History and philosophy of science
Sonya R. Hardin
“Why should nurses be interested in the history and philosophy of science? The history and philosophy of science is important as a foundation for exploring whether scientific results are actually truth. As nurses our practice should be based upon truth and we need the ability to interpret the results of science. Nursing science provides us with knowledge to describe, explain and predict outcomes. The legitimacy of any profession is built on its ability to generate and apply theory.”
(McCrae, 2011, p. 222)
Modern science was established over 400 years ago as an intellectual activity to formalize given phenomena of interest in an attempt to describe, explain, predict, or control states of affairs in nature. Scientific activity has persisted because it has improved quality of life and has satisfied human needs for creative work, a sense of order, and the desire to understand the unknown (Bronowski, 1979; Gale, 1979; Piaget, 1970). The development of nursing science has evolved since the 1960s as a pursuit to be understood as a scientific discipline. Being a scientific discipline means identifying nursing’s unique contribution to the care of patients, families, and communities. It means that nurses can conduct clinical and basic nursing research to establish the scientific base for the care of individuals across the life span. For example, research revealed gaps between the pain management needs of patients and the information communicated by patients and clinicians during office visits. Although many older adults have painful but not readily visible conditions (e.g., symptomatic osteoarthritis), little research has examined how the style or format of a health care practitioner’s questions influence the quality and amount of diagnostic information obtained from older adults. A recent study tested the theory that a certain type of question would elicit the most response. The theory was confirmed when findings supported that the open-ended questions prompted patients to provide a larger amount of diagnostically useful pain information than did the closed-ended questions (McDonald, Shea, Rose, & Fedo, 2009). While this study is one example of nursing science, advance practice nurses should be familiar with the long history of the science of nursing.
Previous author: Sue Marquis Bishop.
Historical views of the nature of science
To formalize the science of nursing, basic questions must be considered, such as: What is science, knowledge, and truth? What methods produce scientific knowledge? These are philosophical questions. The term epistemology is concerned with the theory of knowledge in philosophical inquiry. The particular philosophical perspective selected to answer these questions will influence how scientists perform scientific activities, how they interpret outcomes, and even what they regard as science and knowledge (Brown, 1977). Although philosophy has been documented as an activity for 3000 years, formal science is a relatively new human pursuit (Brown, 1977; Foucault, 1973). Scientific activity has only recently become the object of investigation.
Two competing philosophical foundations of science, rationalism and empiricism, have evolved in the era of modern science with several variations. Gale (1979) labeled these alternative epistemologies as centrally concerned with the power of reason and the power of sensory experience. Gale noted similarity in the divergent views of science in the time of the classical Greeks. For example, Aristotle believed that advances in biological science would develop through systematic observation of objects and events in the natural world, whereas Pythagoras believed that knowledge of the natural world would develop from mathematical reasoning (Brown, 1977; Gale, 1979).
Nursing science has been characterized by two branching philosophies of knowledge as the discipline developed. Various terms are utilized to describe these two stances: empiricist and interpretive, mechanistic and holistic, quantitative and qualitative, and deductive and inductive forms of science. Understanding the nature of these philosophical stances facilitates appreciation for what each form contributes to nursing knowledge.
Rationalism
Rationalist epistemology (scope of knowledge) emphasizes the importance of a priori reasoning as the appropriate method for advancing knowledge. A priori reasoning utilizes deductive logic by reasoning from the cause to an effect or from a generalization to a particular instance. An example in nursing is to reason that a lack of social support (cause) will result in hospital readmission (effect). This causal reasoning is a theory until disproven. The traditional approach proceeds by explaining hospitalization with a systematic explanation (theory) of a given phenomenon (Gale, 1979). This conceptual system is analyzed by addressing the logical structure of the theory and the logical reasoning involved in its development. Theoretical assertions derived by deductive reasoning are then subjected to experimental testing to corroborate the theory. Reynolds (1971) labeled this approach the theory-then-research strategy. If the research findings fail to correspond with the theoretical assertions, additional research is conducted or modifications are made in the theory and further tests are devised; otherwise, the theory is discarded in favor of an alternative explanation (Gale, 1979; Zetterberg, 1966). Popper (1962) argued that science would evolve more rapidly through the process of conjectures and refutations by devising research in an attempt to refute new ideas. For example, his point is simple; you can never prove that all individuals without social support have frequent rehospitalizations since there might be one individual that presents with no rehospitalization. A single person with no social support that does not have a readmission disproves the theory that all individuals with a lack of social support have hospital readmissions. From Popper’s perspective, “research consists of generating general hypotheses and then attempting to refute them” (Lipton, 2005, p. 1263). So the hypothesis that a lack of social support results in hospital readmission is the phenomena of interest to be refuted.
The rationalist view is most clearly evident in the work of Einstein, the theoretical physicist, who made extensive use of mathematical equations in developing his theories. The theories Einstein constructed offered an imaginative framework, which has directed research in numerous areas (Calder, 1979). As Reynolds (1971) noted, if someone believes that science is a process of inventing descriptions of phenomena, the appropriate strategy for theory construction is the theory-then-research strategy. In Reynolds’ view, “as the continuous interplay between theory construction (invention) and testing with empirical research progresses, the theory becomes more precise and complete as a description of nature and, therefore, more useful for the goals of science” (Reynolds, 1971, p. 145).
