The first part of a symposium devoted to Alex Broadbent's essay titled ‘Prediction, Understanding and Medicine’, this article notes the under-development of a variety of issues in the philosophy of medicine that transcend bioethics and the long-standing debates about the nature of health/illness and of evidence-based medicine. It also indicates the importance of drawing on non-Western, and particularly African, traditions in addressing these largely metaphysical and epistemological matters.

The nosological diagnosis is a particular type of nontheoretical diagnosis consisting of identifying the disease that afflicts the patient without explaining the underlying etiopathological mechanisms. Its origins are within the essentialist point of view on the nature of diseases, which dates back at least to 18th-century taxonomy studies. In this article, we propose a model of nosological diagnosis as a two-phase process composed of the categorization of inductive inferences and argumentations by analogy. In the inductive phase, disease entities are identified (...) by means of typicality-based categorization processes, and meaningful clinical samples are learned (abstract clinical cases, i.e., syndromes and actual cases); in the subsequent phase, those samples are used as the bases of argumentations by analogy to obtain a diagnosis for a given patient. This model extends the prototype resemblance theory of disease including also the exemplar theory proposed in cognitive science and, moreover, it frames the clinical activity of nosological diagnosis and how it can be explained within the theory of argumentation. According to it, diagnosis based on the recognition of a typical syndrome is explained in terms of the prototype theory of categorization and the antisymmetrical argumentation by analogy, while diagnosis based on a comparison with a previous clinical case is explained by the exemplar theory of categorization and by the symmetrical argumentation by analogy. (shrink)

In After God: Morality & Bioethics in a Secular Age, Professor H. Tristram Engelhardt, Jr. argues that the now dominant intellectual culture of the West actively shuns any transcendent point of orientation, such as an appeal to God or to a God’s eye perspective on reality. Instead, it seeks to frame its understanding of reality and morality, and thus its bioethics, without reference to any foundation outside of particular human concerns. This article explores the implications of living in a secular (...) culture that eschews any appeal to a fully objective perspective on reality. Drawing on Engelhardt’s analysis, it argues that absent access to a binding moral standpoint that is not already conditioned by a particular society, culture, or place in history, all moral and bioethical commitments are merely contingent, subject to particular human interests, aesthetic inclinations, personal intuitions, idiosyncratic choices, and political objectives. (shrink)

This article is a reply to two critics of my “Prediction, Understanding, and Medicine,” published elsewhere in this journal issue. In that essay, I argued that medicine is best understood not as essentially a curative enterprise, but rather as one essentially oriented towards prediction and understanding. Here, I defend this position from several criticisms made of it.