Is there such a thing as a truly objective account of events? If 'objective' is intended to mean absolutely true and independent of all observers, the answer must be negative. Students and trainee psychiatrists often come to psychiatric clinical work from medical and surgical disciplines where they have been encouraged to 'search for the facts' with the implication that 'true' facts exist. They may need to be reminded that the supposed facts of all medical histories, even those of clearly physical illnesses, depend upon the perceptions, opinions, and memories of individuals who may give different versions of the same events at different times.
'Objective' has several shades of meaning in ordinary usage, but in clinical assessment its most useful meaning is that an account of an event or behaviour is based on agreement between two or more persons or sources. In contrast, 'subjective' can be used to indicate that the account comes from only one person. Objective information is likely to be safer to act upon than subjective, so efforts should always be put into raising as much as possible of the information about a patient into the objective category. Nevertheless, many of the most important symptoms in psychiatry can only be subjective, since they refer to the inner experience of the one person who can describe them.
When assessing the reliability and usefulness of other types of information, such as the results of treatment or possible explanations of causes, a further useful distinction can be made between objective defined as above and 'scientific', taking this to mean that systematic efforts have been made to obtain evidence based upon comparisons (or 'controls') which demonstrate that one explanation can be preferred out of several possibilities that have been considered.
Simple definitions such as these are useful in clinical discussions, but it must be remembered that in the background are many complicated and unsolved problems of philosophy and semantics. Some of these suggestions on the status of information in clinical work are based upon the writings and clinical teaching of Kraupl Taylor.(7)
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