Ulvestad Elling
Department of Microbiology and Immunology, Haukeland University Hospital, and The Gade Institute, University of Bergen, Armauer Hansen Building, Bergen, 5021, Norway.
Med Health Care Philos. 2008 Sep;11(3):285-92. doi: 10.1007/s11019-008-9126-2. Epub 2008 Feb 21.
The article maintains that chronic fatigue syndrome can be properly understood only by taking an integrated perspective in which evolutionary, developmental and ecological aspects are considered. The integrative approach, supplemented by a complexity theory and psychoneuroimmunological research, is capable of explaining why there are so few structural aberrations to be found in chronic fatigue syndrome and why specific treatment is so difficult to establish. A major outcome of the investigation, that all individuals with chronic fatigue syndrome are diseased in their own way, emphasises the need to study the development of personalised life histories. It also highlights an ethical dimension; personalised disease defies essentialist thinking on patient management. Another major outcome, which follows from the developmental systems perspective, is the dissolution of ontological mind-body dualism. This in turn allows for a methodological complementation of the biological and phenomenological approaches to knowledge. New research strategies that may help to resolve chronic fatigue syndrome, grounded in the revised perspective on individual development, are suggested.
该文章认为，只有从综合的角度，即考虑进化、发育和生态等方面，才能正确理解慢性疲劳综合征。这种综合方法辅以复杂性理论和心理神经免疫学研究，能够解释为什么在慢性疲劳综合征中发现的结构异常如此之少，以及为什么难以确定具体的治疗方法。该调查的一个主要结果是，所有慢性疲劳综合征患者都以自己独特的方式患病，这强调了研究个性化生活史发展的必要性。它还突出了一个伦理层面；个性化疾病挑战了关于患者管理的本质主义思维。从发育系统角度得出的另一个主要结果是本体身心二元论的消解。这反过来又允许在知识获取上对生物学和现象学方法进行方法上的互补。文章还提出了基于对个体发展的修正观点、可能有助于解决慢性疲劳综合征的新研究策略。
