• Medical progress
• imagination
• reason
• arts-science divide

Medicine and health care are sometimes thought of as the last bastions of Enlightenment thinking, because they continue to be primarily informed by a nineteenth-century view of scientific rationalism, and hold out endless possibilities for progress, seen as clearly beneficial. There is though nothing in the fabric of Nature to make this “reigning idea” of medical progress either true or inevitable–or even necessarily beneficial were it to be true. Hence, and somewhat in contrast to the objectivist tenor of mainstream Enlightenment thinking, there is a vital and central role for the imagination in the crafting of scientific theory. Ironically, whilst the reality of modern science bears this out, popular conceptions of science–including medical science–continue to cling to the progressivist idea of the perpetual disclosing of new benefit. But as Downie argues in …