Theoretical medicine: a proposal for reconceptualizing medicine as a science of actions

The main task of a critical theory of medicine should be to develop a perspectival, context-fair, and multidimensional science of actions which integrates both diversity and heterogeneity within medicine without eliminating either one. Such a theory should employ diversity in the following areas: (1) in systems, subsystems, and professions, because different medical professions embody different health-care subsystems, thereby influencing the way manpower is utilized, (2) in actors, (e.g., patients, health-care experts, and society), processes, and situations, because each actor potentially conceptualizes health, illness, and desired outcomes differently; and (3) in models of medicine (i.e., as an object science versus an action science). Situational influences modify concepts and explanatory models; even the particular terms, such as illness, disease, and sickness, are not necessarily concordant with each other.