Anna Luise Kirkengen
Rationale, aims and objectives
This paper addresses the movements ‘evidence‐based’ (EBM ) and ‘personalized’ (PM ) medicine. The former is being criticized for failing to do justice to clinical complexity and human individuality. The latter aims at tailoring medical knowledge for every patient in a personalized fashion. Instrumental to this effort is the technological development engendering unlimited amounts of data about bodily fragments. The aim of this article is to stimulate a debate about the notion of the body and knowledge in medicine.
An authentic sickness history is used as a vantage point for a more comprehensive account of biomedicine.
The analysis of the sickness history demonstrates how biomedical logic guided all approaches in the care for this particular patient. Each problem was identified and treated separately, whereby neglecting the interaction between body parts and systems, and between the woman’s bodily condition and her experiences. The specialists involved seemed to look for phenomena that fit categories of disorders ‘belonging’ to their field. These approaches engendered unintended effects: chronification, poly‐pharmacy and multi‐morbidity, leading to an unsustainable increase in medical costs.
The article elucidates how the status that professionals ascribe to the body has vital implications for what they regard as relevant and how they interpret the information they have collected. On this ground, we challenge both the prevailing and tacitly accepted separation between the physical body and human experience and the view of knowledge underpinning EBM and PM . The growing molecularization of the body veils decisive sources of human illness.
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