Category Archives: Articles

What should be reported in medical diagnosis and prediction?

Suppose a patient P is informed by a medical doctor that she has a certain disease and that she is expected to survive for two further years. What consequences for her life should P draw from this information? It seems that without further knowledge, she can draw no precise consequences at all.  P has to know how the doctor came to this decision. This is so because of the reference-class problem.

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In The Reasoner: Antibiotics

Antibiotics play a crucial role in modern medicine by controlling bacterial infection. For instance, much surgery would be life-threatening without an ability to control infection. However, antibiotics are becoming less effective due to antimicrobial resistance. The overuse of antibiotics gives bacteria that happen to be resistant a greater chance of spreading. In the words of a Public Health England report: ‘Antibiotics are unlike other drugs used in medicine, as the more we use them the less effective they become.’

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In The Reasoner: Statins

The ongoing debate over the use of statins has been covered extensively in the mainstream media. Recently, Sally Davies, the chief medical officer, has expressed concern that the lack of resolution to debates such as this is damaging public confidence in medicine. In response, Davies concluded that what is needed is “an authoritative independent report looking at how society should judge the safety and efficacy of drugs as an intervention.” As a result, the Academy of Medical Sciences has begun a working group project on Evaluating evidence. The aim of the project is to “explore how evidence that originates from different sources (e.g. randomised clinical trials and observational data) are used to make decisions about the safety and efficacy of drugs and medical interventions.”

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In The Reasoner: on therapeutic inferences for individual patients.

This month sees the publication of a philosophy themed edition of the Journal of Evaluation in Clinical Practice. The edition contains a number of articles on the nature of health, disease, diagnosis and care, and a section on rethinking medical epistemology. There is also a debates section, which is made up of responses to papers from a previous edition of the journal. The topics discussed there include the nature of causality and also whether evidence-based medicine is failing as a result of industry contamination of research. I recommend that interested readers of The Reasoner take a look at the edition.

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