Is Medical knowledge socially constructed ?

terrygallagher

In answer to your cancer question above, if I were a Christian Scientist I might advise peanut butter +prayer !

But there are some background issues which need to be taken on board to get a fuller picture.

One is that "the self" can be deemed to be a social construction.. that "self" that claims to hold "beliefs" is temporarily evoked within communicative contexts such as this one ! (Consider the "self" that social circumstance has labelled a "Christian Scientist).

Another is that "similarity" and "difference" are always relative to a specific functional context. Trivially we might note that ANY two items are both similar (because they are both focal items) and different (there are two of them). The difference (ho ho) between ourselves and other animals is that we seem to be highly flexible in our functional classifications and given that we also significantly use language we might assume that the two are linked. Add the fact that language is a social feature rather than a person specific one, we complete the point about social construction.

This concept of "social reality" is of course disconcerting to those of us who are attached to the integrity of the "self", but next time such a person has an internal discussion with himself he might like to re-assess the position.

[PS, I feel I should put this post scrit at the top because , I just want to say good luck, my argument confuse me for a long while, I hope you can work out what I mean.]






hmmmmm...

I'm sorry if I'm starting to annoy you.

Before I respond to that post, I just want to ask for some definitions, I don't want to be going round in circles because I don't realise that the river is me...


Knowledge

social construction

If when you say knowledge I think of something other than what you mean when you say knowledge, I definatly will start to annoy you, because I won't stop till I'm at least slight less confused.

To me, knowedgle has to be based on some kind of truth. If I said "I know how to play the guitar", the picked up my guitar and started blowing on it, I wouldn't actualy 'know how to play the guitar'. It could be said that the 'knowledge' that the guitar is not blown on is socially constructed, I would except that is socially constructed knowlegde...

But to me there is knowledge that is not socially constructed as socially constructed mean something that is not true. The knowledge that a guitar should be strummed, is social constructed, because the 'fact'/belief that a guitar should be strummed is created/constructed by sociaty. However the fact that there I can perseve the guitar at all means there is a something there, even if the 'fact' that it's a guitar is something socialy constructed, there is something there. Otherwise you have you have to doubt all reality.

Well...My response to your last points (may as well keep going if I have understood)

My problem seems that even though in theory this may be sound a argument, in practice, in life, it's not something you can really live by. I didn ask what would you do in that situation if you were a christian scientist, I asked what you would do. I'm asking if you personnal live by what your argueing would you personal tell someone who asked whether to use peanutbutter or chemotherapy (I looked it up this time, ) you would tell them to toss a coin?

Even if you did tell them to toss a coin then you would be accepting that all knowlegde is socialy constructed. However if all knowledge is socailly constructed, then the 'fact' that you know that all knowledge is socially constructed, is either:-

socially constructed, however, then the 'fact' you 'know' that all knowledge is socially constructed must be socially constructed as there is no knowledge beond socially constructed knowledge. Therefore you could never actually know that all knowledge is socially constructed, because there is no truth that can be known, only 'truth' that can be 'known'. So you are unable to know, for sure, what socially constructed knowledge is, so how can you claim that all knowledge is socially constructed

True, therefore saying 'all knowledge is socially constructed' is a truth, something beond our agreed discription of reality and something true no matter what socially construct language discribes it as.

I don't think I'm so much attatched to the intergraty of the self, it's more that I'm attached to the integraty of numbers and maths (if my old maths teachers could hear/see me now!) as something beond social control, no matter what sociaty tries to prove, or claims as 'fact', or 'knowledge' it will never change the fact that 2+2=4.

terrygallagher

Very quickly

"truth" and "knowledge" are about "what works".....to "know" is to successfully predict..."truth" is the success of the "prediction".
But notice the PRE (in advance) - DICTION (to say using language).....what other animal has a concept of "time" or uses words ?

