Handbook of Analytic Philosophy of Medicine (eBook)

Kazem Sadegh-Zadeh (born 23 April 1942) is an analytic philosopher of medicine. He studied medicine and philosophy at the German universities of Münster, Berlin, and Göttingen with Internship and residency 1967-1971, assistant professor 1972-1982, full professor of philosophy of medicine at the University of Münster 1982-2004. Sadegh-Zadeh was born in Tabriz, Iran. He has made significant contributions to the analytic philosophy of medicine. His international recognition came especially through his work on clinical logic and methodology, including fuzzy logic and artificial intelligence in medicine. He is the founding editor of the international journals Metamed, founded in 1977 (current title: Theoretical Medicine and Bioethics, published by Springer) and Artificial Intelligence in Medicine, founded in 1989. Among his extensive work are the following innovative theories: theory of medicine, theory of fuzzy biopolymers, the prototype resemblance theory of disease, and theory of the Machina Sapiens.

Part I The Language of Medicine ___________________________________________________________________________ 1. The Epistemic Impact of Medical Language 1.0. Introduction 1.1 Types of Knowledge 1.2. Propositional Knowledge 1.3. Propositions and Facts 1.4. Sentences and Statements 1.5. Medical Concepts 1.6. How to Care About Our Medical Concepts? 1.7. Summary 2. The Syntax and Semantics of Medical Language 2.0. Introduction 2.1. Medical Language Is an Extended Natural Language 2.2. What a Medical Term Means 2.3. Ambiguity 2.4. Vagueness 2.4.1. The Nature of Vagueness 2.4.2. The Sorites Paradox 2.4.3. Varieties of Vagueness 2.5. Clarity and Precision 2.6. Semantic Nihilism 2.7. Summary 3. The Pragmatics of Medical Language 3.0. Introduction 3.1. The So-Called Language Games 3.2. Assertion, Acceptance, and Denial 3.3. Speech Acts in Medicine 3.4. Summary 4. Varieties of Medical Concepts 4.0. Introduction 4.1. Individual, Qualitative, Comparative, and Quantitative Concepts 4.1.1. Individual Concepts 4.1.2. Qualitative Concepts 4.1.3. Comparative Concepts 4.1.4. Quantitative Concepts 4.2. Dispositional Terms in Medicine 4.3. Linguistic and Numerical Variables in Medicine 4.4. Non-Classical versus Classical Concepts 4.5. Summary 5. Fundamentals of Medical Concept Formation 5.0. Introduction 5.1. What a Definition Is 5.2. What Role a Definition Plays 5.3. Methods of Definition 5.3.1. Explicit Definition 5.3.2. Conditional Definition 5.3.3. Operational Definition 5.3.4. Definition by Cases 5.3.5. Recursive Definition 5.3.6. Set-Theoretical Definition 5.3.7. Ostensive Definition 5.4. What an Explication Is 5.4.1. What: Quod vs. Quid 5.4.2. Is 5.5. Summary ___________________________________________________________________________ Part II Medical Praxiology ___________________________________________________________________________ 6. The Patient 6.0. Introduction 6.1. The Suffering Individual 6.2. The Bio-Psycho-Social Agent 6.2.0. Introduction 6.2.1. The Living Body 6.2.2. The Psyche 6.2.3. The Social Agent 6.2.4. Summary 6.3. Health, Illness, and Disease 6.3.0. Introduction 6.3.1. Disease 6.3.2. Health 6.3.3. Illness 6.3.4. Health, Illness, and Disease Violate Classical Logic 6.3.5. Summary 6.4. Systems of Disease 6.4.0. Introduction 6.4.1. Symptomatology 6.4.2. Nosological Systems 6.4.3. Pathology versus Nosology 6.4.4. Nosological Spaces 6.4.5. Summary 6.5. Etiology 6.5.0. Introduction 6.5.1. Cause and Causation 6.5.2. Deterministic Etiology 6.5.3. Probabilistic Etiology 6.5.4. Fuzzy Etiology 6.5.5. Summary 7. The Physician 