오진(誤診): 의료윤리와 의료법에 선행하는 인식론 문제 = Misdiagnosis: Epistemological Problem prior to Medical Ethics and Medical Laws

다국어 초록 (Multilingual Abstract)

Succeeding to Claude Bernard(1813~1878)`s physicochemical reductionism and determinism as well as Pierre Louis(1787~1872)`s statistical and stochastic methodology, Evidence-Based Medicine(EBM) attempted to improve the diagnostic certainty of contemporary medicine. Nevertheless, EBM was not able to diminish significantly the frequency of diagnostic errors. As the patient`s security and rights are emphasized in Western Europe and the U.S., malpractice suits involving misdiagnosis are rapidly increasing and ethical controversies over this fundamental problem of medicine are spreading all over the society. In consideration of such historical and social background of EBM this paper is focusing on misdiagnosis where the uncertainty of medicine is most obvious. After analyzing the reasons why EBM does still not guarantee to avoid misdiagnosis, the indispensable and positive function of clinical intuition in clinical decision-making is revealed. Then, the paper argues that the cognitive limits of doctors and the methodological problems of medicine require an epistemological examination prior to the ethical and legal discussions. In other words, the philosophy of medicine should be taken into account in malpractice suits and ethical debates concerning misdiagnosis as it may contribute to a better resolution of these delicate issues.