Internal and Emergency Medicine

, Volume 12, Issue 5, pp 689–691 | Cite as

Understanding and improving decisions in clinical medicine (I): Reasoning, heuristics, and error

  • Vincenzo CrupiEmail author
  • Fabrizio Elia
CE - Clinical Notes


In considering ourselves as agents who think and make decisions, it is natural to rely on a logic-plus-error model. According to this view, the human mind is essentially a logical machine providing coherent inferences and choices unless disturbing factors interfere and lead us astray. One key point of this idea is that, in principle, were the sources of error subtracted, logical reasoning would flow undeterred, and mistakes would vanish.

The logic-plus-error model has been strongly influential in medicine. One often presupposes that healthcare professionals, too, would reason according to valid logical rules quite naturally, if only their judgment was not distorted by the effects of sleep deprivation, the reality of emotional stress, the concerns of defensive medicine, or sheer work overload. As to interventions to improve practice, the ensuing policy amounts to a combination of the following: strengthen consequential behavior by training (e.g., teaching some statistics)...


Human Mind Cognitive Bias Confirmation Bias Cognitive Error Disturbing Factor 
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Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with human and animals performed by any of the authors.

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Copyright information

© SIMI 2017

Authors and Affiliations

  1. 1.Department of Philosophy and Education, Center for Logic, Language, and CognitionUniversity of TurinTurinItaly
  2. 2.High Dependency UnitSan Giovanni Bosco HospitalTurinItaly

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