Knowledge Building for the Health Sciences in the Twenty-First Century

Preparing a paper of this breadth was quite intimidating. First, I don't consider myself a philosopher of science, rather a scientist who is a student of philosophy. So, in preparation of this paper, I decided to seek the highest and purest of philosophical thinking. With this in mind, I consulted one of the most profound sages of our time . . . Winnie-the-Pooh. For those of you who are a little skeptical about the Great Bear's status as a philosopher, let me remind you that Winnie-thePooh, although he had many friends, lived in the woods all by himself. Now, according to Aristotle, to live alone under these conditions one must be either an animal or a god. But Nietzsche tells us that there is a third case where one must be both animal and god-a philosopher (Williams, 1995, p. 15 1). Furthermore, Pooh, in his Anxious Pooh Song, claims, "Pooh is a Bear of Enormous Brain!" Now, if that isn't proof that he is a philosopher, I don't know what is! I had some help in my attempts to relate Pooh's philosophy to the philosophy of science from John Tyerman Williams in Pooh and the Philosophers. The wisdom of this great ursine philosopher will be integrated within this paper. The purpose of this paper on knowledge building for the health sciences in the twenty-first century is: (1) to present an overview of paradigms of philosophy of science informing our approaches to science; (2) to present an analysis of the current forces impacting health care that have implications for knowledge building in the health sciences; (3) to articulate some values-oriented tensions within the analysis of these contexts and to describe a synthesis of those tensions; and (4) to conclude with a vision for knowledge development in the next century.