Clinical Evaluation and Biomedical Research: The Janus-Faced Testability of Medicine as a Human Science

Abstract

Karl Jaspers already fully understood, as early as 1919, the importance of reconciling the two “souls” of medicine, i.e., the analytical-reductionist and the holistic-normative, the scientific-technological and the clinical. This demand is as (or more) urgent today as it was in Jaspers’s time and in the literature of the last decades about the status of medicine a new awareness has grown that an adequate notion of medical praxis requires an integrative position, which combines the analytic-reductionist with the normative and holistic perspective on medicine. While accepting in its generality Jasper’s thesis of the necessary integration of analytic-naturalistic and phenomenological-existential point of view to understand medicine, we will try to justify the need for such an integration not for (albeit important) ethical-existential reasons, but for epistemological and methodological reasons, intrinsically related to the specific status of medicine as a human science. The peculiarity of the “rules” of medicine as a human science demands a synergistic, reciprocal and continuous interaction of clinical and extraclinical testing. The resulting spiral movement is one of the most general epistemological and methodological conditions for the possibility of realizing, at least in part and in an ongoing process, an ideal of medicine in which objective, biomedical and extraclinical knowledge, on the one hand, and the personal and clinical knowledge, on the other, can work together to reliably counter disease and illness or, which is the same, to reliably promote the goal of health in its two main meanings of the term, the analytic-naturalistic and the phenomenological-existential, ideally opposed but always intimately intertwined in real personal life.