When first published twenty years ago, The Logic of Medicine presented a new way of thinking about clinical medicine as a scholarly discipline as well as a profession. Since then, advances in research and technology have revolutionized both the practice and theory of medicine. In this new, extensively rewritten edition, Dr. Murphy includes changes to show how these different areas of scholarship may affect details of "the logic of medicine" without compromising its fundamental coherence. (...) New to this edition are discussions of the challenge of the flood of new empirical data, new ideas in genetics, molecular biology, homeostasis, pathogenesis, cancer, aging, and Alzheimer's disease. Murphy also comments on such new theoretical topics as dynamic systems, chaos, and fractals and their impact on the burgeoning fields of philosophy and practice of medicine. Written with medical students in mind, the book includes a glossary, many new examples, and problems for solutions with comments on each. An entirely new chapter deals with modeling. Clinicians and researchers will also find the principles thought-provoking and illuminating. (shrink)

It is surely obvious that medicine, like any other rational activity, must be based on evidence. The interest is in the details: how exactly are the general principles of the logic of evidence to be applied in medicine? Focussing on the development, and current claims of the ‘Evidence-Based Medicine’ movement, this article raises a number of difficulties with the rationales that have been supplied in particular for the ‘evidence hierarchy’ and for the very special role within (...) that hierarchy of randomized controlled trials (and meta-analyses of the results of randomized controlled trials). The point is not at all to question the application of a scientific approach to evidence in medicine, but, on the contrary, to indicate a number of areas where philosophers of science can contribute to a proper implementation of exactly that scientific-evidential approach. (shrink)

This paper aims to clarify the nature of understanding in medicine. The first part describes in more detail what it means to understand something and links a type of understanding (i.e., objectual understanding) to explanations. The second part proceeds to investigate what objectual understanding of a disease (i.e., biomedical understanding) requires by considering the case of scurvy from the history of medicine. The main hypothesis is that grasping a mechanistic explanation of a condition is necessary for a biomedical (...) understanding of that condition. The third part of the paper argues that biomedical understanding is necessary, but not sufficient for understanding in a clinical context (i.e., clinical understanding). The hypothesis is that clinical understanding combines biomedical understanding of a _disease_ or pathological condition with understanding _illness,_ which involves some degree of personal understanding of the patient. It is argued that, in many cases, clinical understanding necessitates adopting a particular second-personal stance and using cognitive resources _in addition_ to those involved in biomedical understanding. (shrink)

This title is part of UC Press's Voices Revived program, which commemorates University of California Press's mission to seek out and cultivate the brightest minds and give them voice, reach, and impact. Drawing on a backlist dating to 1893, Voices Revived makes high-quality, peer-reviewed scholarship accessible once again using print-on-demand technology. This title was originally published in 1985.

This article investigates five kinds of vagueness in medicine: disciplinary, ontological, conceptual, epistemic, and vagueness with respect to descriptive-prescriptive connections. First, medicine is a discipline with unclear borders, as it builds on a wide range of other disciplines and subjects. Second, medicine deals with many indistinct phenomena resulting in borderline cases. Third, medicine uses a variety of vague concepts, making it unclear which situations, conditions, and processes that fall under them. Fourth, medicine is based on (...) and produces uncertain knowledge and evidence. Fifth, vagueness emerges in medicine as a result of a wide range of fact-value-interactions. The various kinds of vagueness in medicine can explain many of the basic challenges of modern medicine, such as overdiagnosis, underdiagnosis, and medicalization. Even more, it illustrates how complex and challenging the field of medicine is, but also how important contributions from the philosophy can be for the practice of medicine. By clarifying and, where possible, reducing or limiting vagueness, philosophy can help improving care. Reducing the various types of vagueness can improve clinical decision-making, informing individuals, and health policy making. (shrink)

