Clinical Judgment: A Critical Appraisal

1. Front Matter

   Pages i-xxvi

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2. Intuitions, Hunches, and Rules for Reasoning

   1. Front Matter

      Pages 1-1

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   2. Clinical Judgment

      • Michael Scriven

      Pages 3-16

   3. Human Factors in Clinical Judgment: Discussion of Scriven’s ‘Clinical Judgment’

      • Arthur S. Elstein

      Pages 17-28

   4. The Art and Science of Clinical Judgment:

      • Elliott Sober

      Pages 29-44

   5. When Does a Diagnosis Become a Clinical Judgment?

      • D. L. Rosenhan

      Pages 45-56

3. The Logic of Health Care

   1. Front Matter

      Pages 57-57

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   2. Classification and Its Alternatives

      • Edmond A. Murphy

      Pages 59-85

   3. Comments on Murphy’s ‘Classification and Its Alternatives’

      • Morton Beckner

      Pages 87-92

   4. Simulating Clinical Judgment

      • John L. Gedye

      Pages 93-113

   5. A Clinician’s Quest for Certainty

      • Ernan McMullin

      Pages 115-129

   6. A Reply to Ernan McMullin

      • John L. Gedye

      Pages 131-143

   7. The Logic of Clinical Judgment: Bayesian and Other Approaches

      • Patrick Suppes

      Pages 145-159

   8. Suppes on the Logic of Clinical Judgment

      • Martin E. Lean

      Pages 161-166

4. Clinicians on Clinical Judgment

   1. Front Matter

      Pages 167-167

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   2. The Anatomy of Clinical Judgments

      • Edmund D. Pellegrino

      Pages 169-194

   3. Comments on Pellegrino’s ‘Anatomy of Clinical Judgments’

      • Marjorie Grene

      Pages 195-197

   4. The Subjective in Clinical Judgment

      • Eric J. Cassell

      Pages 199-215

   5. Subjectivity and the Scope of Clinical Judgment

      • Daniel I. Wikler

      Pages 217-226

5. Round Table Discussion Judgment and Methods in Clinical Judgment

   1. Front Matter

      Pages 227-227

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Over a period of a year, the symposium on clinical judgment has taken shape as a volume devoted to the analysis of how knowledge claims are framed in medicine and how choices of treatment are made. We hope it will afford the reader, whether layman, physician or philosopher, a useful perspective on the process of knowing what occurs in medicine; and that the results of the dis­ cussions at the Fifth Symposium on Philosophy and Medicine will lead to a better understanding of how philosophy and medicine can usefully challenge each other. As the interchange between physicians, philosophers, nurses and psychologists recorded in the major papers, the commentaries and the round table discussion shows, these issues are truly interdisciplinary. In particular, they have shown that members of the health care professions have much to learn about themselves from philosophers as well as much of interest to engage philosophers. By making the structure of medical reasoning more apparent to its users, philosophers can show health care practitioners how better to master clinical judgment and how better to focus it towards the goods and values medicine wishes to pursue. Becoming clearer about the process of knowing can in short teach us how to know better and how to learn more efficiently. The result can be more than (though it surely would be enough!) a powerful intellectual insight into a major cultural endeavor, medicine.

• anatomy
• diagnosis
• health
• logic
• medicine
• philosophy
• psychology

• Kennedy Institute of Ethics, Georgetown University, USA

  Hugo Tristram Engelhardt

• University of Connecticut Health Center, Farmington, USA

  Stuart F. Spicker

• University of California at Los Angeles, USA

  Bernard Towers

Policies and ethics