Prognosis in medicine: An analysis of its meaning and rôles

The medical concept of prognosis is analysed into its basic constituents: patient data, medical intervention, outcome, utilities and probabilities; and sources of utility and probability values are discussed. Prognosis cannot be divorced from contemplated medical action, nor from action to be taken by the patient in response to prognostication. Regrettably, the usual decision-theoretic approach ignores this latter aspect. Elicitation of utilities, decision contemplation and prognostic counselling interweave, diagnostics playing a subsidiary role in decision-oriented clinical practice. At times the doctor has grounds for withholding information. As this is known to the patient, prognostic counselling becomes a conflict-prone and rationality-thwarting activity. The meaning of standard phrases such as “prognosis of a disease”, “the prognosis of this patient”, “the prognosis is unknown”, is examined.     

The topics in medieval logic

The topics is a theory of argumentation based upon topoi or in Latin loci. The medieval logicians used works by Aristotle and Boethius as their sources for this doctrine, but they developed it in a rather original way. The topics became a higher-level analysis of arguments which are non-valid from a purely formal point of view, but where it is none the less legitimate to infer the conclusion from the premiss(es). In this connection the topics give rise to a number of discussions about the form and the matter of arguments. Further the topic contribute to the elaboration of the important doctrine of the second intentions, i.e. higher-level concepts of the particular things. In some respects the topics may be said to form a link between formal and informal logic. The topics vanished as a part of logic at the end of the Middle Ages, perhaps because the medieval logicians never got rid of Boethius' claim to have compiled a complete list of the loci, which was an unlucky one. The topics does not have an exact parallel in modern formal logic, but some reflections on non-formal argumentation by recent authors contain certain resemblances to it.