Where there is agreement on "success" such can be called social reality. In the extreme The Christian Scientist might argue that it is "wrong" (in your sense) to interfere with "God's will" because "reality" for him concerns both body and "soul". .....but "reality" is just as negotiable in the world of science and is constantly in social flux (Thomas Kuhn) ....see for example references to the Copenhagen convention on quantum physics.

As Einstein said "Reality is an illusion albeit a very persistent one."

NB See my comments on "1+1=2" on the current "Proof of God"thread.
(You can do this by clicking on fresco)

don't have time to read the posts, but i'd like to toss in a new idea, if i may. agriculture is a social construction, no doubt, but it's not arbitrary, in the sense that it only "works" within certain parameters, and these parameters were "discovered" indepedently by many different cultures. [this is tangential to my argument, but it's not even totally farfetched to claim that leafcutter ants practice a form of agriculture--they use leaves to grow a fungus.] when a technology is developed independently by many different cultures, should it not be classified differently from all the unique characteristics that distinguish one culture from the next, instead of using the blanket term 'social constuction' for both?

yitwail

Good points...I'm off to work. I'll reply later.

"1+1=1 (Drops of water)

1+1=10 (Binary Arithmetic)

1+1=3 (Sexual Reproduction)"

If you know the volume of the drops of water you will be able to predict what the volume will be when the two drops of water combine. Even if the two drops of water combine to form one, there is still a predictible truth based in maths.

Also 1+1=1 isn't always the case, the two drops may not combine, it could well be 1+1=2. With sexual reproduction you could just as easily be 1+1 = 4, 2, or 5.

Overall, I would say that the problem with the Drops of water and sexual reproduction is the nature of the things being 'added' together, rather than the maths. As this is not purly mathmatical, it's not 1 + 1, its a man + a woman = man, woman and child. a more suitable sume would be x + y = x+y+z, as a man and a woman are not the same so to represent them both as 1 would be to say that they are the same.



Also the binary arthmitic is in the meaning, although

[...]0001 + [...]0001 = [...]0010

0010 how a 2 is repressented in binary 0 and 1, even though 0010 is ten in the thousand, hundreds, tens, units way numbers are writen in the 'normal' way, binary represents numbers differently. (Although 2+2 in logaritums does equal 3.9, or it maybe 1+1=1.9, 10+10 definatly = 100 though, this is with a different number system, created to simplify the fact that 1+1=2)

terrygallagher

The point being made about 1+1=2 is that it is an abstraction based on hunan interactions with the world ...either counting "similar" objects or moving along a number line. Mathematics is a metalanguage which is relatively culture free, but the appropriateness of its methods are always context specific. Note that "tree" is an abstraction just like "2"....we manipulate such symbols in "our minds eye" in order to predict our interactions. Much debate occurs in physics for example about the "reality" of the results of equations which for example imply "negative time" etc.

yitwail,

The seeking of "pattern" is certainly an aspect of our cognitive urge to predict and control therefore to classify agricultural practices as "the same" is to be expected. But obviously "same species" with "same needs" cultivating "same planet" are likely arrrive at same "practices" by trial and error alone. The interesting situation is when practices seem to spred without either trial and error or normal modes of communication. Sheldrake for example has investigated the claim that "knowledge" can be dissipated by "morphogenic resonance" or some form of transcendent field effect of "group consciousness".....we get into the realms of mysticism there but I put it anybody who sees "knowledge" or "reality" as being independent of particular observers that they themselves are making a mystical assumption.

fresco, you make good points as well. i find it richly ironic that proponents of an observer-independent reality can be accused of mysticism. ;-)

a better example on behalf of the notion of a cultural universal would be the notion of disease itself. i doubt anyone can prove that the common cold is a social construction.

yitwail,

The "common cold " per se is an easy target for potential demolition...e.g. common = socially frequent...."catching cold" = historical old wives tale origins....and of course "bless you !"

The current Western explanation that it is caused by "a virus" may be sufficient to satisfy "scientific explanation"...but there still remains the differential perception of the symptoms and the degree of incapacity relative to job-satisfaction etc. Then the fact that there may be no effective "anti-viral" opens the door to a plethora of "treatments" of differing social acceptance.

