Biomedical research and global sustainability: Throwing off the straitjacket of hierarchical thinking, making space for nomadic thinking

The biomedical paradigm, characterised by the separation of human from nature, of mind from body, and of ‘us’ from ‘them’, is encrusted with the jewels of western exploitation. Its legacy, one of many, has been to permit critical thinking to be infused with the domination of scientific knowledge over indigenous knowledge, of expert experience over patient experience, and of western knowledge over knowledge from other regions. Planetary sustainability has put us all into an uncomfortable liminal space where there is an urgent need to develop new ways of thinking to navigate the complexity and uncertainties of the Anthropocene. The decolonization/dismantling of the historically biased, epistemically rigid, hierarchical thinking that has led us to the brink of environmental collapse must re-centre a more ‘nomadic’ or ‘rhizomic’ type of thinking that works against the grain of traditional western categories and conventional methods, making breathing space for experiential person-centred, ecological wisdom to blossom. What might this look like for global health and academia? Practicing medicine using an ecological lens; a system with geographically diverse representation in the authorship of scientific literature; methodological diversity in the top journals, placing qualitative research, stories and art on an equal footing with Randomised Controlled Trials; and editorial boards composed in part of lay members. A more inclusive academe, through Cultural Safety, where works from patients, service users, indigenous community voices are published alongside and co-produced with expert/professional communities is a step in the right direction.