Observer Bias: The Emergence of the Ethics of Diagnosis

  • H. Tristram EngelhardtJr.
Part of the Philosophy and Medicine book series (PHME, volume 40)


One of the difficulties in writing history is that ideas change through time. When we describe what took place in the past, we do it through the ideas of the present. But the past had its own ideas, its own priorities, its own ways of seeing what mattered. Generally, we are more at home with recognizing this circumstance when we look at the history of religion or politics. We as a culture feel more comfortable in acknowledging that religious and political ideas change over time. We tend to ook at science and knowledge in more absolute terms. After all, science tells us what is, and what is simply is. This view has only recently been seriously challenged. Over the last two hundred years or so we have begun to take history seriously, and the possibility that the very appreciation of reality changes through time. In part, this has been due to the reflections of Giambattista Vico (1668–1774) and G.W.F. Hegel (1790–1831). Even the idea of scientific revolutions can be traced back to at least Hegel’s Philosophy of Nature, where he says, “All revolutions, whether in the sciences or world history, occur merely because spirit has changed its categories in order to understand and examine what belongs to it, in order to possess and grasp itself in a true, deeper, more intimate and unified manner” ([13], Sec. 246 Zusatz, V of I. p 202). Hegel recognizes that ideas and reality are mutually implicative.


Medical Knowledge Theoretical Account Scientific Revolution Observer Bias Medical Reality 
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  1. 1.
    Bieganski, W.: 1894, Logika Medyzyny, Kowalewski, Warazawa.Google Scholar
  2. 2.
    Blane, G.: 1819, Elements of Medical Logick, T. and G. Underwood, London.Google Scholar
  3. 3.
    Cronin, D.: 1958, The Moral Law in Regard to the Ordinary and Extraordinary Means of Conserving Life, dissertation submitted to Gregorian Pontifical University.Google Scholar
  4. 4.
    Engelhardt, H.T., Jr.: 1986, The Foundations of Bioethics, Oxford, New York.Google Scholar
  5. 5.
    Fleck, L.: 1935, Entstehung und Entwicklung einer wissenschaftlichen Tatsache, Benno Schwabe, Basel; 1979, Genesis and Development of a Scientific Fact, ed. T. Trenn & R. Merton, trans. F. Bradley & T. Trenn, University of Chicago Press, Chicago.Google Scholar
  6. 6.
    Foucault, M.: 1963, Naissance de la Clinique, Presses Universitaires de France, Paris.Google Scholar
  7. 7.
    Gavaret, J.: 1840, Principes generaux de statistique medicale, Bechet jeune et Labe, Paris.Google Scholar
  8. 8.
    John of Gaddesden: 1942, ‘Rosa Anglica practica medicine a capite ad pedes’, in L. Clendening (ed.), Source Book of Medical History, Dover, New York.Google Scholar
  9. 9.
    Kuhn, T. S.: 1970, The Structure of Scientific Revolutions, 2nd ed., University of Chicago Press, Chicago.Google Scholar
  10. 10.
    Lakatos, I. and Musgrave, A. (eds.): 1970, Criticism and the Growth of Knowledge, University Press, Cambridge.Google Scholar
  11. 11.
    Louis, P.C.A.: 1835, Recherches sur les effets de la saignee dans quelques maladis inflammatoires, Bailliere, Paris.Google Scholar
  12. 12.
    Osterlen, F.: 1855, Medical Logic, ed, and trans. G. Whitney, Sydenham Society, London.Google Scholar
  13. 13.
    Petry, M.F. (ed. & trans.): 1970, Hegel’s Philosophy of Nature, Humanities Press, New York.Google Scholar
  14. 14.
    Sydenham, T.: 1979, Medical Observations Concerning the History and the Cure of Acute Diseases, in The Works of Thomas Sydenham, trans. R.G. Latham, Classics of Medicine Library, Birmingham, Alabama.Google Scholar
  15. 15.
    Temkin, O. (trans.): 1956, Soranus’ Gynecology, Johns Hopkins Press, Baltimore.Google Scholar
  16. 16.
    Wulff, Henrik: 1976, Rational Diagnosis and Treatment, Blackwell Scientific, Oxford.Google Scholar

Copyright information

© Kluwer Academic Publishers 1992

Authors and Affiliations

  • H. Tristram EngelhardtJr.
    • 1
  1. 1.Baylor College of MedicineHoustonUSA

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