally challenged our specialty of Occupational Medicine(OM) to adopt a new research and practice paradigm. While the address revolved around inequitable distribution of workplace risks as it relates to workplace related musculoskeletal disorders-the latter being the largest current challenge in Occupational Medicine-more importantly Dr.Punnett presented a compelling case for socio-economic (SES) variables (e.g- poverty,education, power etc) not being viewed as confounding variables in studying disease and conducting academic research but rather as what she calls effect modifiers. Thus, with this recommended study design protocol change that Punnett recommends, SES variables, for example, become far more important factors than bio-medical researchers would heretofore consider. Dr. Punnett also stressed the importance of what the US National Institute of Occupational Safety and Health (NIOSH) calls Organization of Work (OOW) on which I have personally worked. Punnett refers to an inclusive (Holistic?) Multi-level Exposure Paradigm for Occupational Health which must include ALL of these factors including SES, gendered position, work organization and both physical and psycho-social exposures. I pinched myself for the first time at my conference and applauded the conference planners for inviting Dr. Punnett to be our keynoter.
I guess I consider myself a scientific "cyclist"(not bicycles) but rather I believe scientific and medical practice paradigms are historically cyclical. The ancient healers were holistic for example.The full flourishing of contemporary western reductionism without question produced miraculous results from which we have all benefited. But I submit respectfully the model has been taken to excess and has "run it's course".
Also I do not believe that reductionism is inherently wrong or incorrect. But this I am sure of.In any culture-in any time-REDUCTIONISM IS INCOMPLETE.
So welcome to the new age of holistic medicine (Hospice/Palliative Medicine is an excellent interdisciplinary model).This is the new medical world we will live in for the foreseeable future. It is not anti-science but leverages the best that contemporary reductionistic bio-medicine has to offer thus allowing bio-medicine to achieve its full potential.
Please - Let's here from you.
And Be Well,
Dr. Rick Lippin