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Medicine teems with anecdotes, brief, pointed accounts of healthcare episodes, informed by observations and narrative arguments. Initially denoting hitherto undivulged, but notable, historical events, anecdotes narrated by doctors were not easily distinguishable from clinical cases. Those recounted by patients and carers in the modern era are the subject of this chapter, which investigates how they grasp, size up, and characterize human vulnerabilities, resulting from illness and inequalities in healthcare knowledge and power. An unregulated and anti-authoritarian idiom that does not seek to isolate events and experiences from subjective thoughts and feelings about them, these sorts of anecdotes can critically evaluate medical services and glimpse the truth about healthcare situations. Contemporary medicine, however, views anecdotal observations and viewpoints as biased and untrustworthy. Despite the current climate of scepticism concerning anecdotal information, anecdotes remain prolific oral and literary interventions, that provide vital insights into the interpersonal and social relations of healthcare.
I propose to understand knowledge in the context of action, refocusing epistemology in order to make it more suitable for engaging with actual practices in science and other realms of life. What I call ‘active knowledge’ is a matter of ability; active knowledge is a prerequisite of propositional knowledge, and propositional knowledge contributes to it. I offer an analysis of active knowledge as operative in ‘epistemic activities’ and ‘systems of practice’ carried out by purposive epistemic agents. The quality of active knowledge consists in ‘operational coherence’, which is a matter of doing what makes sense to do in order to achieve our aims. Inspired by Dewey, I see inquiry as an effort to increase operational coherence, a process in which no aspects of our activities are immune from revision. Generally my thinking is inspired by pragmatism, which I take as a relentless kind of empiricism, which insists that the full lived experience of epistemic agents is the only source of any learning, including learning in logic, methodology and metaphysics.
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