The Search for Objectivity without Perspective: Historical-Epistemological Notes on Clinical Judgment in Medicine

Clinical judgement has become a central topic in both medicine and the philosophy since the 1960s. With the development of evidence -based medicine in the 1990s, clinical judgment is expected to be more sensitive to the needs and preferences of patients in the face of threats from positivist approaches that are considered to neglect individuality. This paper addresses this problem in the light of a philosophy of medicine that is more sensitive to the historical components of epistemology, ontology, and ethics. The analysis is directed to the 19th century in order to elucidate the tensions about the place of medical knowledge and the commitment, for the sake of professional improvement, to provide clinical judgment with new methods. This trip to the past is useful to understand the current transformations in the field of medicine, especially the way in which they help constitute new types of patients, new types of professional ethos, and new forms of relationship between these actors.