8. Clinical Practice 8.0. Introduction 8.1. The Clinical Encounter 8.1.0. Introduction 8.1.1. The Patient Elroy Fox 8.1.2. Branching Clinical Questionnaires 8.1.3. Clinical Paths 8.1.4. The Clinical Process 8.1.5. Summary 8.2. Anamnesis and Diagnosis 8.2.0. Introduction 8.2.1. The Clinical Goal 8.2.2. The Logical Structure of Medical Knowledge 8.2.3. Action Indication and Contra-Indication 8.2.4. Differential Indication 8.2.5. The Computability of Differential Indication 8.2.6. The Logical Structure of Diagnosis 8.2.7. The Syntax of Diagnosis 8.2.8. The Semantics of Diagnosis 8.2.9. The Pragmatics of Diagnosis 8.2.10. The Methodology of Diagnostics 8.2.11. The Logic of Diagnostics 8.2.12. The Epistemology of Diagnostics 8.2.13. The Relativity of Diagnosis 8.2.14. Summary 8.3. Prognosis 8.3.0. Introduction 8.3.1. The Clinical Role of Prognosis 8.3.2. The Structure of Prognosis 8.3.3. The Uncertainty of Prognosis 8.3.4. Prognosis Is a Social Act 8.3.5. Summary 8.4. Therapy 8.4.0. Introduction 8.4.1. Therapeutic Decisions 8.4.2. Expected Value Therapeutic Decision-Making 8.4.3. Treatment Threshold Probability 8.4.4. Treatments Are Social Acts 8.4.5. Therapeutic Efficacy 8.4.6. Summary 8.5. Prevention 8.5.0. Introduction 8.5.1. What Is a Risk Factor? 8.5.2. Prevention Is Teleological Practice 8.5.3. Summary ___________________________________________________________________________ Part III Medical Epistemology ___________________________________________________________________________ 9. The Architecture of Medical Knowledge 9.0. Introduction 9.1. Detachment of Medical Knowledge from the Knower 9.2. The Syntax of Medical Knowledge 9.2.1. Problematic Sentences 9.2.2. First-Order Sentences 9.2.3. Modal Sentences 9.2.4. Probabilistic Sentences 9.2.5. Fuzzy Sentences 9.3. Medical Hypotheses 9.4. Theories in Medicine 9.4.1. The Statement View of Theories 9.4.2. The Non-Statement View of Theories 9.4.3. Theory-Nets and Intertheoretic Relations 9.4.4. Untestability of Theories 9.4.5. Theories Fuzzified 9.5. Summary 10. Types of Medical Knowledge 10.0. Introduction 10.1. Shallow and Deep Medical Knowledge 10.2. Classificatory Knowledge 10.3. Causal Knowledge 10.4. Experimental Knowledge 10.5. Theoretical Knowledge 10.6. Practical Knowledge 10.7. Clinical Knowledge 10.8. Medical Metaknowledge 10.9. Summary 11. The Semantics and Pragmatics of Medical Knowledge 11.0. Introduction 1111. Justified True Belief 11.1.1. Truth 11.1.2. Justification 11.1.3. Are There Justified True Beliefs in Medicine? 11.2. Realism 11.2.1. Metaphysical Realism 11.2.2. Semantic Realism 11.2.3. Epistemic Realism 11.2.4. Medical Realism 11.3. Anti-Realism 11.3.1. Metaphysical Anti-Realism 11.3.2. Semantic Anti-Realism 11.3.3. Epistemic Anti-Realism 11.3.4. Medical Anti-Realism 11.4. Beyond Realism and Anti-Realism in Medicine 11.4.1. Fuzzy Epistemology 11.4.2. Constructivism 11.5. Social Epistemology 11.5.1. Logical Empiricism and Critical Rationalism 11.5.2. The Rise of Social Epistemology 11.5.3. Medical Knowledge Is a Social Status 11.5.4. Social Constructivism 11.6. Summary 12. Technoconstructivism 12.0. Introduction 12.1. Experiments as Epistemic Assembly Lines 12.2. Epistemic Machines 12.2.1. An Experiment Is a Production System 12.2.2. An Experiment Is an Epistemic Machine 12.3. Epistemic Factories 12.3.1. The Engineering of Materials 12.3.2. The Engineering of Data 12.3.3. The Engineering of Knowledge 12.4. The Global Knowledge-Making Engine 12.5. The Industrialization of Knowledge 12.6. Summary ___________________________________________________________________________ Part IV Medical Deontics ___________________________________________________________________________ 13. Morality, Ethics, and Deontics 13.0. Introduction 13.1. Morality 13.2. Ethics and Metaethics 13.3. Deontics 13.4. Summary 14. Disease as a Deontic Construct 14.0. Introduction 14.1. Common Morality 14.2. Common Morality as a Deontic-Social Institution 14.3. Deontic Sets 14.4. The Deontic Construction of Prototype Diseases 14.5. Summary 15. Medicine Is a Deontic Discipline 15.0. Introduction 15.1. Deonticity in Medical Practice 15.2. Deonticity in Medical Research 15.3. Deontic Things in Medicine 15.4. Summary ___________________________________________________________________________ Part V Medical Logic ___________________________________________________________________________ 16. Logic in Medicine 16.0. Introduction 16.1. Classical Logic in Medicine 16.2. Paraconsistent Logic in Medicine 16.3. Modal Logics in Medicine 16.4. Probability Theory in Medicine 16.4.1. Uncertainty and Randomness 16.4.2. Probabilistic-Causal Analysis 16.4.3. Probabilistic-Causal Factors 16.4.4. Bayesian Reasoning 16.5. Fuzzy Logic in Medicine 16.5.1. Fuzzy Control 16.5.2. Fuzzy Clinical Decision-Making 16.5.3. Similaristic Reasoning in Medicine 16.5.4. Fuzzy Logic in Biomedicine 16.5.5. Fuzzy Deontics 16.5.6. Fuzzy Concept Formation in Medicine 16.6. Summary 17. The Logic of Medicine 17.0. Introduction 17.1. What Is Logic? 17.2. Implication Structures 17.3. On the Logic of Medicine 17.4. Summary ___________________________________________________________________________ Part VI Medical Metaphysics ___________________________________________________________________________ 18. On What There Are 18.0. Introduction 18.1. Ordinary Ontology 18.1.1. Pure Ontology 18.1.2. Applied Ontology 18.1.3. Formal Ontology 18.2. Fuzzy Ontology 18.3. Vague, Fictional, and Non-Existent Entities 18.3.1. Vague Entities 18.3.2. Fictional Entities 18.3.3. Non-Existent Entities 18.4. Summary 19. Medical Ontology 19.0. Introduction 19.1. The Ontology of Medical Knowledge 19.1.1. Ontological Commitments of Medical Knowledge 19.1.2. Medically Relevant Ontological Categories 19.1.3. Models of Medical Knowledge 19.2. Clinical Ontology 19.2.1. Disease Nominalism 19.2.2. Disease Platonism 19.2.3. Disease Tropism 19.2.4. Disease Realism 19.3. The Ontology of Psychiatry and Psychosomatics 19.3.1. The Mind-Body Problem 19.3.2. Mental States 19.3.3. The Ontology of Mental Diseases 19.3.4. The Ontology of Psychosomatic Diseases 19.4. Biomedical Ontology Engineering 19.5. Formal Medical Ontology 19.5.1. Mereology and Mereotopology 19.5.2. Fuzzy Formal Ontology 19.6. Medical Ontology De re and De dicto 19.7. Summary 20. On Medical Truth 20.0. Introduction 20.1. Truth in Medical Sciences 20.2. Truth in Clinical Practice 20.3. Misdiagnoses 20.4. Truth Made in Medicine 20.5. Summary 21. On the Nature of Medicine 21.0. Introduction 21.1. The Subject and Goal of Medicine 21.2. Is Medicine a Natural Science? 21.3. Is Medicine an Applied Science? 21.4. Does Medicine Belong to Humanities? 21.5. Is Medicine a Practical Science? 21.5.1. Practical versus Theoretical Sciences, 21.5.2. Means-End Research 21.5.3. Clinical Research Is a Practical Science, 21.5.4. The Relationships Between Biomedicine and Clinical Medicine 21.6. Medicine Is Moral as Well as Ethics 21.7. Quo Vadis Medicina? 