The Logic of Diagnosis: Peirce, Literacy Narrative, and the History of Present Illness
Journal of Medicine and Philosophy 2006 August; 31(4): 363-384
This essay presents a theoretical construct upon which to base a working--"pragmatic"--definition of the History of Present Illness (HPI). The major thesis of this essay is that analysis of both the logic of hypothesis formation and literary narrative--especially detective stories--facilitates understanding of the diagnostic process. The essay examines three elements necessary to a successful development of a patient's HPI: the logic of hypothesis formation, based upon the work of the philosopher-logician, Charles Sanders Peirce; the organization of knowledge in relation to structures of narrative; and the feedback necessary to the successful physician-interviewer. It concludes with a systematic description of the design of hypothesis formation within diagnoses.
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The Narrative Imperative: Stories in Medicine, Illness and Bioethics Reviews of DOCTORS' STORIES: THE NARRATIVE STRUCTURE of MEDICAL KNOWLEDGE, by Kathryn Montgomery Hunter; the WOUNDED STORYTELLER: BODY, ILLNESS, and ETHICS, by Arthur W. Frank; STORIES and THEIR LIMITS: NARRATIVE APPROACHES to BIOETHICS, Edited by Hilde Lindemann Nelson Tanner, David E. (1999-06)