Empiricism
The empiricist view is based on the central idea that scientific knowledge can be derived only from sensory experience (i.e., seeing, feeling, hearing facts). Francis Bacon (Gale, 1979) received credit for popularizing the basis for the empiricist approach to inquiry. Bacon believed that scientific truth was discovered through generalizing observed facts in the natural world. This approach, called the inductive method, is based on the idea that the collection of facts precedes attempts to formulate generalizations, or as Reynolds (1971) called it, the research-then-theory strategy. One of the best examples to demonstrate this form of logic in nursing has to do with formulating differential diagnoses. Formulating a differential diagnosis requires collecting the facts and then devising a list of possible theories to explain the facts.
The strict empiricist view is reflected in the work of the behaviorist Skinner. In a 1950 paper, Skinner asserted that advances in the science of psychology could be expected if scientists would focus on the collection of empirical data. He cautioned against drawing premature inferences and proposed a moratorium on theory building until further facts were collected. Skinner’s (1950) approach to theory construction was clearly inductive. His view of science and the popularity of behaviorism have been credited with influencing psychology’s shift in emphasis from the building of theories to the gathering of facts between the 1950s and 1970s (Snelbecker, 1974). The difficulty with the inductive mode of inquiry is that the world presents an infinite number of possible observations, and, therefore, the scientist must bring ideas to his or her experiences to decide what to observe and what to exclude (Steiner, 1977).
In summary, deductive inquiry uses the theory-then-research approach, and inductive inquiry uses the research-then-theory approach. Both approaches are utilized in the field of nursing.
Early twentieth century views of science and theory
During the first half of this century, philosophers focused on the analysis of theory structure, whereas scientists focused on empirical research (Brown, 1977). There was minimal interest in the history of science, the nature of scientific discovery, or the similarities between the philosophical view of science and the scientific methods (Brown, 1977). Positivism, a term first used by Comte, emerged as the dominant view of modern science (Gale, 1979). Modern logical positivists believed that empirical research and logical analysis (deductive and inductive) were two approaches that would produce scientific knowledge (Brown, 1977).
The logical empiricists offered a more lenient view of logical positivism and argued that theoretical propositions (proposition affirms or denies something) must be tested through observation and experimentation (Brown, 1977). This perspective is rooted in the idea that empirical facts exist independently of theories and offer the only basis for objectivity in science (Brown, 1977). In this view, objective truth exists independently of the researcher, and the task of science is to discover it, which is an inductive method (Gale, 1979). This view of science is often presented in research method courses as: “The scientist first sets up an experiment; observes what occurs …. reaches a preliminary hypothesis to describe the occurrence; runs further experiments to test the hypothesis [and] finally corrects or modifies the hypothesis in light of the results” (Gale, 1979, p. 13).
The increasing use of computers, which permit the analysis of large data sets, may have contributed to the acceptance of the positivist approach to modern science (Snelbecker, 1974). However, in the 1950s, the literature began to reflect an increasing challenge to the positivist view, thereby ushering in a new view of science in the late twentieth century (Brown, 1977).
Emergent views of science and theory in the late twentieth century
In the latter years of the twentieth century, several authors presented analyses challenging the positivist position, thus offering the basis for a new perspective of science (Brown, 1977; Foucault, 1973; Hanson, 1958; Kuhn, 1962; Toulmin, 1961). Foucault (1973) published his analysis of the epistemology (knowledge) of human sciences from the seventeenth to the nineteenth century. His major thesis stated that empirical knowledge was arranged in different patterns at a given time and in a given culture and that humans where emerging as objects of study. In The Phenomenology of the Social World, Schutz (1967) argued that scientists seeking to understand the social world could not cognitively know an external world that is independent of their own life experiences. Phenomenology, set forth by Edmund Husserl (1859 to 1938) proposed that the objectivism of science could not provide an adequate apprehension of the world (Husserl 1931, 1970). A phenomenological approach reduces observations or text to the meanings of phenomena independent of their particular context. This approach focuses on the lived meaning of experiences.
In 1977, Brown argued an intellectual revolution in philosophy that emphasized the history of science was replacing formal logic as the major analytical tool in the philosophy of science. One of the major perspectives in the new philosophy emphasized science as a process of continuing research rather than a product focused on findings. In this emergent epistemology, emphasis shifted to understanding scientific discovery and process as theories change over time.
Empiricists view phenomena objectively, collect data, and analyze it to inductively proposed theory (Brown, 1977). This position is based upon objective truth existing in the world, waiting to be discovered. Brown (1977) set forth a new epistemology challenging the empiricist view proposing that theories play a significant role in determining what the scientist observes and how it is interpreted. The following story illustrates Brown’s premise that observations are concept laden; that is, an observation is influenced by values and ideas in the mind of the observer:
“An elderly patient has been in a trauma and appears to be crying. The nurse on admission observes that the patient has marks on her body and believes that she has been abused; the orthopedist has viewed an x-ray and believes that the crying patient is in pain due to a fractured femur that will not require surgery only a closed reduction; the chaplain observes the patient crying and believes the patient needs spiritual support. Each observation is concept laden.”
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