John Gunkler wrote:
>Even though physicians will spend their entire working lives being
>confronted with people showing symptoms (and have to work from there >to diagnosis/understanding of what is happening in the body, then to
>treatment), that's not how they are taught! In fact, they are taught from
>almost the reverse perspective. They are taught about how the body
>functions -- from the inside out, as it were -- and how certain bodily
>conditions show up as certain symptoms or clusters of symptoms.
Thank you John, that's inspiring! I will take it as a case study and
perform a brief analysis using (and learning about) cause-effect-logic
(CEL) and the three steps of the scientific method (observation,
speculation and falsification):
TEACHING medicine uses CEL STATEMENTS:
IF cause THEN effect !
WORKING as a physician requires CEL QUESTIONS:
IF effect THEN cause ?
Statements are required to answer questions. If statements are not
available, answering has to be done by means of speculation. In fact all
statements are speculations with varying degrees of confirmation: From
"often tested and never failed" to "not yet tested".
I as a patient expect from a physician, that he has the full set of state
of the art statements at hand, when he is doing his diagnosis business -
answering the questions, asking me (or his diagnostic equipments including
million $ investments available today) questions about other not mentioned
effects (observable symptoms) to make even more sure about the causes -
the illness.
I definitely want to have as less as possible speculation in his
diagnosis, when he starts his falsification business - the therapy. As a
patient in therapy, I really prefer to confirm the existing system, making
the therapy a success in curing my illness. (Although admittedly the
epistemological value of the therapy with respect to improving the state
of the art net of statements of cause-effect relations would be higher if
the therapy failed. But as a patient, it is difficult to be proud of
contributing to that, isn't it?)
>In other words, they are taught deductively how to predict symptoms from
>illnesses -- then have to spend their lives inducing illnesses from
>symptoms. Why?
I think the leading idea is, that one need to understand a system in terms
of cause-effect-relations (isn't this at least part of systems thinking?)
before one can answer questions on the system effectively. Of course one
can learn about these relations in both directions: from causes to effects
and from effects to causes. Both directions would be preferable to learn
about sufficient causes and necessary effects.
Inducing illnesses (causes) form symptoms (effects) is of course only half
of the business, namely diagnoses. Inducing cure (effect) from therapy
(cause) the other.
(Side remark: John, your "inducing illnesses" and my "inducing cure" are
of coures two very different uses of the word "inducing". Yours refer to
RTL (relation of terms logic), my to CEL. There is not too much sense in
arguing which usage is the right one. But as a physician, you would have a
hard time explaining your usage to a common patient, especially when the
patient shows signs of "irrational" fear or even succeeds in finding the
fastest way out of your praxis. Does this mean that the patient belong to
those 50% of adults who have not yet mastered the developmental state of
abstract, formal RTL-thinking? He might very well be able to understand,
that a black bird is neither yellow nor a cat, inducing correctly from
black bird to black and bird.)
It was fun to make this analysis. I hope you enjoy it as well.
Liebe Gruesse,
Winfried
--"Winfried Dressler" <winfried.dressler@voith.de>
Learning-org -- Hosted by Rick Karash <rkarash@karash.com> Public Dialog on Learning Organizations -- <http://www.learning-org.com>