The book starts with a scandal, that is, Socrates’s mortality as entailed in the Aristotelian syllogism,All men are mortal,Socrates is a man,Therefore, Socrates is mortal. The scandal pertains to the deduction of Socrates’s death from the logical connections of premises, which, according to Braude, renders it “meaningless.” But, what does this scandal have to do with a philosophical defense of intuition in medicine? For Braude, the scandal is emblematic of a crisis in medicine and philosophy—a crisis in which (...) human mortality is severed from its morality. Braude articulates the crisis with the following question:Where, therefore, between the cracks of universal logic and reifying medicine is there a place for the individual patient, for a response to the cry of pain to which medicine responds, or to the voice of injustice upon which moral philosophy is founded? For him, intuition provides a means to answer the question and thereby to resolve the crisis. It serves as “a bridge be .. (shrink)

This is a major work by Ian Maclean exploring the foundations of learning in the Renaissance. Logic, Signs and Nature offers a profoundly learned, compelling and original account of the range of what was thinkable and knowable by learned medics of the period c.1530-1630. This is a study of great significance to the history of medicine, as well as the history of European ideas in general.

The main purpose of this article is to present the methodological characteristics of a diagnostic process. A proposal is put forward to treat that process as a specific type of a research investigation. The research investigation can be represented in the notional systems of various concepts of the question logic. In this article I attempt to formulate a preliminary notional description of the diagnostic process with the use of terms being questions. Adopting this perspective of deliberations, I maintain that (...) during a diagnostic process a doctor employs a specific type of reasoning, where questions constitute lingual formulations of diagnostic problems. The article describes the structure of a diagnostic question which is used to incorporate diagnostic problems. I provide arguments for a thesis that such questions are meant to correlate information obtained on a patient’s condition. Pointing at various aspects of temporality of a diagnostic process, I intend to present its preliminary characteristics in terms of a research investigation. My deliberations are based on exemplifications in the area of medical diagnostics, mainly in cardiology. (shrink)

In the same spirit with the theme of last issue of this SGJ journal (“Ongoing creation”), this paper shortly reviews a plausible mechanism from Aether to become ordinary matter from the perspective of Neutrosophic Logic. We also discuss two other possible applications of Neutrosophic Logic, including a resolution of conflicting paradigms in medicine. We hope that some ideas as outlined herein will be proved useful in the near future.

Background Despite decades of anti-racism and equity, diversity, and inclusion (EDI) interventions in academic medicine, medical racism continues to harm patients and healthcare providers. We sought to deeply explore experiences and beliefs about medical racism among academic clinicians to understand the drivers of persistent medical racism and to inform intervention design. Methods We interviewed academically-affiliated clinicians with any racial identity from the Departments of Family Medicine, Cardiac Sciences, Emergency Medicine, and Medicine to understand their experiences and (...) perceptions of medical racism. We performed thematic content analysis of semi-structured interview data to understand the barriers and facilitators of ongoing medical racism. Based on participant narratives, we developed a logic framework that demonstrates the necessary steps in the process of addressing racism using if/then logic. This framework was then applied to all narratives and the barriers to addressing medical racism were aligned with each step in the logic framework. Proposed interventions, as suggested by participants or study team members and/or identified in the literature, were matched to these identified barriers to addressing racism. Results Participant narratives of their experiences of medical racism demonstrated multiple barriers to addressing racism, such as a perceived lack of empathy from white colleagues. Few potential facilitators to addressing racism were also identified, including shared language to understand racism. The logic framework suggested that addressing racism requires individuals to understand, recognize, name, and confront medical racism. Conclusions Organizations can use this logic framework to understand their local context and select targeted anti-racism or EDI interventions. Theory-informed approaches to medical racism may be more effective than interventions that do not address local barriers or facilitators for persistent medical racism. (shrink)

This article sets out to investigate aspects of the uptake of Renaissance law and medicine from some of the logical and natural-philosophical components of the university arts course. Medicine is shown to have a much laxer operative logic than law, reflecting its commitment to the theory of idiosyncrasy as opposed to the demands made upon the law by the need for a uniform application of justice. Symptomatic of the different uptake arc the contrasting meanings of "regulariter" and (...) "generaliter" in the two disciplines. Whereas the law treats the rule as inviolable and the exception as only valid if made explicit in due legal form, medicine is able to conceive of a nature as a field of knowledge broader than that encompassed by its rules of art. Both law and medicine approach evidence. (shrink)

