Abstract

Patients are interested in receiving accurate diagnostic and prognostic information. While models and reasoning about diagnoses have been extensively investigated from a foundational perspective, prognosis yet needs to receive a comparable degree of philosophical and methodological attention, which may be due to the difficulties inherent in accurate prognostics. In the light of these considerations, I discuss a substantial body of critical thinking on the topic of prognostication and its strict relations with diagnostic reasoning, starting from the distinction between nosographic and pathophysiological types of diagnosis and prognosis. I then identify various forms of hypothetical reasoning that can be applied to reach diagnostic and prognostic judgments, comparing them with specific forms of abductive reasoning. The main thesis is that creative abduction regarding clinical hypotheses in diagnostic process is very unlikely to occur (though still possible), whereas this seems to be often the case for prognostic judgments. The reasons behind this distinction are based on the different types of uncertainty involved in diagnostic and prognostic judgments.

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