| The problem which this dissertation addresses is the current absence of an inclusive epistemology for Family Medicine and Family Therapy. While biomedicine requires the empirical method to establish diagnoses, Family Therapy often embraces entirely subjective perspectives which deny the existence of norms. This poses problems for the integration of Family Therapy into health care and medical education.; My research involved the examination of clinical cases. I utilize Bernard Lonergan's Transcendental Method in which I reflect on my experience as a family therapist and family physician. Describing the whole of reality was initially defined by Three Ways of Thinking which evolved into four quadrants as described by Ken Wilber. A critique of family systems theory allows a more inclusive epistemology to be derived.; With this approach I find that both the objective and subjective dimensions of knowing can be retained. The world is mediated by meaning. objectivity is the result of authentic subjectivity. Therapy is seen as progressing towards a good of order. The assumptions of both client and therapist are taken into account.; Reflection upon my own process of coming to know leads to an inclusive epistemology which encompasses ascending levels of consciousness, starting from attention to the data, and progressing to the deriving of intelligent hypotheses through the use of questions, to the making of judgments about which hypothesis most likely fits the data of my research. Responsible decisions can then be made based on these judgments.; With an inclusive epistemology defined, one can more clearly recognize the limits of the biomedical model, the biopsychosocial model, patient-centered medicine and systems theory. The place of spirituality and alternative medicine can also be more clearly described. This epistemology is supportive of problem-based learning.; My conclusion is that an inclusive epistemology can be described which allows the integration of science and non-science into the medical school curriculum. It provides a basis for interdisciplinary education and a foundation for the philosophy of medical education. |
