David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Jack Alan Reynolds
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Theoretical Medicine and Bioethics 30 (3):215-229 (2009)
A debate has simmered concerning the nature of clinical reasoning, especially diagnostic reasoning: Is it a “science” or an “art”? The trend since the seventeenth century has been to regard medical reasoning as scientific reasoning, and the most advanced clinical reasoning is the most scientific. However, in recent years, several scholars have argued that clinical reasoning is clearly not “science” reasoning, but is in fact a species of narratival or hermeneutical reasoning. The study reviews this dispute, and argues that in a theoretical sense, the dispute rests upon a naïve—but very popular—caricature of what constitutes “science reasoning.” But, if the dispute rests upon just such a caricature, why is it so persistent? The study concludes by suggesting that we, as patients and as physicians, have deep psychological tendencies that incline us to adopt the very naïve “science” concept/model of diagnostic reasoning, even if (or when) we understand its inaptness.
|Keywords||Clinical reasoning Clinical science Narrative Hermeneutics|
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References found in this work BETA
Eric J. Cassell (2004). The Nature of Suffering and the Goals of Medicine. Oxford University Press.
David Hume (2009/2004). An Enquiry Concerning Human Understanding. In Steven M. Cahn (ed.), Exploring Philosophy: An Introductory Anthology. Oxford University Press. 112.
Drew Leder (1990). Clinical Interpretation: The Hermeneutics of Medicine. Theoretical Medicine and Bioethics 11 (1).
James D. Lock (1990). Some Aspects of Medical Hermeneutics: The Role of Dialectic and Narrative. Theoretical Medicine and Bioethics 11 (1).
Kathryn Montgomery (2006). How Doctors Think: Clinical Judgment and the Practice of Medicine. Oxford University Press.
Citations of this work BETA
Stephen G. Henry (2010). Polanyi's Tacit Knowing and the Relevance of Epistemology to Clinical Medicine. Journal of Evaluation in Clinical Practice 16 (2):292-297.
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