In a previous paper the concept of disease was fuzzy-logically analyzed and a sketch was given of a prototype resemblance theory of disease (Sadegh-Zadeh (2000). J. Med. Philos., 25:605–38). This theory is outlined in the present paper. It demonstrates what it means to say that the concept of disease is a nonclassical one and, therefore, not amenable to traditional methods of inquiry. The theory undertakes a reconstruction of disease as a category that in contradistinction to traditional views is not (...) based on a set of common features of its members, that is individual diseases, but on a few best examples of the category, called its prototypes, and a similarity relationship such that a human condition is considered a disease if it resembles a prototype. It enables new approaches to resolving many of the stubborn problems associated with the concept of disease. (shrink)

ZusammenfassungWas ist praktisches Wissen?Die Diskussion über diese Frage hat sich in den letzten Jahrzehnten darauf konzentriert, das praktische Wissen als ein Wissen- wie aufzufassen. Im Folgenden wird eine weitere Differenzierung dieser Ansicht vorgenommen, indem durch eine Analyse der Syntax des klinischpraktischen Wissens dafür geworben wird, dieses Wissen als eine Kategorie von bedingten Geboten für das ärztliche Handeln in der klinischen Entscheidungsfindung zu betrachten. Syntaktisch gesehen, sind diese Gebote deontische Normen („conditional obligations“). Da sie durch die diagnostisch-therapeutische Forschung (= klinische Forschung) (...) aufgestellt und erforscht werden, muss die klinische Forschung als eine deontische Disziplin angesehen werden. Sie ist deshalb dem Bereich der normativen Ethik zuzuordnen. Im direkten Zusammenhang damit ist die klinische Praxis – als eine überzeitliche Institution, nicht als das Handeln von Einzelpersonen – als praktizierte Moral im Dienste der Menschen („Karitas“) einzustufen, weil sie aus dem Versuch besteht, jene Gebote umzusetzen. (shrink)

On the basis of a ten-place comparative value relation, artificially reduced to a binary relation, some human value structures are studied and a concept of value kinematics is proposed. A miniature value logic is outlined, making it possible with precision to handle several explicated value notions and to analyze interrelations between them. Finally, the question is discussed whether health can be said to be an absolute and an intrinsic value.

Medical practice is practiced morality, and clinical research belongs to normative ethics. The present book elucidates and advances this thesis by: 1. analyzing the structure of medical language, knowledge, and theories; 2. inquiring into the foundations of the clinical encounter; 3. introducing the logic and methodology of clinical decision-making, including artificial intelligence in medicine; 4. suggesting comprehensive theories of organism, life, and psyche; of health, illness, and disease; of etiology, diagnosis, prognosis, prevention, and therapy; and 5. investigating the moral and (...) metaphysical issues central to medical practice and research. Many systems of (classical, modal, non-classical, probability, and fuzzy) logic are introduced and applied. Fuzzy medical deontics, fuzzy medical ontology, fuzzy medical concept formation, fuzzy medical decision-making and biomedicine and many other techniques of fuzzification in medicine are introduced for the first time. -/- . (shrink)

The brief sketch of the problematic character of the traditional semantic conception of meaning demonstrated that meaning cannot be separated from the role the users of a language play in their communication with one another. One of the features of this role is the control of the language use and verbal behavior of individuals by the community. It is thus the community that determines and judges what words and sentences ‘mean’. This is just indicative of the pragmatic dimension of language. (...) Consequently, what medical terms and sentences ‘mean’, and what someone ‘means’ by using a particular medical term or sentence, also depends on pragmatic contexts and circumstances. To understand the importance and practical consequences of this pragmatic perspective, we will now consider the following three central aspects: 3.1 The So-Called Language Games, 3.2 Assertion, Acceptance, and Rejection, 3.3 Speech Acts in Medicine, 3.4 The Pragmatic Impact of Medical Language, 3.5 The Communal Origin of Medical Language. (shrink)

In this paper, we define the notion of PC-lattice, as a generalization of finite positive implicative BCK-algebras with condition and bounded commutative BCK-algebras. We investiate some results for Pc-lattices being a new class of BCK-lattices. Specially, we prove that any Boolean lattice is a PC-lattice and we show that if X is a PC-lattice with condition S, then X is an involutory BCK-algebra if and only if X is a commutative BCK-algebra. Finally, we prove that any PC-lattice with condition is (...) a distributive BCK-algebra. (shrink)

What follows is a brief comment on Ludwik Fleck's paper on the foundations of medical knowledge translated by Thaddeus J. Trenn in this issue. Since the original is much older than I am, I have some scruples in presenting the critical thoughts which occurred to me when I read it a few years ago. Despite the criticism, I am very sympathetic to most of what Fleck has told us in his tragically neglected work. Two facts make Fleck's tragedy even more (...) disturbing: (i) others have given rise to post-Fleck revolutions in epistemology by exploiting his ideas while omitting proper references to him, and (ii) sociology of science, precisely what Fleck wanted to promote, has emerged without his work being operative in any sense. In my commentary, I shall examine his concept of social conditioning of knowledge. CiteULike Connotea Del.icio.us What's this? (shrink)

Patrick Suppes'' set-theoretical approach to the analysis of theories, and Joseph D. Sneed''s metatheory are briefly outlined. The notions of observation, illusion and hallucination are reconstructed according to these approaches. It is argued that the terms perception and truth are theoretical with respect to observation but nontheoretical with respect to illusion and hallucination. Hallucination is construed as a special kind of illusion.

