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)

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)

In this paper, I have analyzed the relationship The Principle of Congruence maintains between reason and religion. I have not discussed any of the arguments put forward by various thinkers. Furthermore, I have refrained from any exegetical discussion of the Principle. I have raised and discussed three principal questions: first, is it the case that “whatever reason dictates religion does so too”? Second, what is to be done if dictates of reason and religion turn out to be different or incompatible? (...) Third, how are we to ascertain that dictates of reason or inferences made by reason are Satanic/impure/vicious?Some of the Conclusions To find out whether any particular reason is or isn’t Satanic/impure/vicious we have no choice but to evaluate the dictates of reason which in turn leads us into a series of intractable problems. Calling reason virtuous or vicious does not solve the problem of evaluating each and every dictate or inference of reason. This approach is utterly futile and is effectively useless. These difficulties finally lead to The Problem of the Principle of Congruence which cannot be solved unless we somehow give up the independent authority of reason. (shrink)

Due to the intricate nature of its subject matter, medicine is always threatened by speculations and disagreements about which among its entities exist, e.g., any specific biological structures, substructures or substances, pathogenic agents, pathophysiological processes, diseases, psychosomatic relationships, therapeutic effects, and other possible and impossible things. To avoid confusion, and to determine what entities an item of medical knowledge presupposes to exist if it is to be true, we need medical ontology. The term “medical ontology” we understand to mean the (...) study that seeks to ascertain what entities exist in the world of medicine, which formal relations hold between them, and whether there are any relatioships between types of medical research and practice, on the one hand; and the new worlds they create, on the other. (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)

SummaryThe early writings of Barry Barnes, as the co‐founder of the Edinburgh School of sociology of scientific knowledge, are explored to bring out and to evaluate his main presuppositions and arguments. Barnes is highly critical of anthropologists' conception of scientific knowledge, rationality, truth, and their asymmetrical explanatory approach towards different belief‐systems. Likewise he rejects the prevalent View of science among sociologists of knowledge, and also their approach to explanation of knowledge or belief‐adoption. His proposal is based on a Kuhnian model (...) of science, and offers his own socio‐causal explanatory scheme applicable to all beliefs and knowledge‐claims. I have challenged the basis of his model of science and have tried to show that his use of Kuhn's concepts of normal practice and paradigm is problematic, and that his idea of social causation of beliefs is highly problematic.“new paradigms may gain support not because of any demonstrable superiority over the old but simply because scientists welcome the opportunity of a new try at explanation” Barry Barnes “all belief‐systems, scientific or preliterate, ‘true’ or ‘erroneous’, are most profitably compared and understood within a single framework” Barry Barnes. (shrink)

Edinburgh School's theory of natural rationality, enunciated to render symmetrical explanation plausible, thereby providing support for its relativism, is presented and evaluated. I have endeavoured to demonstrate that there are gross misinterpretations of Hesse's theory of science, network model, and her conceptions of classification of objects and of universals; that Edinburgh School's theory of natural rationality suffers from a considerable area of ignorance concerning its foundation. I have further shown that not only the theory is not descriptive of the actuality (...) of people's reasoning, but it in fact is normatively laden. Even if these problems can be overcome, I have shown that it ultimately does not render all beliefs equivalent insofar as rationality status is concerned, and hence symmetrical explanation will still not be possible. Concerning the Edinburgh School's interest theory, I have argued that there are some incoherencies in the proposed positions; and that even if these are rectified the resulting theory leads to grotesque absurdities. (shrink)

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 language of medicine is an extension of everyday language by adding technical terms such as "appendicitis", "angina pectoris", "blood pressure" and the like. It is therefore characterized by semantic chaos. Most of its terms are either not defined or ill-defined. The chaos would not deserve any attention, however, if it were not practically detrimental in research and practice. The best way to prevent the damage it causes is to learn in medicine something about methods of scientific concept formation. The (...) present chapter provides a concise and unrivalled introduction to such a methodology. We shall discuss the main methods of scientific concept formation known today, that is, all methods of definition and explication. Our discussion divides into the following four sections and is based on, and extends, the most valuable pioneering studies by Carl Gustav Hempel and, especially, Patrick Suppes (Hempel, 1952; Suppes, 1957, 151–173, 246–260): 6.1 What a Definition is; 6.2 What Role a Definition Plays; 6.3 Methods of Definition; 6.4 What an Explication is. (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.

