PHaR conference 2019.

7th December - Techne versus Phronesis: Can they co-exist? 

At this meeting we considered Donald Polkinghorne's chapter on Culture and Practice from his book of 1991, Practice and the Human Sciences: the case for a judgment-based practice of care.

This was chosen because it poses a challenge to our way of thinking. As a group of phenomenologists our worldview probably fits better in the realm of phronesis as a guide to practice, but as people involved in applied research, we also need to consider the importance of techne, and not throw out the baby with the bathwater.

So, what are these things? Techne represents the rational way of thinking that dominates normative science, it involves calculation, and can be represented in some small way by the use of statistics to test probabilities in the creation of general laws that might be conceived as governing human behaviour.

Phronesis is more deliberative, it involves a dialectic, and calls on judgement. Phronesis fits much better with a phenomenological mindset. It is context-sensitive, weighs up pros and cons, and is responsive.

On reading this chapter, we were a little concerned that Polkinghorne's message was anti-techne in order to be pro-phronesis. However, that's the problem with reading one chapter out of context. I chose this chapter (Rachel Shaw) because I wanted to 'think aloud' about its message. I have read the preceding chapters and can see that in those yet to be read, Polkinghorne does advocate ways of incorporating both ways of knowing to create something which might be referred to a judgment-based practice of care. Chapters to come include Embodied Reasoning and then Reflective Understanding and Practitioner Judgment - I shall have to feedback on those!

Discussing this chapter brought up contemporary issues of the 'crisis' in evidence based medicine. We know the history of evidence based medicine, that it was introduced to provide some evidence to support medical practice, and that it was necessary. However, there is some concern these days that perhaps we are going too far in the other direction: is there only one kind of knowing that 'qualifies' as evidence? The techne seems to be winning the fight; RCTs dominate, experimental work is prized, and yet, patient experience is considered to be more important now than arguably it ever has in the recent history of applied health research.

Polkinghorne described Bourdieu's notion of habitus - the social arena in which we live, practise, and which is constituted historically and socially through the accumulation of cultural capital. The habitus of practice is something we can envisage, a set of unwritten rules, a result of socialisation, that generates a kind of practical generalisation of practice. Thus, understanding the context is critical to the understanding of individual practitioner behaviour and experience.

The question remains, can the techne and phronesis co-exist? Polkinghorne tells us that we are forever being pushed toward the techne, which we can see all around us, but perhaps increased investment in stakeholder involvement and increased value being given to patient experience will help us convince those that need convincing of the benefits of phronesis, and judgment. Let's hope it's more than a token gesture and results in a human science of which we can be proud!