Cognition-Based Medicine: A new paradigm for medicine - applied to Homoeopathy

Abstract

The objective of this article is to introduce the concept of Cognition Based Medicine (CBM) as a convincing alternative to Evidence Based Medicine (EBM). CBM was developed on the basis of a refutation of the positivist paradigm through Karl Duncker and Curt J. Ducasse. Contrary to Hume´s ideas, we are well capable to discern causality by observation in single cases. This has been demonstrated by Duncker through some simple examples of causal cognition. He termed this concept “Gestalt-cognition”. “Gestalt” means form, structure and process and stretches from a cause into its effect.Helmut Kiene, a German medical doctor and researcher, introduced CBM in 2001, by publishing his book “Komplementäre Methodenlehre der Klinischen Forschung” (Complementary Methodology in Clinical Research).Following Kiene´s arguments, the development of the epistemological foundations for EBM from the 16th up to the 20th century will be depicted, with a special focus on RCTs, and on “placebo” in its role as a surveyor´s rod for measuring the effect of any given therapy.Next, CBM with its focus on single-case-cognition as the basis of progress in medicine will be described. Kiene analyzed the published research of four volumes of ´The Lancet´ to demonstrate the validity of this concept.Hahnemann´s finding of the Law of Similars serves as an example of gestalt-cognition.Practitioners should make the tacit knowledge they are gaining from single-case-cognition available to other colleagues, to improve the bases of clinical judgement. Kiene and his co-researchers propose a structure for the publication of single cases, which contains various important criteria to be fulfilled.This structure will be applied to the special necessities of Homoeopathy. A custom-made questionnaire will be presented.