Wulff H R
J Med Philos. 1986 May;11(2):123-34. doi: 10.1093/jmp/11.2.123.
Clinical decisionmaking includes reasoning from prescientific or scientific theories, reasoning from uncontrolled or controlled experience, and reasoning based on empathic understanding and moral beliefs. The development of contemporary clinical thinking is discussed, and it is found that successive generations of medical practitioners have had different views of the rationality and relative importance of these modes of reasoning: that which is considered rational by one generation of doctors is sometimes denounced by the next. The author's book, Rational Diagnosis and Treatment, which is an example of clinical thinking in the 1960s and early 70s, is used to illustrate one particular view of clinical decisionmaking.
临床决策包括依据前科学或科学理论进行推理、依据无对照或有对照的经验进行推理,以及基于共情理解和道德信念进行推理。本文讨论了当代临床思维的发展,发现历代医学从业者对这些推理模式的合理性和相对重要性持有不同观点:一代医生认为合理的东西,有时会受到下一代医生的谴责。作者的《合理诊断与治疗》一书是20世纪60年代和70年代初临床思维的一个例子,被用来阐释临床决策的一种特定观点。