The Social Presuppositions of Medical Knowledge

Abstract

The title of this volume, The Ethics of Diagnosis, suggests a problem that is directly related to the subject of my essay. The problem, in short, is this: on the one hand, diagnosis is a case of scientific judgment, a cognitive procedure that aims at discovering the answer to a factual question, i.e., “What disease or illness is the patient suffering from?” or “What is the cause (or what are the causes) of the symptoms, signs, and complaints that the patient presents?”. On the other hand, if one poses the question about the ethics of diagnosis, then presumably, this concerns normative or valuative considerations that go beyond what are usually regarded as purely scientific or cognitive contexts. Such considerations are presumably not simply factual but concern what is ethically right or wrong. I would suppose that such ethical or normative considerations bear upon the well-being of the patient, the moral responsibility of the physician, or on his or her honesty or integrity; or upon considerations of the values involved in the diagnostic process itself, with respect to costs and benefits, or the risks involved in the use of certain diagnostic tests, etc.