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How to make real, constructive, progress in medicine


  • Jeremy R. Simon MD PhD

    Corresponding author
    1. Assistant Professor of Clinical Medicine, Department of Medicine and Scholar-in-Residence, Center for Bioethics, Columbia University, College of Physicians and Surgeons, New York, NY, USA
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Dr Jeremy R. Simon, Columbia University, College of Physicians and Surgeons, 630 West 168th Street, 3-470, New York, NY 10032, USA, E-mail:


Rationale  One's understanding of medical progress – what it is, how it is pursued and how it is assessed – may be deeply dependent on one's understanding of the metaphysics of medicine, and of diseases in particular.

Aims and Objectives  In this paper I present a new account of the nature of diseases, neither realist nor constructivist, and describe what progress in medicine looks like if we understand diseases in this way.

Conclusions  This new account, Constructive Realism, may provide a better account of medicine than either realism or constructivism.