21.7.1. Medicine as An Engineering Science 21.7.2. Medicine Toward Anthropotechnology 21.8. Summary ___________________________________________________________________________ Part VII Epilog ___________________________________________________________________________ 22. Science, Medicine, and Rationality 22.0. Introduction 22.1. On the Concept of Science 22.1.1. Research Institutions 22.1.2. Scientific Research Fields 22.1.3. Science in General 22.1.4. Varieties of Science 22.2. On the Scientific Status of Medicine 22.3. On Rationality in Medicine 22.3.1. Theoretical and Practical Rationality 22.3.2. Rationality in Medical Sciences 22.3.3. Rationality in Clinical Practice 22.3.4. The Relativity of Rationality 22.4. Summary 23. Perspectivism 23.1. Relativism, Contextualism, Perspectivism 23.2. Perspectivism de re and Perspectivism de dicto 24. The Doubter ___________________________________________________________________________ Part VIII Logical Fundamentals ___________________________________________________________________________ 25 Classical Sets 25.0. Introduction 25.1. Sets 25.2. Operations on Sets 25.2.1. Intersection 25.2.2. Union 25.2.3. Subset 25.2.4. Complement 25.2.5. Powerset 25.2.6. Two Basic Laws 25.3. Relations 25.3.1. Ordered Tuples 25.3.2. Cartesian Products 25.3.3. n-ary Relations 25.4. Functions 25.4.1. Functions Are Single-Valued Relations 25.4.2. Composition of Functions 25.4.3. Restriction of a Function 25.4.4. Point and Set Functions 25.5. Summary 26 Classical Logic 26.0. Introduction 26.1. Basic Concepts 26.1.0. Introduction 26.1.1. Reasoning, Argumentation, and Proof 26.1.2. The Classical Concept of Inference 26.1.3. Object Language and Metalanguage 26.1.4. Syntax, Semantics, and Pragmatics 26.1.5. Material and Formal Truth 26.1.6. Summary 26.2 Classical First-Order Predicate Logic with Identity 26.2.0. Introduction 26.2.1. The Syntax of the Language L1 26.2.2. The Semantics of the Language L1 26.2.3. A Predicate-Logical Calculus 26.2.4. Metalogic 26.2.5. Summary 27 Modal Extensions of Classical Logic 27.0. Introduction 27.1. Alethic Modal Logic 27.1.1. Alethic Modalities and Operators 27.1.2. A First-Order Alethic Modal Logic 27.1.3. Metalogic 27.1.4. Necessary vs. Contingent Identity 27.1.5. De re and De dicto 27.1.6. Summary 27.2. Deontic Logic 27.2.1. Deontic Modalities and Operators 27.2.2. The Standard System of Deontic Logic 27.2.3. Metalogic 27.2.4. Deontic Conditionals 27.2.5. De re and De dicto 27.2.6. Summary 27.3. Epistemic Logic 27.3.1. Epistemic Modalities and Operators 27.3.2. A First-Order Epistemic Logic 27.3.3. Metalogic 27.3.4. Opaque Epistemic Contexts 27.3.5. De re and De dicto 27.3.6. Dynamic Epistemic Logic 27.3.7. Summary 27.4. Temporal Logic 27.4.1. Temporal Modalities and Operators 27.4.2. A Minimal System of Temporal Logic 27.4.3. Metalogic 27.4.4. Since and Until 27.4.5. Metric Temporal Logic 27.4.6. Alternative Approaches 27.4.7. Summary 28 Non-Classical Logics 28.0. Introduction 28.1. Relevance logic 28.2. Intuitionistic Logic 28.3. Paraconsistent Logic 28.4. Non-Monotonic Logic 28.5. Many-Valued Logic 28.6. Summary 29 Probability Logic 29.0. Introduction 29.1. Probability Theory 29.1.1. Probability Space 29.1.2. Probability Distributions 29.1.3. Probabilistic Independence 29.1.4. Conditional Probability 29.1.5. Bayes Theorem 29.1.6. What Does “Probability” Mean? 29.2. Inductive Logic 29.3. Bayesian Logic 29.4. Summary 30 Fuzzy Logic 30.0. Introduction 30.1. Fuzzy Sets 30.2. Operations on Fuzzy Sets 30.2.1. Fuzzy Complement 30.2.2. Fuzzy Intersection and Union 30.2.3. Empty Fuzzy Set and Fuzzy Powerset 30.2.4. Fuzzy Theory Is a Non-Classical System 30.3. Fuzzy Relations 30.3.1. The Concept of a Fuzzy Relation 30.3.2. Composition of Fuzzy Relations 30.4. Fuzzy Logic Proper 30.4.1. Linguistic and Numerical Variables 30.4.2. Fuzzy Quantifiers 30.4.3. Fuzzy Sentences 30.4.4. Fuzzy Reasoning 30.5. Summary