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What are the failures, if any, of today’s coronary heart disease medicine or of our several decades old “war” on cancer? How do we answer these questions? We might measure failures against goals set by cardiovascular or oncological researchers and clinicians themselves. But understandably, these goals will be couched in terms of the very model they operationalize. What we cannot do is measure successes and failures against what would have been achieved had research and practice taken a different turn, been conducted according to a different agenda.

Imagine further that as a consequence a careful reviewer could marshal an extensive body of experimental studies elucidating the biologic basis of blushing. This reviewer could now confidently point to mechanisms of blushing that enabled the design of highly selective antagonist drugs that block cellular and subcellular processes implicated in the production of blushing. Given this capability, MEDICAL ONTOLOGY 25 imagine the reviewer concluding: It is time for many practitioners of medicine to change their views and to acknowledge that blushing is a neurobiologic not a psychogenic disorder.

And mind-body dualism. It leaves no room within its framework for the social, psychological, and behavioral dimensions of illness. —George L. ” I would like to call attention to certain “unfortunate lapses” in today’s medical theory that might never have happened were a commissioner of medicine—a Medical Oversight Board— alive today. This is a commissioner or czar (or board) that periodically reexamines the conceptual foundations of medical science and, in particular, their ongoing fit with the incoming findings from the medical literature and with contemporary developments in the more basic sciences underpinning medical science.

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