_The_ _Routledge Companion to Philosophy of Medicine _is a comprehensive guide to topics in the fields of epistemology and metaphysics of medicine. It examines traditional topics such as the concept of disease, causality in medicine, the epistemology of the randomized controlled trial, the biopsychosocial model, explanation, clinical judgment and phenomenology of medicine and emerging topics, such as philosophy of epidemiology, measuring harms, the concept of disability, nursing perspectives, race and gender, the metaphysics of Chinese medicine, and narrative medicine. Each of (...) the 48 chapters is written especially for this volume and with a student audience in mind. For pedagogy and clarity, each chapter contains an extended example illustrating the ideas discussed. This text is intended for use as a reference for students in courses in philosophy of medicine and philosophy of science, and pairs well with _The_ _Routledge Companion to Bioethics_ for use in medical humanities and social science courses. (shrink)

Documenting and Describing. The Epistemic Function of Psychiatric Records, their Archiving and Reinterpretation into Case Histories. The paper attempts to reconstruct the writing of published case histories. Due to the establishment of a scientific classification system in psychiatry there were at the Charité several changes from the late 1870s onwards: (1) Not only was the documentation in the clinical records altered significantly, but also (2) the archive was reorganized into a double filing system and (3) the casuistic made a development (...) from describing seldom or sensational cases into a mode which aimed to unfold psychiatric theory through ‘typical cases’. Original medical records, the internal documentation of psychiatric observation, will be compared to their published version. Both, the narrative of a case study and the documentation in the clinical records reveal performative processes of observation and documentation. (shrink)

This paper examines the rise of an epistemic genre, the Observationes, a new form of medical writing that emerged in Renaissance humanistic medicine. The Observationes originated in the second half of the sixteenth century, grew rapidly over the course of the seventeenth, and had become a primary form of medical writing by the eighteenth century. The genre developed initially as a form of self-advertisement by court and town physicians, who stressed success in practice, over and above academic learning, as a (...) core element of their professional identity. This unprecedented emphasis on practice as a source of knowledge remained a key feature of the Observationes in its subsequent development. As the genre evolved, the original emphasis on therapeutic success gave way to a new focus on the descriptive knowledge of disease through detailed observation. The authorial identity projected by the writers of Observationes was increasingly that of the learned and experienced observer, bent on comparing notes and sharing his cases with the fellow members of the res publica medica. This paper charts the development of the genre, examining how its growth contributed to the new epistemological value of observation in the age of the Scientific Revolution. (shrink)

The provocative paper by John Forrester ‘If p, Then What? Thinking in Cases’ opened up the question of case thinking as a separate mode of reasoning in the sciences. Case-based reasoning is certainly endemic across a number of sciences, but it has looked different according to where it has been found. This article investigates this mode of science – namely thinking in cases – by questioning the different interpretations of ‘If p?’ and exploring the different interpretative responses of what follows (...) in ‘Then What?’. The aim is to characterize how ‘reasoning in, within, with, and from cases’ forms a mode of scientific investigation for single cases, for runs of cases, and for comparative cases, drawing on materials from a range of different fields in which case-based reasoning appears. (shrink)

The psychoanalytical case history was in many ways the pivot point of John Forrester’s reflections on case-based reasoning. Yet the Freudian case is not without its own textual forebears. This article closely analyses texts from two earlier case-writing traditions in order to elucidate some of the negotiations by which the case history as a textual form came to articulate the mode of reasoning that we now call ‘thinking in cases’. It reads Eugène Azam’s 1876 observation of Félida X and her (...) ‘double personality’—the case that brought both Azam and Félida to prominence in late 19th-century French science—against a medico-surgical case penned by the Bordeaux physician in the same decade. While the stylistics of Azam’s medical case mirror its epistemic underpinnings in the ‘vertical’ logics of positivist science, the multiple narratives interwoven in Félida’s case grant both Azam and his patient the role of knowledge-making actors in the text. This narrative transformation chimes with the way Azam reasons ‘horizontally’ from particulars to Félida’s singular condition, but sits in tension with his choice to structure the observation along a ‘vertical’ axis. Between the two, we glimpse the emergence of the psychological observation as a mode of writing and thus of thinking in cases. (shrink)

Fallgeschichten werden seit dem 18. Jahrhundert zunehmend genutzt, um juristisches, psychologisches und medizinisches Wissen einer grösseren Öffentlichkeit zu vermitteln. In den letzten zehn Jahren haben sie auch in den Geistes- und Sozialwissenschaften mehr Aufmerksamkeit erfahren. Die Diskussion über paradigmatische Fälle in diesem Band zielt darauf ab, Fallgeschichten in ihrer Funktion als besonders anschauliche oder lehrreiche Beispiele in verschiedenen historischen Kontexten zu untersuchen und zu vergleichen. Die in diesem Heft versammelten Texte gehen der Frage nach, wie Fälle dazu beitragen, Debatten zu (...) verdichten und Entwicklungen erzählbar zu machen, wie sie über den Einzelfall hinausgehendes Wissen generieren und so paradigmatischen Status erlangen. Neben konzeptuellen Gesichtspunkten widmen sich die Beiträge mehreren Forschungsfeldern, darunter der Rechts- und Medizingeschichte, der Geschichte der Geschichtsschreibung, literarischen Fällen, den Sozialwissenschaften und der Technikgeschichte. (shrink)

Although cases are central to the epistemic practices utilized within clinical medicine, they appear to be limited in their ability to provide evidence about causal relations because they provide detailed accounts of particular patients without explicit filtering of those attributes most likely to be relevant for explaining the phenomena observed. This paper uses a series of recent case reports to explore the role of cases in casual attribution in medical diagnosis. It is argued that cases are brought together by practitioners (...) to generate causal attributions and testable predictions using a manipulability view of causation. (shrink)

Facts often acquire a life of their own; the stories in this book explain why.