Chapter Contents

Introduction

Health research is a systematic and principled way of obtaining evidence (data, information) for solving health care problems and investigating health issues. Research is systematic in that researchers follow a sequential process (see Ch. 3) and principled in that research is generally carried out according to explicit rules. These rules or principles constitute the method. The term ‘method’ derives from the Greek word ‘methodoi’, meaning a ‘way of travelling’ or ‘the path which we follow’. It is the application of appropriate methods which guarantee the validity of the evidence and the truth of knowledge. In health research, ‘method’ refers to a set of rules which specify:

Strictly speaking, the terms ‘method’ and ‘methodology’ have different meanings. Method refers to the rules of evidence followed for collecting data in a project. Methodology refers to the critical discussion, comparison and application of methods. The present chapter is concerned with methodology. Later chapters in this book are concerned with specific methods used in health research.

The primary aim of this chapter is to examine the philosophical foundations of scientific research methods. Emphasis is placed on method as a means of conducting applied research and producing the best possible evidence for solving health problems.

The general aims of this chapter are to:

Knowledge and methods

Two concepts drawn from philosophy are relevant to our discussion: ontology and epistemology.

Ontology refers to the question of what exists in the world, what is ‘real’. Different knowledge systems take diverse positions on what constitutes reality. In contrast to the natural sciences, various traditional interpretations hold different views on what constitutes the reality. For example, the notion of life force or qi/chi, a central concept in traditional Chinese medicine, is absent in contemporary Western medicine. Of historical interest, is the classical Greek belief in humors that was once central to Western medicine. The balance of humors was thought to determine mental and physical wellbeing; however humors are no longer seen as ‘real’ in Western medicine.

Epistemology is a field of philosophy concerned with the nature, source and legitimacy of knowledge. In the domain of health research we are interested in knowledge as applicable to:

Before we begin discussion of scientific knowledge and research it is useful, as a means of contrast, to look at some other epistemological approaches.

The scientific method

Science and the scientific method evolved over a period of thousands of years (Fara 2009). Great civilizations, such as Babylonia, China and India, devised written languages and symbols for numbers, to permanently record observations and speculations about the world. This was an essential step in the development of formal science. Disciplines such as astronomy, mathematics and medicine were further developed by Greek and Roman philosophers and physicians. For example, the Roman physician Galen worked as a surgeon treating injured gladiators and used experimental methods to test hypotheses about physiology and anatomy. Much of the classical knowledge was lost during the dark ages, but an important fraction was preserved and expanded upon by Muslim and Christian scholars (Fara 2009).

The beginnings of modern Western science are generally traced to the beginning of the 16th century, a time in which Europe experienced profound social changes and a resurgence of great artists, thinkers and philosophers. Gradually, scholars’ interests shifted from theology and armchair speculation to systematically describing, explaining and attempting to control natural phenomena. These changed circumstances enabled philosophers such as Descartes and Francis Bacon to challenge tenets of medieval thinking, and scientists such as Galileo, Newton and Harvey to propose new ways of conducting research and building knowledge.

The following points represent the essential characteristics of the early scientific world view:

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