Because we tend to study fight books in isolation, we often forget how difficult it is to understand the precise place they occupy in the sociocultural and historical fabric of their time, and spill the many clues they inevitably contain on their owner, their local society, their precise purpose. In order to unlock that information, we need to study them in their broader sociocultural and historical context. This requires a background and research skills that are not always easily accessible to (...) everyone. To illustrate the point, in this paper I show in some detail what is required to make sense of the claim that Aristotelian philosophy and science influenced the medieval fight books in relevant ways, and that understanding this influence helps us to better understand the fight books per se. I give an outline of the general historical framework, and apply it to a testcase: Talhoffer’s Thott 290 2° Ms., with some interesting results. My hope is that this framework may be of some use to other researchers in HEMA Studies who want to dig deeper in sources of interest to them. (shrink)

The Term 'Practical Progress' in Biomedical Sciences. A Structuralistic Approach to the Reconstruction of Epistemological Terms in Medicine. An attempt is made to elucidate the structure of the term 'practical progress' and to reconstruct it logically. The importance of discovery and confirmation of new regularities as well as of practical rules arising from them depends on their contribution to the solution of practical problems. The application of this structuralistic definition of 'practical progress' is demonstrated with an example from cardiac (...) surgery concerning the solution of the practical medical problem of myocardial protection during open heart surgery. (shrink)

Medical decisions, including diagnosis, prognosis, and disease classification, must often be made on the basis of incomplete or unsatisfactory information. Data which are essential to the care of one patient may be unobtainable for technical or ethical reasons in another patient. For this reason the principles of controlled experimentation may be impossible to satisfy in human studies. In this paper, some formal aspects of medical decision making are discussed. Special operators for the intuitive concepts of certainty, demand, and effort, akin (...) to the operators of modal logic, are used to accommodate the technical and ethical limitations on human studies. Theorems are stated and proved which show how this system handles incomplete information. The embryogenesis of the human heart is presented as a sample problem in classification. (shrink)

The Philosophy and logic in Islamic thought, unlike Christian culture, developed uncensored and as a result of great demand. After the biggest translation movement in history, important components of Ancient Greek, Syriac, Persian, Jewish and Hindu cultures were transferred to Arabic. Kalam, which developed earlier in Islamic culture, has also been effective in understanding and accepting the philosophical content. In the beginning, translations were made in fields such as medicine, chemistry, astronomy and mathematics. Philosophy literature was also translated (...) into Arabic due to its close relationship with other sciences and the need to fill the "gaps" in Islamic culture. The philosophy of logic was also transferred to Arab culture in its Aristotelian form. Especially the great influence of Aristotle helped strengthen the thought of logic among Arab philosophers and some theologians. As with other translation content, the logic has been translated into Arabic without any censorship. Contrary to the thinkers of Christian culture, Islamic philosophers learned all the subtleties of logic in a free intellectual environment, and as a result, this fact created a way for them to make a unique contribution to the discipline of logic. Logic, as it has been transformed into Arabic elements in Islamic culture, has been influential in basic areas such as theology, language, fiqh and kalam. In this process, logic, which was handled intertwined with traditional philosophy, has progressed to become a refined thought, especially with the influence of the first great philosopher Fârâbî. Fârâbî is not only a great philosopher but also a great Islamic scholar, and these qualities enabled him to adapt logic to Arab culture and Islamic sciences from his Aristotelian roots. Fârâbî, just like Aristotle, wanted to use logic as a criterion of truth for philosophical fields. Fârâbî, who designed logic under two main headings such as concepts and judgments, adapted logic to Arab culture for Muslims in the reasoning process. This solid construction of logic not only strengthened philosophical thought, but also contributed to the later establishment of a solid structure in Islamic sciences. In this context, the understanding of Islamic philosophy and its transformation with the effect of logic require a close examination of Fârâbî's thought. In our article, we will briefly discuss the pre-Islamic origins of philosophy and logic, and on this plane, we will examine Fârâbî's contribution to philosophy of some basic issues such as God, the classification of sciences, and the philosophical dimension of logic and try to reveal his effects on Islamic culture from a general point of view. (shrink)

