Maung Hane Htut
Department of Politics, Philosophy, and Religion, Lancaster University, Lancaster, LA1 4YL, UK.
Theor Med Bioeth. 2017 Feb;38(1):41-59. doi: 10.1007/s11017-016-9377-5.
Diagnoses in medicine are often taken to serve as explanations of patients' symptoms and signs. This article examines how they do so. I begin by arguing that although some instances of diagnostic explanation can be formulated as covering law arguments, they are explanatory neither in virtue of their argumentative structures nor in virtue of general regularities between diagnoses and clinical presentations. I then consider the theory that medical diagnoses explain symptoms and signs by identifying their actual causes in particular cases. While I take this to be largely correct, I argue that for a diagnosis to function as a satisfactory causal explanation of a patient's symptoms and signs, it also needs to be supplemented by understanding the mechanisms by which the identified cause produces the symptoms and signs. This mechanistic understanding comes not from the diagnosis itself, but rather from the theoretical framework within which the physician operates.
医学诊断通常被认为是对患者症状和体征的解释。本文探讨它们是如何做到这一点的。我首先指出，尽管某些诊断解释的实例可以被表述为涵盖律论证，但它们的解释性既不取决于其论证结构，也不取决于诊断与临床表现之间的一般规律。然后我考虑这样一种理论，即医学诊断通过在特定病例中识别症状和体征的实际原因来进行解释。虽然我认为这在很大程度上是正确的，但我认为，要使诊断作为对患者症状和体征的令人满意的因果解释发挥作用，还需要通过理解已识别原因产生症状和体征的机制来加以补充。这种机制性理解并非来自诊断本身，而是来自医生所操作的理论框架。
