Uncritical Thinking in Medicine

Abstract

NO ONE involved in providing health care, whether a professional or a patient, would disagree that the primary goal of the system is maintenance of the health of the patient. A corollary of this position is the assertion that ideally every prophylactic or therapeutic maneuver should have a greater chance of improving rather than of worsening the health of the patient. While it is easy to make this assertion, a number of factors have ensured that in practice it may be extremely difficult for a physician to be certain that a specific clinical maneuver is indeed indicated for a specific patient. Ingelfinger¹has succinctly defined the ingredients that distinguish the good physician as "the exercise of well based and independent clinical judgment." Although this communication will address itself to a discussion of problems inherent in deciding what is or is not a well-based therapeutic maneuver, it is not intended