Racjonalne modele rozumowania klinicznego

Wojciech Rutkiewicz

Abstrakt


Debata dotycząca medycyny opartej na dowodach (EBM) w obecnym stanie coraz częściej skupia się na filozoficznych założeniach paradygmatu ogłoszonego w 1992 roku przez Grupę Roboczą EBM. Jednym z obszarów zainteresowania badaczy jest problem rozumowania klinicznego, prowadzącego do wydania diagnozy oraz podjęcia decyzji klinicznej. W polskiej literaturze temat ten wciąż nie doczekał się wyczerpującego zaprezentowania. W niniejszym artykule dokonuję przeglądu modeli rozumowania klinicznego. Zaczynam od debaty o pojęciu racjonalności, w której wyróżniam dwa stanowiska: melioryzm i panglozjanizm. Następnie przechodzę do omówienia trzech typów ujęcia rozumowania klinicznego w perspektywie meliorystycznej. Omówienie modeli rozumowania lekarskiego z perspektywy debaty o racjonalności daje możliwość przyjrzenia się regułom rozumowania przyświecającym decyzjom klinicznym, co może mieć ciekawe konsekwencje badawcze i edukacyjne.

Słowa kluczowe


medycyna oparta na dowodach, diagnoza, rozumowanie, racjonalność, melioryzm

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DOI: http://dx.doi.org/10.7206/DEC.1733-0092.132

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