Our infinite ignorance

In today's issue of the British Medical Journal, Dr Iona Heath frames the philosophies of Karl Popper and Immanuel Kant in the context of modern medicine, in particular the widening schism between research and clinical practice.

Her assertion is that only a select band of clinicians are involved in research that itself focuses on patients whose outcomes conform with trends (rather than the fascinating conundrums posed by those that buck the trend, such as octogenarian smokers). The remaining clinicians are 'handed down' the results of such research in the form of 'guidelines, incentives and imperatives'. In Heath's opinion, this state of affairs stifles autonomous thought on the part of the clinician and she invokes Kant's 'battle cry of the Enlightenment': '"Sapere aude" Dare to use your own intelligence!', encouraging its use as a battle cry for every clinician.

It might be well for all of us to remember that, while differing widely in the various little bits we know, in our infinite ignorance we are all equal. (Karl Popper)