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Theor Med Bioeth. 1998 Jun;19(3):253-61.

The significance of prognosis for a theory of medical practice.

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Abteilung für Ethik und Geschichte der Medizin, Universität Göttingen, Germany.


A typical problem of modern medicine results from the gap between scientific knowledge and its application in individual cases. Whereas scientific knowledge is generalized and impersonal information, medical practice takes place under conditions which are singular, individual and irreversible. The paper examines whether prognosis is able to bridge this gap or "hiatus theoreticus". It is shown that diagnosis of a single case always relies on prognostic considerations. The individual prognosis (as distinguished from the nosologic prognosis of a certain disease) enables doctors to apply scientific knowledge and practice according to the actual situation, the history and personal preferences of the patient. Prognosis--not diagnosis--therefore legitimizes medical interference. A methodology of individual prognosis as the basis for a theory of practice is discussed.

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