Rogler G
Klinik und Poliklinik für Innere Medizin I, Universität Regensburg.
Dtsch Med Wochenschr. 2003 Nov 28;128(48):2553-7. doi: 10.1055/s-2003-44946.
The understanding of the scientific basis and the theory of knowledge are surprisingly heterogeneous in practical and clinical medicine. It is frequently influenced or based on the philosophical theory of critical rationalism founded by Sir Karl Popper. Because the theory of knowledge and the understanding of scientific truth is the central basis for cautious and good clinical practise it is necessary to discuss both points to avoid unscientific auto-immunisation against critique in a type of medicine that regards herself as science-based. Evidence-based medicine would not be possible without interpretation and explanation of existing data into the individual treatment context. Besides an inductive or deductive logic the historical and situative side-conditions of the gathering of knowledge and of experiments are of central importance for their interpretation and their relevance in clinical practice. This historical and situative context warrants reflection but must also be paid attention to in the reflections on medical ethics.
在实践医学和临床医学中，对科学基础和知识理论的理解惊人地多样化。它常常受到卡尔·波普尔爵士创立的批判理性主义哲学理论的影响，或者以其为基础。由于知识理论和对科学真理的理解是谨慎且良好临床实践的核心基础，因此有必要对这两点进行讨论，以避免在一种自认为以科学为基础的医学中出现不科学的自我免疫，抗拒批评。如果不将现有数据解读并融入个体治疗背景中，循证医学就不可能实现。除了归纳或演绎逻辑外，知识收集和实验的历史及情境性附带条件对于其在临床实践中的解读及其相关性至关重要。这种历史和情境背景值得反思，但在医学伦理学的思考中也必须予以关注。
