Intuition in Medicine: A Philosophical Defense of Clinical Reasoning

By Betcher, Jeffrey G. | Ethics & Medicine, Spring 2016 | Go to article overview

Intuition in Medicine: A Philosophical Defense of Clinical Reasoning


Betcher, Jeffrey G., Ethics & Medicine


Intuition in Medicine: A Philosophical Defense of Clinical Reasoning Hillel D. Braude. Chicago, IL: The University of Chicago Press, 2012. ISBN-1 3: 978-0-226-07166-4, 256 PAGES, CLOTH, $54.00.

Since antiquity, the practice of medicine has been considered an art-the practitioner investigating and managing a patient and illness using both knowledge as well as insight into the pathophysiology of disease. Medical practice also involves a physician drawing on past experience while using an intuitive sense to guide clinical decision making. In the past, physicians relied heavily on intuition. Medical science had not yet matured to the degree it has in the present day.

The last decade of the twentieth century saw the emergence of the phenomenon of evidence-based medicine-the practice of basing medical decision making and treatment plans on the best evidence available from highly structured clinical trials that have undergone rigorous statistical analysis. The most ardent of those who support this approach would suggest that this is all that is really required to guide clinical practice. Such is the thinking behind the development of clinical practice guidelines, preprinted order sets, and clinical pathways that direct patient therapies. A shortcoming to this approach, however, is that it fails to account for the varying contingencies in patients. Thus, intuition as it guides clinical reasoning remains an important aspect of the practice of medicine.

Hillel D. Braude, in his book Intuition in Medicine, provides a look at the role of intuition in clinical reasoning from a philosophical perspective. He suggests that intuition provides a link between reasoning in the medical sense, in the moral sense and what it means to be human. Throughout the book, Braude brings a philosophical understanding to intuition and its role in clinical reasoning. He begins with a discussion of the role of intuition in the emergence of medical ethics in the 1970s and 1980s and progresses to moral intuitionism. …

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