Medical Progress: Science versus Practice

In recent years, notable figures within the medical community have expressed concerns about the rate of medical progress, suggesting that the rapid advances of medicine’s ‘golden age’ are now giving way to an ‘age of disappointment’. While these pessimistic pronouncements about medical progress must–implicitly if not explicitly–appeal to some criteria for what medical progress would be, the task of explicitly defining medical progress has been notably neglected. We take up this task, drawing on insights from the philosophy of science concerning both scientific progress and the aims of medicine. Among other things, we differentiate between medical scientific progress and progress in medical practice, and suggest that this distinction helps to evaluate the aforementioned concerns about the current rate of medical progress. While it is not our goal to draw conclusions relating to the state of medicine at the present time, we propose a unifying account of medical scientific progress according to which such progress leads, necessarily, to progress in medical practice, and show how this account both plausibly distinguishes between medical scientific progress and other (non-medical) instances of scientific progress, and does justice to the ‘dual character’ of medicine.