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Title: Philosophy/Philosophy of Logic/Informal Logic - Logic and Diagnostic Article by Paul Tomassi discussing the application of logical reasoning in medical diagnostic. Appeared in Minerva.
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Logic and Diagnostic
LOGIC AND DIAGNOSTIC
Paul Tomassi
INTRODUCTION
The value and importance of the clinician's ability to identify the
presence of a disease in a patient and to prescribe effective medical treatment
on that basis needs no explanation. And, of course, such abilities are
diagnostic and prognostic in character. But what is diagnosis? It seems
clear enough that diagnosis is a matter of judgement. However, it is also
perfectly clear that to say this is really to say very little. What kind
of judgement is diagnostic judgement? And how are such judgements arrived
at? Making a diagnostic judgement can be a relatively simple matter, e.g.
self-diagnosis of a common cold. But the domain of diagnostic judgement
extends across the whole of the disease taxonomy, from the common cold
through states of organs, anatomical structures and the immune system,
to pathogenic factors, i.e. to the foundations of biology. Properly understood,
then, diagnostic judgement is scientific judgement and, indeed, expert
diagnostic judgement is scientific judgement par excellence.
Given the scientific character of diagnostic judgement, it is surprising
that the nature of the diagnostic process has been so little scrutinised
by contemporary philosophers of science. 0. It follows logically that some constraint on the range of possible
hypotheses is required for, according to the Principle of Indifference,
prior to any empirical evidence, every hypothesis must be awarded equi-probability.
If the range of hypotheses were infinite, then, every hypothesis across
the infinite range must be awarded equi-probability, which cannot in sum
exceed 1. But in any such case most hypotheses in the range must possess
a zero value and, therefore, Bayesian reasoning could never get off the
ground.
This particular objection can
easily be met. Certainly, in order to exploit Bayes's Theorem as I have
suggested, the clinician must be able to determine prior probabilities
for hypotheses but, as I have shown, the clinician could generate initial
sets of diagnostic hypotheses on the basis of crude frequencies in defined
populations of patients and subsequently consider those hypotheses as a
basis for subjective appraisal.
Further, the number of hypotheses
considered at any one time by the clinician will be strictly limited if
only for purely practical reasons. |
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Article | by | Paul | Tomassi | discussing | the | application | of | logical | reasoning | in | medical | diagnostic. | | Appeared | in | Minerva. |
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