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)

The concepts of categorical diagnosis and conjectural diagnosis are introduced. It is argued that in diagnostic reasoning conjectural diagnosis plays a more important role than categorical diagnosis. Attention is called to the inevitable vagueness of clinical language and to the suitability of epistemic logic and fuzzy logic for diagnostic reasoning.

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.

Medical knowledge as well as clinical practice are characterized by inescapable uncertainty. There are many reasons this is the case, but foremost among them is that almost everything in medicine is inevitably vague, be it something linguistic such as the term “illness”, or something extra-linguistic such as the condition referred to as illness. If we ask ourselves, then, what the term “illness” means exactly, on the one hand; and how we may precisely delimit the condition illness, on the other; we (...) shall realize that to answer these and similar questions requires specific methods that enable us to adequately cope with vagueness. As we shall see below, fuzzy logic provides us with just such methods. (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)

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)

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)

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)

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)

In this paper, first we discuss an old problem in teaching electron configuration of transition metals and the order in which the orbitals are filled. Then we propose two simple computational experiments, in order to show that in the case of first row transition metals and the main group elements after them, the electrons occupy the 3d subshell before the 4s. It is shown that if we begin with the bare nucleus of above elements in the vacuum and then continue (...) with adding the electrons the 19th electron firstly occupies the 3d subshell and not the 4s. Indeed, the 4s subshell in the third row of periodic table only fills first in the case of K and Ca atoms. However, the 3d subshell in transition metals and the main group elements after them is more stable than 4s and so fills first. Thus there is no scientific reason to write the electron configuration of transition elements as [Ar] 4s 3d and the correct form is [Ar] 3d 4s.Graphical. (shrink)

After the advent of the theory of special relativity, the existence of absolute time in nature was rejected within the society of physics. In recent decades, William Lane Craig has endeavoured to offer an interpretation of the empirical evidence that support the theory of relativity while maintaining the concept of absolute time. His interpretation, however, is based upon supernatural presuppositions due to which it cannot be accepted as a scientific argument. After explaining Craig’s view, we attempt to reconstruct his explanation (...) for absolute time using the concept of general substantial motion of nature, well-known in Mulla Sadra’s philosophy as the most important approach in Islamic philosophy; thereby, proving general time for the natural world. Although Craig considers some evidence from modern physics in his reasoning for absolute time, here, after pointing to some evidence, it is discussed that the approach used here better bridges the gap that exists between the metaphysics and the physics of the argument. (shrink)

Clinical judgment, also called clinical reasoning, clinical decision-making, and diagnostic-therapeutic decision-making, lies at the heart of clinical practice and thus medicine. In thepast, clinical judgment was considered the expert task of the physician. But the advent of computers in the 1940s and their use in medicine as of the late 1950s gradually changed this situation. In the 1960s, a new discipline emerged that has come to be termed medical computer science or medical informatics, including clinical informatics. Clinical informatics is concerned (...) with all aspects of the application of computing machinery in clinical research and practice. As one of its accomplishments in clinical practice, the physician’s capacity for clinical judgment is in the process of being turned over to computers. We are told that computers will be responsible for making diagnoses and treatment decisions in a not-too-distant future. This prospect, its historical, methodological and philosophical background, and its impact on health care will be discussed in the present Part VI which divides into these three chapters: 19 Medical Decision-Making 20 Clinical Decision Support Systems 21 Artificial Intelligence in Medicine? (shrink)