A
What counts as knowledge? What do we mean when we say that we know something? Whatis the status of different kinds of knowledge? In order to explore thesequestions, we are going to focus on one particular area of knowledge –medicine.
B
How do you know when you are ill? This may seem to be an absurd question. You know youare ill because you feel ill; your body tells you that you are ill. You mayknow that you feel pain or discomfort but knowing you are ill is a bit morecomplex. At times, people experience the symptoms of illness, but in fact, theyare simply tired or over- worked or they may just have a hangover. At othertimes, people may be suffering from a disease and fail to be aware of theillness until it has reached a late stage in its development. So how do we knowwe are ill, and what counts as knowledge?
C
Think about this example. You feel unwell. You have a bad cough and always seem to betired. Perhaps it could be stress at work, or maybe you should give up smoking.You feel worse. You visit the doctor who listens to your chest and heart, takesyour temperature and blood pressure, and then finally prescribes antibioticsfor your cough.
D
Things do not improve but you struggle on thinking you should pull yourself together,perhaps things will ease off at work soon. A return visit to your doctor shocksyou. This time the doctor, drawing on years of training and experience,diagnoses pneumonia. This means that you will need bed rest and a considerabletime off work. The scenario is transformed. Although you still have the samesymptoms, you no longer think that these are caused by pressure at work. Youknow have proof that you are ill. This is the result of the combination of yourown subjective experience and the diagnosis of someone who has the status of amedical expert. You have a medically authenticated diagnosis and it appearsthat you are seriously ill; you know you are ill and have the evidence uponwhich to base this knowledge.
E
This scenario shows many different sources of knowledge. For example, you decide toconsult the doctor in the first place because you feel unwell – this ispersonal knowledge about your own body. However, the doctor’s expert diagnosisis based on experience and training, with sources of knowledge as diverse asother experts, laboratory reports, medical textbooks and years of experience.
F
One source of knowledge is the experience of our own bodies; the personal knowledgewe have of changes that might be significant, as well as the subjectiveexperiences are mediated by other forms of knowledge such as the words we haveavailable to describe our experience, and the common sense of our families andfriends as well as that drawn from popular culture. Over the past decade, forexample, Western culture has seen a significant emphasis on stress-relatedillness in the media. Reference to being ‘stressed out’ has become a commonresponse in daily exchanges in the workplace and has become part of popularcommon-sense knowledge. It is thus not surprising that we might seek such anexplanation of physical symptoms of discomfort.
G
We mightal so rely on the observations of others who know us. Comments from friends andfamily such as ‘you do look ill’ or ‘that’s a bad cough’ might be anothersource of knowledge. Complementary health practices, such as holistic medicine,produce their own sets of knowledge upon which we might also draw in decidingthe nature and degree of our ill health and about possible treatments.
H
Perhaps the most influential and authoritative source of knowledge is the medicalknowledge provided by the general practitioner. We expect the doctor to haveaccess to expert knowledge. This is socially sanctioned. It would not beacceptable to notify our employer that we simply felt too unwell to turn up forwork or that our faith healer, astrologer, therapist or even our priest thoughtit was not a good idea. We need an expert medical diagnosis in order to obtainthe necessary certificate if we need to be off work for more than the statutoryself-certification period. The knowledge of the medical sciences is privilegedin this respect in contemporary Western culture. Medical practitioners are alsoseen as having the required expert knowledge that permits them legally toprescribe drugs and treatment to which patients would not otherwise haveaccess. However, there is a range of different knowledge upon which we drawwhen making decisions about our own state of health.
I
However,there is more than existing knowledge in this little story; new knowledge is constructedwithin it. Given the doctor’s medical training and background, she mayhypothesize ‘is this now pneumonia?’ and then proceed to look for evidenceabout it. She will use observations and instruments to assess the evidence and– critically – interpret it in light of her training and experience. Thisresults in new knowledge and new experience both for you and for the doctor.This will then be added to the doctor’s medical knowledge and may help in thefuture diagnosis of pneumonia.
Questions 27-32
Complete the table
Choose NO MORE THAN THREE WORDS fromthe passage for each answer. Write your answers in boxes 27-32 onyour answer sheet
Questions 33-40
The Reading Passage has nineparagraphs A-I
Which paragraph contains the followinginformation?
Write the correct letter A-I, in boxes 33-40 onyour answer sheet.
33 ....................... thecontrast between the nature of personal judgment and the nature of doctor’sdiagnosis
34 ....................... areference of culture about pressure
35 ....................... sickleave will not be permitted without the professional diagnosis
36 ....................... howdoctors’ opinions are regarded in society
37 ....................... theillness of patients can become part of new knowledge
38 ....................... adescription of knowledge drawn from non-specialized sources other than personalknowledge
39 ....................... anexample of collective judgment from personal experience and professional doctor
40 ....................... areference that some people do not realize they are ill
Answer keys：
27. bad cough
28. blood pressure
29. families and friends
30. Practitioner
31. Diagnosis
32. background
33. E
34. F
35. H
36. H
37. I
38. G
39. D
40. B
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