But irrespective of easy targets and intellectual demolition exercises, a general point, is that if we think about it "disease" always has a "social dimension" even if we employ mechanistic analogies within its classification and treatment. furthermore the cost/benefit analysis of treatments essentially depends on social concepts like "quality of life".

fresco, i'm not in anyway denying that disease management has a social dimension. what i don't accept is that it's a purely social phenomenon. for example, when an ape is SIV-positive--ie. has antibodies for simian immunodeficiency virus--is that a social construction? ditto mad cows? if so, do non-human organisms construct their own diseases, or do humans socially construct animal diseases?

yitwail,

The point is that the knowledge of the disease is socially constructed starting with the concept of "disease". Thus we have the class of "diseases"(things that incapacitate our social functions including conditions of both mind and body) and we have "knowledge" about causes and treatments which is couched in socially negotiated terminology describing diagnosis and prognosis of changes of "state" of bodily structure and function. This negotiation has been well documented by Kuhn in the "hard sciences"(Structure of Scientific Revolutions) and we do not need to look far to see examples of radical medical paradigm shifts from say "the humours" through to the latest vogue such as "cholesterol levels".

Objections might be raised on the basis that medical "progress" is an indicator of independence from social construction. But such "progress" is surely measured by social indices such as prolongation of "useful" life. Indeed some would claim that medicine has even "hindered" society by burdening it with individuals whose lives have been artificially prolonged or sustained thereby draining communal resources.

fresco, i understand all that. you explain it well. the point i'm interested in is whether there is such a thing as a disease, or it's only a label society attaches to individuals who exhibit behaviors that it regards as indicative of a bodily malfunction, ie. symptoms, including complaints of various discomforts such as pain, nausea, sleep disturbance, and so on. if disease is simply a label, then there's no difference between hypochondria and a "real" medical ailment. common sense/intuition suggests there *is* a difference, and that's why i brought in examples of animal diseases, because as far as we know, non-human organisms aren't subject to hypochondria.

yitwail,

I did not intend to imply that disease is simply a label. In many cases there are clear physical or biologically identifiable underlying states which correlate with gross symptoms. What I am saying is that the descriptions of these states even at that level are subject to social consensus. Potential pathogens such as bacteria or viruses have been classified as such by agreement....and it is the agreed naming of the categories which constitutes the transfer of "knowledge" between situations.

I came on this A2k in order to know things I didn't know before.At last it has started to happen.

I like picking people's brains.Thanks you two.

Are road accidents indicative of the behaviour that set them in train?

I think it is important to acknowledge that because knowledge and reality are social/culturally constructedd that does not mean that they are delusional errors; they may be indispensable illusions: they may WORK for our purposes. But there is little of our inventory of knowledge today that is guaranteed knowledge of the distant future. Our present "knowledge" (the very concept) of disease is useful, but it is constructed nonetheless. All we know is our constructed "knowledge" of the world, not the world itself--except in our artistic and mystical moments, but that is not knowledge in the usual sense.

fresco & JLN, you both have a metaphysical bent without being dogmatic about it. i only dabble in metaphysics myself, so i appreciate your indulging me.

i was mainly indulging my curiosity, spendius, but if you found the discussion informative in some way, i'm gratified.

i think prior behavior may contribute to an accident, but often it's just one of many risk factors. going back to medical examples, it's more accurate to say smoking is a risk factor for cancer than to say it causes cancer; it increases the probability of developing cancer. likewise, drinking and driving increases the risk of a vehicle accident, but one could drive in a perfectly safe manner & still suffer an accident due to another driver's error or even a mechanical problem with the car.

Yes, Yiwail, at the level of everyday practical life we DO seem to live in a Newtonian world, but PHILOSOPHICALLY speaking, it is more likely that the NEW physics has a better grasp of "reality." And THEIR grasp is also constructed.

Beautiful!

I think I actually understand this. Just don't ask me to take a test on it. Yet.