This book is a collection of contributions written by philosophers and scientists active in different fields, such as mathematics, logics, social sciences, computer sciences and linguistics. They comment on and discuss various parts of and subjects and propositions introduced in the Handbook of Analytical Philosophy of Medicine from Kadem Sadegh-Zadeh, published by Springer in 2012. This volume reports on the fruitful exchange and debate that arose in the fuzzy community upon the publication of the Handbook. This was not only (...) very much appreciated by the community but also seen as a critical starting point for beginning a new discussion. The results of this discussion, which involved many different perspectives from science and the humanities and was warmly encouraged by Kadem Sadegh-Zadeh himself, are accurately reported in this volume, which is intended to be a critical companion to Kadem Sadegh-Zadeh ́s handbook. Rudolf Seising is currently an adjunct researcher at the European Centre for Soft Computing in Mieres, Asturias (Spain) and a college lecturer at the Faculty of History and Arts, at the Ludwig Maximilians University of Munich (Germany). Marco Elio Tabacchi is currently the Scientific Director of the Italian National Research & Survey Organization Demopolis, and a research assistant in the Soft Computing Group at University of Palermo (Italy). (shrink)

The purpose of this study was to investigate the relationship between authentic leadership and the three dimensions of employee well-being. Furthermore, attachment insecurity was considered as a mediating factor between authentic leadership and the three dimensions of employee well-being. Data were obtained from a field sample of 212 health care providers with patient contact at five hospitals in the North East of Iran. Initially, collected data were analyzed with multiple confirmatory factor analyses. Then, structural equation modeling was applied to test (...) proposed hypotheses. First, it was shown that authentic leadership negatively impacted attachment insecurity. Second, attachment insecurity proved to be a factor impinging upon job satisfaction. On the contrary, higher levels of attachment insecurity was associated with higher levels of perceived stress and stress symptoms. Third, it was revealed that attachment insecurity partially mediated the relationship between authentic leadership and job satisfaction and fully mediated the relationship between authentic leadership, perceived stress, and stress symptoms. According to the literature of authentic leadership, this is one of the first research studies, and literally the first in the East exploring the effects of authentic leadership on the exclusive combination of dimensions offered in this paper. Moreover, researchers in the field of management have not delved enough into attachment and its antecedents and consequences in leader–follower relationship. This is one of the first studies to provide evidence of the relationship between authentic leadership, attachment security and employee well-being. As a further analysis, the final model was separately put under the two different lens of gender and some interesting findings were discussed in the discussion. (shrink)

Two common medical-ethical axions, the health-maximizing axiom and the personhood-respecting axiom, are discussed. On the basis of a philosophical analysis of personhood and freedom of the will it is shown that these two axioms are incompatible. The rejection of the first axiom is suggested.

Since the advent of the natural sciences, natural scientists have spread the idea that the pursuit of truth about the facts of the world is the main drive of scientific research. The aim, they say, is to acquire knowledge and to provide explanations and predictions of phenomena and events. Surprisingly, even in our contemporary world in which scientific research is strongly involved in seeking solutions to practical problems pertaining to the pursuit of food, water, energy, health, labor, peace, war, nuclear (...) weapons, money, and the like, the pursuit-of-truth postulate nevertheless enjoys vigorous advocacy, especially in philosophy. In this chapter, the role that truth actually plays in medicine will be examined. Our discussion of this issue divides into the following four sections: 24.1 Truth in Medical Sciences; 24.2 Truth in Clinical Practice; 24.3 Misdiagnoses; 24.4 Truth Made in Medicine. In summary, it is shown that medical knowledge does not contain much truth because it mainly consists of hypotheses, theories, and deontic rules. The truth values of the former are unknown, while theories and deontic rules do not assume truth values. Likewise, in clinical practice true diagnoses and prognoses are not always attainable because (i) medical knowledge is inevitably vague, uncertain, and unreliable and is therefore scarcely truth-conducive; (ii) this also applies to most parts of patient data; (iii) physicians are not trained in viable and efficient methodology of clinical reasoning; and (iv) neither clinical decision support systems nor the automation of clinical decision-making will be able to compensate for the first two shortcomings. So, misdiagnoses will remain inevitable forever, although their frequency may be reduced by improving the techniques of clinical judgment. Since medical theories are artifactual structures and medical languages are artifactual systems, the truth of diagnoses and prognoses, and of any other judgment based thereon is made in medicine. (shrink)

The notions of health, illness, and disease are fuzzy-theoretically analyzed. They present themselves as non-Aristotelian concepts violating basic principles of classical logic. A recursive scheme for defining the controversial notion of disease is proposed that also supports a concept of fuzzy disease. A sketch is given of the prototype resemblance theory of disease.

