Likhwa Ncube

Medicine has persisted for thousands of years despite frequent therapeutic failures. What explains its persistence despite its failure to cure? I contend that the Inquiry thesis’s view – seeing medicine’s “core business” as prediction and understanding – rests on an unhelpful conceptual distinction between main goal and core business, along with an implausible “No Bullshit” premise. Instead, I support the refined Curative Thesis (RCT): medicine is united by a teleological (constitutive) aim to help the sick through socially organised and accountable interventions, even when cures are uncertain. Using conceptual analysis and analogies from comedy, mining, and policing, I demonstrate that professions can survive repeated failures in their main goals, revealing a symmetry: prediction and explanation often fail as well. This work is innovative in three ways: it discards “core business” as a defining tool, introduces a teleological boundary that accommodates epistemic diversity, and redefines prediction and understanding as instrumental goods intrinsic to medicine. It also relates RCT to other recent curative-focused and related accounts, such as Smart (Synthese 201(6):194, 2023); Varga (Science, medicine, and the aims of inquiry, Cambridge University Press, Cambridge, 2024); Stegenga (Care and cure, University of Chicago Press, Chicago, 2018), clarifying their significance.

This paper critically evaluates Alex Broadbent’s Inquiry Thesis, which defines medicine by the core competencies of prediction and understanding. While the thesis seeks to avoid parochialism by identifying features that could apply across traditions, its applicability falters when examined against African traditional medicine (ATM). Using ATM as a test case, this paper demonstrates that legitimate medical systems can operate coherently and enjoy broad social legitimacy without consistently exercising prediction or understanding in Broadbent’s sense. This challenges the Inquiry Thesis both as a general account of medicine and as an inclusive framework. Accordingly, this paper tentatively advances a Refined Curative Thesis (RCT), which shifts the unifying criterion from competencies to aims: medicine is defined as the organized, socially recognized effort to restore or maintain health through interventions directed at beneficial change. RCT accommodates epistemic diversity, preserves conceptual discipline, and avoids collapsing into unstructured pluralism. By centring the curative aim, this revised account offers a more inclusive, philosophically robust, and culturally sensitive definition of medicine. The analysis deepens philosophical understanding of medicine while also bearing practical significance for global health policy, intercultural dialogue, and the recognition of diverse medical systems.