TURNING A PRACTICE INTO A SCIENCE - RECONCEPTUALIZING POSTWAR MEDICAL-PRACTICE

In recent years, many editorials in leading North American medical jou rnals have argued that medical practice is seriously flawed. Often, de cision-support techniques are mentioned as a potential solution to thi s problem. I argue that these recent calls embody a specific reconcept ualization of medical practice and its problems. Within the postwar me dical literature, divergent discourses on the virtues and troubles of postwar medical practice can be found. Through a focus on medical edit orials, I demonstrate the existence of several different notions of th e 'scientific nature' of medical action. Comparing the more recent of these images to those dominating earlier medical journals, one main sh ift is apparent. While, earlier, medical action was often described as an artful application of scientific knowledge, only mildly tainted by external, social problems, recent conceptualizations often locate bot h the scientific nature of medicine and the causes of its problems in the physician's brain. Even within this new discourse, however, scient ific rationality does not always speak with the same voice, as reflect ed in the existence of different decision-support techniques. I argue that these different techniques, which are presented as solutions to t he flaws of medical practice, lay at the root of the development of th e cognitivist image(s) in the first place.