THE LEGITIMACY OF CLINICAL KNOWLEDGE - TOWARDS A MEDICAL EPISTEMOLOGYEMBRACING THE ART OF MEDICINE

The traditional medical epistemology, resting on a biomedical paradigm atic monopoly, fails to display an adequate representation of medical knowledge. Clinical knowledge, including the complexities of human int eraction, is not available for inquiry by means of biomedical approach es, and consequently is denied legitimacy within a scientific context. A gap results between medical research and clinical practice. Theorie s of knowledge, especially the concept of tacit knowing, seem suitable for description and discussion of clinical knowledge, commonly denote d ''the art of medicine.'' A metaposition allows for inquiry of clinic al knowledge, inviting an expansion of the traditional medical epistem ology, provided that relevant criteria for scientific knowledge within this field are developed and applied. The consequences of such approa ches are discussed.