Book contents
- Frontmatter
- Contents
- List of figures and tables
- List of examples
- Acknowledgements
- Introduction
- 1 Rethinking theories: the basis of practical research and problems with paradigms
- 2 Basic critical realist concepts
- 3 Structure and agency: making connections
- 4 Health and illness research: value-free or value-laden?
- 5 Four planes of social being: more connections
- 6 Researching transformative change over time
- 7 The point is to change it: connecting research to policy and practice
- ABCD–Articles, books, commentary and dictionary-glossary
- Notes
- References
- Index of subjects
- Index of names
1 - Rethinking theories: the basis of practical research and problems with paradigms
Published online by Cambridge University Press: 05 January 2022
- Frontmatter
- Contents
- List of figures and tables
- List of examples
- Acknowledgements
- Introduction
- 1 Rethinking theories: the basis of practical research and problems with paradigms
- 2 Basic critical realist concepts
- 3 Structure and agency: making connections
- 4 Health and illness research: value-free or value-laden?
- 5 Four planes of social being: more connections
- 6 Researching transformative change over time
- 7 The point is to change it: connecting research to policy and practice
- ABCD–Articles, books, commentary and dictionary-glossary
- Notes
- References
- Index of subjects
- Index of names
Summary
During a cholera epidemic in the Soho area of London in 1854, Dr John Snow hoped to find the cause of the illness. He mapped the households where the people with cholera lived and tracked their daily life and movements in the area. These centred on a water pump used by poorer families. The pump was next to a workhouse and a brewery that had their own water supplies and where people seemed to be safe from the disease. Snow questioned the dominant view that cholera and malaria (‘bad air’) are airborne. To test his theory that cholera is waterborne, he had the infectious handle removed from the pump. Numbers of cholera cases quickly fell.
Snow is also renowned for another innovation. He administered chloroform to Queen Victoria while she was having her eighth child, and her doctors at last agreed to grant her wish to be relieved of the pain of childbirth. He helped to transform public attitudes towards anaesthesia as well as to hygiene and public health. Public patronage from aristocratic and wealthy clients was as vital then, to develop and spread new ideas, as research grants and academic journals are today.
John Snow set examples of health and illness research that critical realism (CR) supports. He used three methods. Induction: when he observed many cases and began to form theories about the cause of cholera. Deduction: when he formed his hypothesis that cholera is waterborne and set out to test it through counting households and mapping people's daily movements and habits. Thirdly, he used retroduction: this involves:
• searching beyond evidence for the unseen cause only seen in its effects;
• working out the simplest explanation;
• imagining new possibilities;
• taking seriously a new idea (that most doctors dismissed);
• asking ‘what must the world be like for this to occur?’ (that disease perhaps spreads through water); and
• rethinking and potentially rejecting older beliefs (about the actual nature of clean water and cross-infection).
Retroduction, a major CR concept, is ‘democratic’ in that scientists and everyone else in everyday life use it. Snow put his research idea into practice. By having the pump handle removed, he changed the world through helping to reduce and prevent disease and eventually to change medical knowledge and practice. He promoted equality by assisting disadvantaged groups, who had to rely on public water pumps.
- Type
- Chapter
- Information
- Critical Realism for Health and Illness ResearchA Practical Introduction, pp. 11 - 40Publisher: Bristol University PressPrint publication year: 2021