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We distinguish three aspects of medical diagnosis: generating new diagnostic hypotheses, selecting hypotheses for further pursuit, and evaluating their probability in light of the available evidence. Drawing on Peirce’s account of abduction, we argue that hypothesis generation is amenable to normative analysis: physicians need to make good decisions about when and how to generate new diagnostic hypothesis as well as when to stop. The intertwining relationship between the generation and selection of diagnostic hypotheses is illustrated through the analysis of a (...) |
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Increasing philosophical attention is being directed to the rapidly growing discipline of evidence-based medicine. Philosophical discussions of EBM, however, remain narrowly focused on randomization, mechanisms, and the sociology of EBM. Other aspects of EBM have been all but ignored, including the nature of clinical reasoning and the question of whether it can be standardized; the application of EBM principles to the logic, value, and ethics of diagnosis and prognosis; evidence synthesis ; and the nature and ethics of placebo controls. Philosophical (...) |
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Forrester’s proposed seventh style of reasoning – thinking in cases – functions as an analogous, dyadic relationship that, whilst indebted philosophically to the logical reasoning and semiotics of Charles Peirce, is prone to creating feedback loops between induction and deduction, precluding novel abductive hypotheses from advancing medical knowledge. Reasoning with a Peircean triadic model opens up the contexts and methods of meaning-making and reasoning through medical cases, and the potent influence of their genre conventions, to intellectual critical scrutiny. Vitally, it (...) |
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Clinical diagnostic medicine is an experimental science based on observation, hypothesis making, and testing. It is an use dynamic process that involves observation and summary, diagnostic conjectures, testing, review, observation and summary, new or revised conjectures, i.e. it is an iterative process. It can then be said that diagnostic hypotheses are also ‘observation-laden’. My aim is to enlarge on the strategies of medical diagnosis as these are meshed in training and clinical experience—that is, to describe the patterns of reasoning used (...) |
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Exploring the early development of an area of medical literature can inform contemporary medical debates. Different methods of inference include deduction, induction, abduction, and inference to the best explanation. I argue that early shaken baby research is best understood as using abduction to tentatively suggest that infants with unexplained intracranial and ocular bleeding have been assaulted. However, this tentative conclusion was quickly interpreted, by some at least, as a general rule that infants with these pathological signs were certainly cases of (...) |
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