Zácek A
Ustav sociálního lékarství a verejného zdravotnictví, LF MU, Brno.
Cas Lek Cesk. 1997 Jul 14;136(14):427-30.
One of the most important roles of epidemiology is to seek causes of diseases. The causality in medicine is a difficult philosophical category which requires deep ontological thinking and a thorough methodological preparation. If this condition is not met, various misunderstandings and errors develop with serious consequences for clinical practice. In recent medical literature we find many controversial views which are abused by the press and cause mistrust of the public to medical science and attract patients to the dubious practices of alternative medicine. It is therefore the duty of research workers to pay more attention to modern epidemiological methods and their philosophy. The predominating pluricausal model of risk factors is recently criticized because of its excessive simplicity. reductionism and dualism which separates health from disease. The need arises of a new universal model of health where the dominant position will be held by social environmental, behavioral and psychological aspects. Modern epidemiology needs not only a correct methodology but also a proper theory.
流行病学最重要的作用之一就是探寻疾病的病因。医学中的因果关系是一个复杂的哲学范畴,需要深入的本体论思考和全面的方法论准备。如果不满足这一条件,就会产生各种误解和错误,给临床实践带来严重后果。在最近的医学文献中,我们发现了许多有争议的观点,这些观点被媒体滥用,导致公众对医学科学产生不信任,并吸引患者采用替代医学的可疑做法。因此,研究人员有责任更加关注现代流行病学方法及其理念。最近,占主导地位的多因素风险模型因其过于简单、还原论以及将健康与疾病分离的二元论而受到批评。一种新的普遍健康模型的需求应运而生,在这种模型中,社会环境、行为和心理方面将占据主导地位。现代流行病学不仅需要正确的方法论,还需要恰当的理论。