The Meaning and the Most Important Practical Implications of the Social Discourse of Health and Illness

Cilj je ovoga rada opovrći pozitivistička shvaćanja, ne samo u prirodnim već i u socijalnim znanostima, po kojima su intelektualni i tehnički sadržaji moderne medicinske znanosti – njezini koncepti, činjenice, metode – “čisto” empirijske, prirodnoznanstvene. U suprotnosti spram toga prevladavajućeg stava, polazi se od tvrdnje da u proučavanju zdravlja i bolesti valja primijenjivati bitno metodologijsko načelo “dvostrukog diskursa”, koje uključuje prirodnoznanstveni ali i socijalni diskurs kao jednakovrijedne. Tek u okviru sadržajno-disciplinarno različitih, ali bitno komplementarnih načina proučavanja (jedan prirodnoznanstveni a drugi socijalni), otvaraju se brojni putovi za plodno i mnogostruko istraživanje zdravlja i bolesti. Obveza da se o zdravlju i bolesti, uz biomedicinski referentni sustav, raspravlja i u okviru socijalnoga referentnog sustava, određena je najmanje dvjema bitnim činjenicama: čovjek je po prirodi “neprirodan”; velik dio čovjekova biologijskog bivstvovanja podliježe stalnom društvenom uplitanju, što znači da su “egzistencijalne” osnove zdravlja i bolesti izvanmedicinske. U zaključnom dijelu rada navode se neke strukturne osobine i funkcije socijalnog diskursa zdravlja/bolesti koje ga bitno razlikuju od prirodnoznanstvenog. Za razliku od prirodnoznanstvenoga diskursa, socijalni diskurs zdravlja/bolesti otvara prostor za afirmaciju potreba najvećeg broja ljudi koji se nalaze izvan tokova medicinsko-profesionalnog i/ili političkog odlučivanja, tj. dovodi do demokratizacije područja zdravstva. Najvažnije implikacije socijalnog diskursa valja očekivati u većoj “produktivnosti” suvremenog liječnika; sasvim je sigurno da suvremeni liječnik, polazeći isključivo od biomedicinskog diskursa, nije više u dovoljnoj mjeri kompetentan ni u razumijevanju a još manje u liječenju mnogih bolesti koje prevladavaju u suvremenom društvu. Upravo zato je iznimno važno da suvremeni liječnik što prije shvati intelektualnu vrijednost socijalnog diskursa u svome svakodnevnom djelovanju.The aim of this paper is to refute the positivistic understandings, not only in the natural but also social sciences, on the basis of which the technical contents of the modern medical science – its concepts, facts and methods – are \u27purely\u27 empirical, scientific. Contrary to this dominating attitude, the starting point is that the important methodological principle of \u27the double discourse\u27 should be applied in the study of health and illness. It includes the scientific and the social discourse with equal value. Only within the substantially and disciplinary different, but essentially complementary manners of study (one scientific and one social), the numerous paths for fruitful and manifold research of health and illness are opened. The obligation to discuss health and illness within the social referential system and not only within the bio-medical referential system is determined by at least two substantial facts: man is by his nature \u27unnatural\u27; a large part of man\u27s existence is subject to constant social interference, which means that the \u27existential\u27 foundations of health and illness lie outside medicine. The concluding part of the paper mentions some structural characteristics and functions of the social discourse of health/illness, which make it essentially different from the scientific one. Unlike the scientific discourse, the social discourse of health/illness opens space for the affirmation of the needs of the majority of people outside the mainstream of medical-professional and/or political decision-making i.e. leads to the democratisation of the sphere of health. The most important implications of the social discourse should be expected in the increased \u27productivity\u27 of contemporary physicians: it is certain that a contemporary physician, starting exclusively from the bio-medical discourse, is no longer sufficiently competent in understanding, and even less in curing many illnesses that dominate the world today. Due to that, it is extremely important that contemporary physicians understand the intellectual value of the social discourse in their everyday activities as soon as possible