Directions in biomedical research: a plea for ideological pluralism.

Feinstein [A.R. Feinstein, Am. J. Med. 107 (1999) 461] complained that 'basic medical science' has overwhelmed 'pathophysiological medical science' during the past half century, and 'destroyed the bridge between bedside and bench'. We agree that a 'drastic reorientation' will be necessary to correct the overemphasis and imbalance. Re-examining the roots of his problem, we believe that a plea to restore a balance between the 'status' (esteem) of 'large research' and 'small research' in medical science brings back into question the decision of academic physiologists to invoke the framework of Physics in/of 1847 [P.F. Cranefield, J. Hist. Med. Allied Sci. 12 (1957) 407] (together with an absolutist 'Prime Mover'/Metaphysic which Einstein would delete from Physics in 1905). The current 'imbalance' arose when that Cartesian 'Prime Mover' was NOT deleted from the Biological frame. Feinstein felt that the 'privileged status' (esteem) in which fund-giving bodies hold 'Small' researches compared to 'Large' should be cancelled. Once Biology replaces its Cartesian absolutism with a relativist framework, redress will follow naturally when living-material has regained the status of cause as well as effect. Descartes' 'Great Watchmaker' is a Dead God in Biology: a non-metaphysical Biological Perspective would restore balance between 'large' and 'small' investigations. ('Pluralism' implies that no scientific perspective would be second-rate in a relativist framework.)