Philosophy of Science

The Emergence of the Philosophy of Medicine: A Critical Encounter with Classical Philosophy of Science

Document Type : Research Paper

Author

Alireza Monajemi

Associate Professor of Department Philosophy of Science and Technology, Institute for Humanities and Cultural Studies, Tehran, Iran

https://doi.org/10.30465/ps.2026.54069.1819
Abstract
The central claim of this article is that the philosophy of medicine emerged through a critical confrontation with classical philosophy of science, a confrontation that coincided with the very possibility of articulating the contemporary medical crisis. This simultaneity is not accidental; rather, it discloses the inability of classical philosophy of science to grasp the practical, clinical, and social character of medicine. The rise of the philosophy of medicine is thus presented as internally connected both to the limits of classical philosophy of science and to the formulation of the modern medical crisis. The paper first reconstructs the conceptual framework of classical philosophy of science and identifies its shortcomings in accounting for the nature of medicine. It then examines the idea of medical crisis, arguing that excessive scientification and technologization have dehumanized the clinical encounter and prompted critical reflection. The Kaplan–Pellegrino debate is analyzed as a key historical moment. Drawing on Wieland, Fleck, and Sadeghzadeh, the article develops a positive account of medicine as a distinct kind of knowledge and considers its implications. The implications of this shift include a critique of contemporary medicine and a rethinking of the relationship between science, practice, and the modern human sciences.
Keywords: classical philosophy of science; philosophy of medicine; medical crisis; classification of the sciences; practice.

Introduction
Medicine has long occupied a problematic epistemic position within the modern classification of the sciences. Unlike the natural sciences, whose theoretical foundations appear comparatively stable, medicine has persistently stood at the intersection of scientific knowledge, practical intervention, ethical judgment, and social institution. While it relies heavily on biomedical research and empirical methodologies, its core activity—clinical practice—unfolds within the physician–patient relationship and involves value judgments, uncertainty, and responsibility. This dual character has made medicine difficult to situate within the traditional tripartite division of the sciences into natural, human, and social domains.
The central claim of this article is that the philosophy of medicine emerged through a critical confrontation with classical philosophy of science, and that this confrontation coincided with the very possibility of articulating what has come to be described as the modern medical crisis. This simultaneity is not accidental. Rather, it reveals the conceptual inadequacy of classical philosophy of science in grasping the practical, clinical, and social character of medicine. The rise of the philosophy of medicine must therefore be understood as internally connected both to the limits of classical philosophy of science and to the formulation of the contemporary crisis in medicine.

Materials and Methods
This study adopts a conceptual–historical and analytical methodology. It reconstructs the conceptual framework of classical philosophy of science as it developed in logical positivism, critical rationalism, and law-centered models of scientific explanation. These traditions, despite internal differences, share a commitment to understanding science primarily as theoretical, proposition-based, and truth-oriented knowledge. The analysis then examines how medicine was interpreted within this framework, either as a branch of natural science reducible to biology and ultimately physics–chemistry, or as an applied science whose philosophical problems could be resolved within the general philosophy of science.
To evaluate these assumptions, the article engages with major figures in twentieth-century philosophy of medicine and science, including Wieland, Fleck, Pellegrino, Caplan, and Sadeghzadeh. Wieland’s distinction between theoretical and practical sciences provides a systematic critique of the reduction of practical domains to theoretical models. Fleck’s notion of thought style and the rejection of the “Euclidean ideal” illuminates the historically situated and practice-embedded character of medical knowledge. Pellegrino’s emphasis on phronesis and the telos of healing clarifies the normative and relational dimensions of clinical medicine. Sadeghzadeh’s analytic distinction between biomedical science and clinical medicine sharpens the conceptual differentiation between theoretical research and practical judgment. The study also incorporates an analysis of the 1970s Kaplan–Pellegrino controversy as a historical moment in which the autonomy of philosophy of medicine was explicitly debated.

Discussion and Results
The analysis demonstrates that classical philosophy of science lacks the conceptual tools necessary to account for the distinctive rationality of medicine. Its focus on truth, explanation, and theoretical structure marginalizes domains whose primary orientation is toward action, decision, and responsibility.
The medical crisis of the late twentieth century—often described in terms of declining quality of care, dehumanization, and excessive technologization—exposed the limits of an exclusively scientific model of medicine. Excessive scientification and technological mediation contributed to the objectification of the patient and the reduction of illness to measurable pathology. Yet the crisis did not represent a failure of science as such. Rather, it revealed the insufficiency of a framework that treated theoretical science as the exclusive model of rationality.
The Kaplan–Pellegrino debate crystallized this issue. Caplan defended the view that philosophy of medicine lacked independent foundations and should remain subordinate to philosophy of science and bioethics. Pellegrino countered that medicine is fundamentally a moral and practical enterprise centered on the physician–patient encounter. This disagreement reflected two divergent conceptions of medicine: one as applied science, the other as a practice structured by its telos—healing—and guided by practical wisdom (phronesis).
Drawing on Wieland, the article argues that medicine belongs to the domain of practical sciences. Theoretical sciences aim at describing and explaining what is; practical sciences guide action within concrete and uncertain situations. Clinical medicine is paradigmatic in this regard: it integrates scientific knowledge, contextual judgment, and normative evaluation in order to reach decisions concerning a particular patient.
Fleck’s critique of the “Euclidean ideal” further undermines the expectation that medicine should conform to a deductively structured, context-independent theoretical model. Medical knowledge develops within historically situated thought styles and institutional practices. Its variability and context-dependence are structural features rather than epistemic defects.
Sadeghzadeh’s distinction between biomedical research and clinical medicine reinforces this conclusion. While biomedical sciences generate theoretical knowledge, clinical medicine organizes conditional rules of action oriented toward therapeutic goals. The criterion of validity shifts from propositional truth alone to the responsible guidance of action in singular situations.
The result of these analyses is a positive reconfiguration of medicine as a distinct kind of knowledge—practical, normative, institutional, and relational. This reconfiguration opens broader implications beyond medicine itself. It challenges the monopoly of theoretical science as the universal model of rationality and invites reconsideration of the relationship between science, practice, and the modern human sciences.

Conclusion
The emergence of the philosophy of medicine cannot be understood as a mere specialization within philosophy of science. It arose from a critical recognition that the dominant theoretical model of science was incapable of adequately accounting for the nature of medicine. This recognition coincided with the articulation of the medical crisis and enabled its philosophical formulation.
By relocating the center of analysis from abstract scientific knowledge to the clinical encounter, philosophy of medicine has made possible an immanent critique of contemporary medicine—one that does not reject science or technology, but resists their unqualified dominance. It restores attention to practical judgment, normative responsibility, and the physician–patient relationship.
More broadly, the distinction between theoretical and practical sciences, clarified through the case of medicine, invites a reconsideration of modern rationality itself. Medicine becomes a field in which knowledge and action, science and institution, and fact and value are inseparably intertwined. In this sense, philosophy of medicine serves not only as a response to the internal tensions of modern medicine, but also as a critical site for rethinking the relationship between science, practice, and the human sciences in the modern world.

Keywords

classical philosophy of science
philosophy of medicine
medical crisis
classification of the sciences
practice
Subjects
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Fleck, L. (1979). Genesis and development of a scientific fact (F. Bradley & T. J. Trenn, Trans.). University of Chicago Press. (Original work published 1935)
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Philosophy of Science
Volume 15, Issue 1 - Serial Number 1
November 2025
Pages 57-84

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