Statistics is the science of collection, summarizing, presentation and interpretation of data. Moreover, it yields methods used in the verification of research hypotheses. The presence of a statistician in a research group remarkably improves both the quality of design and research and the optimization of financial resources. Moreover, the involvement of a statistician in a research team helps the physician to effectively utilize the time and energy spent on diagnosing, which is an important aspect in view of limited healthcare resources. (...) Precise, properly designed and implemented Computerized Clinical Decision Support Systems certainly lead to the improvement of healthcare and the quality of medical services, which increases patient satisfaction and reduces financial burdens on healthcare systems. (shrink)

Obviously medicine should be evidence-based. The issues lie in the details: what exactly counts as evidence? Do certain kinds of evidence carry more weight than others? (And if so why?) And how exactly should medicine be based on evidence? When it comes to these details, the evidence-based medicine (EBM) movement has got itself into a mess – or so it will be argued. In order to start to resolve this mess, we need to go 'back to basics'; (...) and that means turning to the philosophy of science. The theory of evidence, or rather the logic of the interrelations between theory and evidence, has always been central to the philosophy of science – sometimes under the alias of the 'theory of confirmation'. When taken together with a little philosophical commonsense, this logic can help us move towards a position on evidence in medicine that is more sophisticated and defensible than anything that EBM has been able so far to supply. (shrink)

Polynomizing is a term that intends to describe the uses of polynomial-like representations as a reasoning strategy and as a tool for scientific heuristics. I show how proof-theory and semantics for classical and several non-classical logics can be approached from this perspective, and discuss the assessment of this prospect, in particular to recover certain ideas of George Boole in unifying logic, algebra and the differential calculus.

I read Stefan Collini’s What are Universities For? last week with very mixed feelings. In the past, I’ve much admired his polemical essays on the REF, “impact”, the Browne Report, etc. in the London Review of Books and elsewhere: they speak to my heart. If you don’t know those essays, you can get some of their flavour from his latest article in the Guardian yesterday. But I found the book a disappointment. Perhaps the trouble is that Collini is too decent, (...) too high-minded, has too unrealistically exalted a view about what actually happens in universities which is too coloured by attitudes appropriate to the traditional humanities. And he is optimistic to the point of fantasy if he thinks that people are so susceptible to “the romance of ideas and the power of beauty” that they will want, or can be brought to want, lots and lots of universities in order to promote the ideas (as if they would suppose that the task of “conserving, understanding, extending and handing on to subsequent generations the intellectual, scientific, and artistic heritage of mankind” was clearly ill-served when there were only forty universities in England, as opposed to a hundred and whatever). (shrink)

A common reaction to Hegel’s suggestion that we collapse Kant’s distinction between form and content is that, since such a move would also deprive us of any way of distinguishing the merely logical from the real possibility of our concepts, it is incoherent and ought to be rejected. It is true that these two distinctions are intimately related in Kant, such that if one goes, the other does as well. But it is less obvious that giving them up as Kant (...) conceives them is as incoherent a proposal as many of Hegel’s critics think. It has been the point of a recent account of Hegel’s idealism to demonstrate that his critique of Kant’s dichotomy between form and content or concept and intuition does not commit him to the view that human cognition is materially creative of its content in the manner of a God-like or intuitive intellect—does not, in other words, signify a return to a pre-Critical metaphysics. This is the interpretative stance I adopt here as well, in hope of giving defenders of Kant reasons for taking Hegel more seriously. (shrink)

1. At least since W.F. Edwards’ pioneering articles on medieval and renaissance interpretations of the prologue to Galen's Art of Medicine,1 it has often been maintained that Latin scholastics inte...