Words – Part 1
Etymologists note the word pragmatic has a checkered past, and a multiform present. The Greek root pragma means ‘a thing to be done, a fact, rightly done.’
But pragmatic has veered far and wide over the centuries to mean meddlesome, opiniated, according to common practice,…..and nowadays a fusion of compromise, abandonment of stated goals, opportunistic. Jacques Barzun reminds us this is not what Charles Peirce, William James, and John Dewey (pioneers of pragmatism) meant as they developed their incandescent, oddly under-appreciated branch of philosophy and science.
William James was a magnanimous, obsessively curious intellect whose contributions to psychology and consciousness understanding, the scientific method, and religious studies are so pervasive it is now taken for granted as everyday knowledge (similar to Spinoza, Hume, Kant, Nietzsche, Freud). By pragmatism, James an authentic radical empiricist, meant “Truth is what will be steadily borne out by subsequent experience.” Something is true (like a hypothesis or opinion) if the consequences and hard facts of acting on that ‘truth’ are supported by subsequent objective experience. So, we are constantly modifying what is thought to be ‘true’,……..the scientific method only securely reveals what is false.
A belief, in contrast, is an idea or sentiment that has yet to be, or cannot be, verified by a shared, objective experience. James never implied ‘belief’ was wrong or undesirable (quite the opposite actually),…..he just made a clear distinction between pragmatism as a discipline of truth-seeking, versus the vagaries of human consciousness, our flux of streaming perceptions/emotions/memories.
Nobody ever has precisely the same thought or experience twice, because we simply cannot, he believed. Our brain is a material thing,…..consciousness is an event, zillions of interactions, a process.
So, I am cautious when someone labels a QI project or randomized clinical trial as pragmatic. If simpatico with William James, that is high praise of empiricism and the scientific method. If they are inferring it’s practical, or real-world, or compromise-filled, or short-of-expectations,……well, I am confused what they are implying.
Attached is a pragmatic QI experience (and commentary) founded upon solid principles of evidence-review, education, feedback loops, and the ethos of collaboration – how can we meaningfully reduce unnecessary cesarean sections in nulliparous, term, singleton, primiparous pregnancies?
Joe Kaempf, MD
Oregon Representative
Portland, OR
Volume 13, Number 15