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.

Philosophy of Medicine has for a long time been preoccupied with analyzing the concepts of health, disease and illness. Relatively speaking, the concept of medicine itself has received very little attention. This paper is a contribution to the relatively neglected debate about the nature of medicine. Building on the work of Alex Broadbent (Broadbent, 2018a, b), Chadwin Harris (Harris, 2018) and Thaddeus Metz (Metz, 2018), in this paper I question the persuasiveness of Broadbent’s account of the “core business” of medicine, (...) The Inquiry Thesis, and propose an alternative: a revised version of The Curative Thesis, which I coin The Best Available Intervention Thesis. Crudely, this suggests that Medicine is the sustained and organised effort to determine and prescribe the best available treatment (curative or preventative) for patients. (shrink)

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 ; 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)