Other than a being a leading physician, Hahnemann was a researcher – finding out what worked through methodological experimentation. He was driven to put medical practice on a more rational footing. Hahnemann starts out in aphorism 6 by speaking of “the unprejudiced observer”. To find thus described would almost seem impossible at the present time. All men are prejudiced. Man is fixed in his politics, his religion, his ideas of medicine etc and so cannot reason. Men of the present day cannot recognize law, and hence they are prejudiced.
Key Words: Prejudice, Aphoricm 6, Evidence Based Medicine, capitalism, science,
Prejudice lies not only at the conscious level but subconscious and still deeper into the unconscious so its recognition becomes the first step in overcoming it. Men cannot get rid of their prejudices until they settle upon and recognize authority, like suppose we have a large dictionary that we say is an authority on the spelling of words henceforth there would be no argument on the question of spelling. But if there were no authority one man would spell one way and another man in another way; there would be no standard of spelling. Such is the state of medicine at the present day, there is no standard authority. One book is authority in one school, another book in another school and so there is confusion. In Homoeopathy the law and its principles must be accepted as authority. Even law will deceive if man is of prejudiced mind, because then he misreads the law and doctrine. If you cannot put aside your prejudices the principles will be folly to you. If we believe our senses only, we will accept all the opinions and beliefs of men. If the senses were invariable men would agree, but they are variable and no two men will agree in everything, because men’s observations differ so different beliefs and theories will be established. We must try to get rid of the prejudices so that we can examine the principles, doctrines and seek to verify them. Prejudice being premature judgement, in order to gain a solid foundation of system of knowledge and belief, one must first doubt everything. Only by eliminating preconceptions and prejudgments can one come to know what is true (Rene Descartes). Clinicians are, and should be, scientists which is about discovering the truth about patients and their illnesses.
It is no secret that today’s health care system is in crisis. Care relates to the quality of medical decisions. Are the decisions made during doctor‐patient encounters rational? Rationality is commonly defined as decision making that helps us achieve our goals. Rationality does not guarantee that a decision is error free rather, rational decision making accounts for the potential consequences of possible errors of our action—false negatives and false positives—to help us arrive at optimal outcomes. Low‐quality decision making to a significant extent violates various rationality criteria. The choice of theoretical framework influences both our policy and individual decision making. Evidence-based medicine today has presented a paradigm shift in the way clinicians learn and practice medicine; its prejudice based medicine as well antithetic, full of juxtaposition of contrasting words or ideas to give a feeling of balance. Prejudice—making assumptions and decisions based on inaccurate or faulty information and assumptions—is the stuff of history. Being the dominant mode of clinical practice today; rationality of evidence‐based medicines’ recommendations rests on the link between taking action and believing what is true. These recommendations are rational and better graduated when the evidences are of higher quality. In many cases, perhaps most, the recommendations cannot be made because of an absence of evidence. “Absence of evidence is, however, not evidence of absence”- a lack of high‐quality evidence does not mean that the intervention is not effective. This may lead primarily to denying health interventions to those who may need it or an irrational policy occurs when clinicians use their uncontrolled experience or “best judgment” in the absence of empirical data. ‘The evidence base’ applies to populations, whereas decision-making is at the level of individual patients. EBM describes only ‘the how of medical treatment’ and is not an appropriate term when ‘consent to being treated’ is involved. Quantum physics has shown us that phenomena are rarely black or white. The closer we get to boundaries, the fuzzier things become. We are all a mixture of qualities, positioned differently on thousands of different spectra. Attempts to force human experience into a straitjacket are destined to reduce the humanity of medicine. It is built into the process of medical education: multiple choice exam papers are easy to mark but how knowledge can be applied with humanity is not easy without giving the candidate an opportunity to consider and demonstrate it. A complex society can’t function without categories, life cannot be reduced to tick boxes; one has to recognize it.
Capitalism is a key development in mankind’s history – and resistance to its harmful consequences must be thought through. Science and Capitalism are mutually reciprocally supportive but an extended verbal expression in speech, writing and empty talks of grandiosity represses our awareness of this. EBM covers the truth that our senses represents of the world as ‘real’ and blinds us to the imaginary status of our view of the world. It is a kind of religious faith as this faith, is essential for capitalism to function. EBM’s faith in the validity of the calculable, is essential to the market and exchange value and hence to making profits. The market uses EBM as a tool to generate profits. EBM’s crisis is that it is both corrupted and corrupting. The EBM’s aim is the illusory narrations that are beneficently useful but especially in the field of medicine the essential nature of ‘capitalist scientism’ is a ‘thoughtless’ faith in growth, limitless growth; the trickledown effect. EBM maximizes the growth with the claims and implements them forcefully. It is good to raise awareness of life’s intrinsic uncertainties and Medicine’s limited capacity to affect but today again there is a battle to be fought to tackle the colonisation of medical practice spreading throughout by the ‘capitalist scientific’ consciousness and it’s faith in the truth of objective scientific knowledge – ‘always’ biased by Capital’s interests to create surplus value, as the dominant mode of medical practice. ‘The evidence base’ applies to populations, whereas decision-making is at the level of individual patients; an accurate scientific diagnosis makes an otherwise untreatable condition treatable and cannot be replaced by any amount of caring humanity. The key to this achievement is our ability to observe. We learn to observe – others first and then ourselves. Finding our way through the errors of mal-observation and non-observation we gradually learn to be objective in our assessment so that we perceive the patient truly and well. This is taken up further through the cases. Hahnemann had given all the directives regarding education and training in the first six aphorisms of the Organon: Aim of education and training – Aphorism 1,2; Curriculum of education and training – Aphorism 3,4; Methods and Techniques – Aphorism 5,6 (Dr. ML Dhawale). Passing through this process helps physician to understand the meaning of prejudice, recognition of prejudice and freedom from prejudice.
All education and training begins with perceiving. No one is immune from prejudice; thus, it is hardly surprising that it has an effect on how we practice medicine and so, Dr.Hahnemann allerts Homoeopaths in § 6 – “The unprejudiced observer – well aware of the futility of transcendental speculations which can receive no confirmation from experience – be his powers of penetration ever so great, takes note of nothing in every individual disease, ….”
1. Lectures and essays on homoeopathic philosophy – S.Close
2. Lectures on homoeopathic philosophy – J.T.Kent
3. The principles and art of cure by homoeopathy – H.A.Roberts
4. Organon of Medicine – Dr Samuel Hahnemann – B Jain publishers, New Delhi
5. The Lesser writings – Dr Boenninghausen – B Jain publishers, New Delhi
6. Hahnemann’s Organon, Commentary by B.K.sarkar