Department of General Practice and Primary Health Care, University of Auckland, Auckland Mail Centre, Private Bag 92019, Auckland, 1142, New Zealand,
Health Care Anal. 2014 Jun;22(2):160-73. doi: 10.1007/s10728-012-0214-3.
Cooperation and conversation in the public sphere may overcome historical and other barriers to rational argumentation. As an alternative to evidence-based medicine (EBM) and patient-centered care (PCC), the recent development of a modern version of person-centered medicine (PCM) signals an opportunity for a conversational pluralogue to replace parallel monologues between EBM and its critics, and the calls to EBM to debate its critics. This article draws upon elements of Habermas's theory of communicative action in order to suggest the kind of pluralogue that is required for stakeholders in modern medicine to benefit more from publicly conversing with each other than speaking alone or using debate to argue against each other. This reasoned perspective has lessons for all discourse when deep value-based and epistemological differences cannot be easily adjudicated.
在公共领域的合作与对话可能会克服理性论证的历史和其他障碍。作为循证医学（EBM）和以患者为中心的护理（PCC）的替代方案，最近现代版以患者为中心的医学（PCM）的发展为对话多元论提供了一个机会，以取代 EBM 与其批评者之间的平行独白，以及呼吁 EBM 辩论其批评者。本文借鉴了哈贝马斯的交往行动理论的一些元素，以表明现代医学的利益相关者需要进行什么样的多元对话，才能从彼此公开对话中获益更多，而不是各自为政，或利用辩论相互攻击。当深层次的基于价值观的和认识论的差异不容易裁决时，这种理性视角对所有话语都有借鉴意义。
