Title : Understanding PHE within the philosophy of medicine framework
Abstract:
This presentation is conducted within the framework of the Philosophy of Medicine, which makes a rough distinction between two domains in Modern Medicine, namely Clinical Medicine on the one hand and Epidemiology (and Public Health) on the other. It focuses on the following aspects respectively of these two domains. Clinical Medicine concerns itself by and large (as it cannot and does not ignore the past or the future) with the present, that is with the patient who walks through the door of the premises of her General Practitioner or the reception of her local hospital. As such, Clinical Medicine concentrates on a particular individual, the person who feels unwell and is seeking for some relief from the doctor for her symptoms. Given these main characteristics just outlined, Clinical Medicine presupposes a linear causal paradigm which may be said to rely on Newtonian physics, sometimes referred to as the Billiard-ball Model of Causation. That is to say that a particular individual has been infected by a pathogen, be it SARS-CoV-2 (the virus in the Covid-19 epidemic) or the bacterium, Y. Pestis which killed more than a third of Europe’s population (about 25 million) during the bubonic plague pandemic. (Do bear in mind however, that not all bacteria kill us, indeed. We need the good ones to keep us alive and healthy). In contrast, Public Health and Epidemiology are concerned primarily with the future (though of course, necessarily they cannot and do not ignore the present and the past). They are also not so much interested in saving the individual as patients as in preventing populations from being exposed to pathogens and thus become infected by them, it does this in the main via pre-emptive strategies such as vaccination, which has been successful in eradicating the smallpox virus worldwide by 1979 according to WHO. The causal paradigm implied by such strategies may be called Ecosystem Thinking which embodies non-linear causation, inter-connectivity within a causally complex system which in turn ontologically implies Wholism.
