The ampliative leap in diagnostics: the advantages of abductive inference in clinical reasoning

Authors

  • Alexander L. Gungov St. Kliment Ohridski University of Sofia 15 Tsar Osvoboditel Blvd., 1504 Sofia Center, Sofia, Bulgaria Author

Keywords:

clinical reasoning, the ampliative leap, clinical diagnosis, logical inferences in diagnostics

Abstract

Examining diagnostics in logical terms, attention is usually paid to the interaction between deductive and inductive reasoning.
his article discusses Ch.S. Peirce’s theory of abductive inference in the clinical diagnosis. The process of diagnostics is seen as a logical transition from the effect (patient’s symptoms and signs) to the cause (the current health disorder), which is the direc-tion common to abductive reasoning. For Peirce, abduction is performed through the transposition of the conclusion and the major premise in the categorical syllogism or, in his later writings, of the result and the rule. An emphasis is put on the amplia-tive leap from the premise (individual clinical signs and symptoms) to the conclusion (particular diagnosis) abduction features;the universal rule (the nosological unit) mediates between the individual clinical picture and the particular patient’s diagnosis.
 The abductive inference draws on Kantian view on reflective judgment and G.B. Vico’s ideas about imaginative univer-sals. Reflective judgment aims at identifying a concept for some sensible data, whereas imaginative universals are not rational concepts but contain general characteristics like the regular concepts; formation of an imaginative universal resembles giving a diagnosis where an imagination drive inference is performed based on the combination of general elements of the relevant nosological unit and individual clinical signs and symptoms.
 Attention is also paid to the principles of coherence and teleology in performing an abductive inference in diagnostics as well as to the dual criterion of its truthfulness based both on coherence and correspondence. Examples from various medical fields are offered to illustrate the validity of the above logical claims in clinical practice.

Downloads

Download data is not yet available.

References

Antiseri D, Federspil G, Scandellari C (2003) Epistemologia, clinica medi-

ca e la “questione” delle medicine “eretiche”. Rubbettino Editore. 240 p.

Ballinger A, Patchett S (2007) Pocket Essentials of Clinical Medicine. 4th

edition. Edinburgh: Sounders Elsevier.

Federspil G (2010) Diagnosi. Filosofia della medicina. Ed. by Pagnini,

A. Roma: Carocci editore. 583 p.

Gabbani C (2013) Epistemologia e clinica. Tre saggi. Pisa: Edizioni ETS.

Gadamer H-G (1996) Enigma of Health: e Art of Healing in a Scien-

tific Age. Stanford, CA: Stanford University Press. 192 p.

Ginzburg C (1979) Spie. Radici di un paradigma indiziario. Crisi del

la ragione. Nuovi modelli nel rapporto tra sapere e attività umane.

A cura di Aldo Gargani. Torino: Einaudi Paperbacks. 366 p.

Groopman J (2008) How Doctors ink. Boston: Houghton Mifflin

Company. 307 p.

Hunter KM (1993) Doctors’ Stories: e Narrative Structure of Medical

Knowledge. Princeton: Princeton University Press. 238 p.

Kaag J (2014) inking through Imagination: Aesthetics in Human Cog-

nition. New York: Fordham University Press. 272 p.

Kant I (2007) Critique of Judgement. Oxford: Oxford University

Press.

Kant I (1998) Critique of Pure Reason. Cambridge: Cambridge Univer-

sity Press.

Levi I (2006) “Beware of Syllogism Statistical Reasoning and Conjec-

turing according to Peirce.” e Cambridge Companion to Peirce.

Cambridge: Cambridge University Press. p. 257–286.

Longmore M, Wilkinson I, Davidson E et al. (2010) Oxford Handbook of Clin-

ical Medicine. e 8th edition. Oxford: Oxford University Press. 863 p.

Marcum JA (2008) An Introductory Philosophy of Medicine: Humanizing

Modern Medicine. Springer. 376 p. DOI: 10.1007/978-1-4020-6797-6.

Murphy EA (1997) e Logic of Medicine. Baltimore: e John Hopkins

University Press.

Peters A (2007) BMA Illustrated Medical Dictionary. London: DK.

Verene DP (2009) Speculative Philosophy. Lanham: Lexington

Books.

Vico GB (1984) e New Science of Giambattista Vico. Ithaca: Cornell

University Press.

Downloads

Published

2018-08-31

Issue

Section

Articles

How to Cite

L. Gungov, A. (2018). The ampliative leap in diagnostics: the advantages of abductive inference in clinical reasoning. History of Medicine, 5(4). http://13.200.237.241/HOM/index.php/medicine/article/view/221