Hillel D. Braude, “Intuition in Medicine: A Philosophical Defense of Clinical Reasoning” (U Chicago Press, 2012)

Can we define ‘clinical reasoning’? Is it the ability to marshal the best available evidence to come to adecision within a medical framework, or is it the capacity to think holistically aboutwhether a given intervention is in the patient’s best interest? In his book, Intuition in Medicine: A Philosophical Defense of Clinical Reasoning (University of Chicago Press, 2012), Hillel Braude considers this apparent gap in the history of medical thought. He argues throughout that intuition provides the missing link between medical and moral reasoning. Rather than setting forth a definition of intuition outright, Braude traces its articulations through canonical works of philosophy and medical ethics. One comes away with an understanding that intuition is something like a pre-reflective practical wisdom bound to human faculties, resisting abstraction. Even this definition is contextually malleable, and through his historical and philosophical exploration he draws out the epistemological (and often practical) consequences of assuming it to be anything more finite or less consequential.

The scope of Braude’s work is impressive, as it touches on classic philosophical texts–including a thorough treatment of Aristotle–as much as work better known by medical ethicists. It also tackles the modernization of medicine, from the works of pathologist Xavier Bichat and statistician Francis Galton to more contemporaryissues such asequipoise in clinical trials and Evidence Based Medicine. Throughout, Braude’s clarity and scrutiny shine through his treatment of the material, while he suggests new ways forward through phenomenology as a deeper consideration of both the doctor and patient as subjects. Intuition in Medicine keeps the doors of the medical humanities open to both physicians and philosophers by elucidating a foundational issue about which both groups can–and must–learn from one another.

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