Spinelli Hugo
Doctor en Salud Colectiva. Director del Instituto de Salud Colectiva, Universidad Nacional de Lanús, Buenos Aires, Argentina.
Salud Colect. 2023 Mar 9;19:e4365. doi: 10.18294/sc.2023.4365.
This article intends to critique of the cultural authority of the medical sciences, opening up a discussion on its publicization from a political standpoint. At the same time, from a more technical standpoint, it proposes the implementation of an epidemiology of health systems and services. Based on Pierre Bourdieu's concept of interest in disinterestedness and Joseph Gusfield's notion of the cultural authority of public problems, it analyzes why epidemiological information is so rarely used in the evaluation and monitoring of clinical, population, institutional, and territorial practices. That is, why does the dominant culture of decision making eschew epidemiological information? Within this conceptual framework, a body of documental evidence is analyzed that sheds light on the weak scientific basis that upholds or that has underpinned certain practices in the health field at different historical moments. The discussion is organized around three major themes: assistentialist professional practice, medication, and biomedical technologies.
本文旨在批判医学科学的文化权威,从政治角度开启关于其普及的讨论。同时,从更技术的角度,它提议实施卫生系统与服务的流行病学。基于皮埃尔·布迪厄的“无私之利”概念以及约瑟夫·古斯菲尔德的公共问题文化权威观念,本文分析了为何流行病学信息在临床、人群、机构及地域实践的评估与监测中极少被使用。也就是说,为何决策的主流文化回避流行病学信息?在这一概念框架内,分析了一批文献证据,这些证据揭示了在不同历史时刻支撑或曾支撑卫生领域某些实践的薄弱科学基础。讨论围绕三个主要主题展开:辅助主义专业实践、药物治疗和生物医学技术。