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That is the reason why in reality it is not possible to achieve “a diagnosis
and treatment
in general
” - nor to learn a kind like that as students in medicine.
Therefore Sadegh-Zadeh says: “we had acquired nothing about how to search for
a diagnosis and treatment
in general
, i.e.
how to arrive at a clinical judgment
...
My extensive search was disappointing.
It revealed that there was no such
methodology.”
8
Taking the individual patient as an object in medicine is strictly speaking a cate-
gory mistake. The only thing to be in fact taken as an object is empirical data or a
detailed description or a quantified model of a measurable symptom, not the patient
as a whole, individual person can be objectively verifiable.
But even if there is no technique or distinct method to give in general for medical
diagnostics, it nevertheless is possible to get
practical knowledge
, to increase the
insight into the interplays of an organism by exercise. That is what happens in good
medical education and that characterizes a physician with long term experience: to
achieve an understanding of the patient as “a bio-physical-agent”, to get the “eye”
by training,
9
to train the intuition for judging and treating the patient as an individual
taking him seriously as an expert in his own history and body.
7.1.3
Vague Decision If a Person Is a Patient or Not
As Sadegh-Zadeh shows (especially in §12), the advantage of introducing fuzzy
logic into the field of medicine is to develop a philosophy of medicine that will be
tailored to the needs and interests of the human being, therefore: “My starting point
is
the patient
”. But it is not so easy to decide, if a person
is
a patient or not. “The aim
is to inquire into how medicine is engaged in shaping the human world by deciding
who is a patient - to be subjected to diagnostics - and who is a non-patient.”
10
In general a 'patient' is a person, (a) who has a living body, (b) which develops a
psyche as it grows and (c) which is always embedded in a surrounding world. Con-
sequently Sadegh-Zadeh wants the 'patient' being understood and interpreted as “a
bio-phsycho-social and moral agent” (§12.2). The next step will be to grasp what
it means to say, that such an agent can be categorized as diseased. The question is:
How can we notice or confirm that a person is a 'patient'? If there are observable
8
[5], Preface, p. 2.
9
In every profession dealing with a complex and changing subject, there is necessary to get
“the eye” by exercise, theoretical know-how, increasing measure methods and modeling is
not enough. Take for example the job of an editor or corrector of texts: To understand a
language, to see the mistakes, hear what's wrong, to find a fast solution to express it better
- that's similar to the physician's situation in face of the patient: he has to understand the
structure of physiology, the language of the body, his task is to find “the mistake”, to see
what's going wrong, to find a solution. The professional role of a physician is much more
comparable to an editor dealing with texts written in a natural grown and living language,
not with a mechanic repairing machines.
10
[5], Preface, p. 4.