At least as important as a particular item of medical knowledge itself is to know something about the relationships of that knowledge to the experiential world it is talking about. The reason is that the patients the physician is concerned with are parts of that experiential world. So, when using any knowledge in her practice, e.g., some knowledge on infectious diseases, a morally conscientious doctor will be interested in whether, and in what way, this knowledge relates to the ‘world out (...) there’. Does the medical knowledge she employs bear any relevance to the bodies and souls of her patients? Does it enable her to understand the patient’s suffering, illness experience, and illness narrative? Will it help her find useful diagnoses and treatments? Are there in fact any indicators of such qualities of medical knowledge? Why not use astrology, Ayurveda, or exorcism instead of the theory of infectious diseases? A prerequisite for dealing with such questions is the awareness of the relationships between medical knowledge and its referent, i.e., of the semantics of medical knowledge, on the one hand; and of the pragmatic factors beyond this semantics, which influence the role medical knowledge plays in health care, on the other, e.g., social and economic processes. In the present chapter, we shall look at these issues with an eye toward understanding why some particular information is allowed to enter the medical world as knowledge, whereas other information is considered unacceptable or quackery. Is there a clear line of demarcation between medical knowledge and self-deception? To begin with, we will discuss the issues of truth and justification because, as pointed out in Section 10.1 on page 402, knowledge is traditionally defined as justified true belief . These two defining features of knowledge, truth and justifiedness, are due to the classical conception of knowledge as the representation of some ‘reality’. This ancient, representational postulate brings with it that the predominant view on the semantics of medical knowledge is realism, i.e., the view that medical knowledge is concerned with and represents ‘the real world out there’. We shall therefore need to inquire into the philosophy and medical relevance of this doctrine before we proceed to alternative views. Our discussion thus divides into the following five parts: 12.1 Justified True Belief; 12.2 Realism; 12.3 Anti-Realism; 12.4 Beyond Realism and Anti-Realism in Medicine; 12.5 Social Epistemology. (shrink)

Western (deductive) logic originated in Greek antiquity. It found its first expression in those works of the great philosopher Aristotle (384–322 BC) which have come to be known as the Organon, i.e., ‘instrument’. Aristotle’s logic, also known as syllogistics, was unsystematically concerned with patterns of reasoning and argumentation. It remained in this rudimentary state relatively unchanged and unchallenged until the second half of the nineteenth century. At that time, logic underwent a period of unprecedented reform and modernization, due in large (...) part to the German mathematician Gottlob Frege (1848– 1925) It thus became more and more a mathematical endeavor of studying the structure and peculiarities of artificial, formal languages. In this new form, logic gave rise in the twentieth century to disciplines such as theoretical informatics and programming languages, and transformed our lives through computation, information processing, and the Internet. A formal language consists, in effect, of a particular alphabet and some precise rules of forming, and transforming, strings over this alphabet. There exist several types of formal languages analyzed in logic. Depending on their structure, they are called first-order languages, second-order languages, and so on. Today a logic is considered a theory of such a language and is, correspondingly, referred to as a first-order logic, a second-order logic, and so on. In this chapter, we shall outline a first-order logic as a paragon of deductive logic. Its full name is: “Classical, first-order predicate logic with identity”. What all these expressions mean exactly, will become clear below. The logic we shall study first is termed classical logic because the idea to create such an instrument, or ‘organon’, is rooted in Greek antiquity. Owing to its origin, it is based on three time-honored Aristotelian doctrines. For these and several other reasons that we shall discuss later in this chapter, it is also called a logic of the Aristotelian style, or an Aristotelian logic for short. (shrink)

Linguistics, in general, is the basic science of all language studies. It is concerned with the nature and structure of language and with the role it plays in human communication. Medical linguistics uses some methods of general linguistics and also creates additional ones. This is motivated by the following practical needs: Computer-aided data record, storage, and retrieval in medical practice and research require that medical data be stored in such a manner that enables their computational processing. However, databases written in (...) natural medical language cannot be easily processed. To enable efficient natural language processing, medical terms and sentences used in them must be made amenable to syntactic and semantic operations by computer programs. Medical linguistics is an ill-defined, interdisciplinary branch of medical informatics and medical information and library sciences concerned with methods and problems of natural language processing in medicine. (shrink)

In Western culture, human medicine has evolved as a healing profession, and as such, it is oriented toward curing sick people, caring for sick people, preventing maladies, and promoting health. This orientation is primarily centered around the healing relationship, a relationship that is usually thought of as a dyadic structure, comprising the physician and the patient. Venerable terms such as “the physician-patient relationship” and “the doctor-patient interaction” reflect this view. A closer look at the structure of a healing relationship reveals, (...) however, that it is more complex than a dyadic structure. For the doctor is not the only determinant of the healing relationship. There are additional components that shape it and its success or failure. Among these components are, for example, the physician’s assistants and the patient’s family members. This complex, polyadic healing structure with its function, effects, and defects will be the subject of our concern in the next chapter. It embraces the physician as one of its most important components. (shrink)