Perspectives on clinical possibility: elements of analysis

Abstract

Possibility is one of the most common modalities in reasoning and argumentation. Various kinds of modal concepts have been identified in philosophical and logical discussion of the metaphysics of modality. We focus here on the concept of clinical possibility. A critical analysis of what is intended as clinical possibility has not yet received sufficient examination, although the concept is extensively used in clinical reasoning. We present arguments to emphasize some desirable features associated with the concept of clinical possibility. We argue that almost all clinical possibilities are potentialities, that is, possibilities that may be actualized by effective, appropriate and feasible interventions. However, in some limited cases, even mere possibilities - which may or may not be actualized, since we do not have the required knowledge - may be involved in clinical reasoning, and we present some examples in this paper. We then introduce some basic views on the nature of possibility showing their validity and limitations when applied to the concept of clinical possibility. Lastly, we conjecture that clinical possibility is a normative modality that can be formalized in a multimodal system with epistemic and deontic logical operators.

Meaning and Affect in the Placebo Effect

“…By giving a permission to change, the patient's present state of health 8 may undergo a modification because the patient is capable of perceiving those future changes in the light of conceivable situations that are real, in the sense of being real possibilities that may become actual. What matters within the realm of real possibilities is not what we expect to happen or what we would or could obtain in the light of the calculations of probabilities of an expected outcome of various interventions (Chiffi and Zanotti, 2016). Expectations do not give permission for habits of action that characterize the subject's present behaviour to be modified in the future.…”

Theory, experience and practice

“…The view that scientific reasoning can indeed embody significant philosophical commitment is taken seriously by Chiffi and Zanotti [30]. Presenting examples from clinical reasoning, these authors explore the epistemological and metaphysical commitments in perspectives on clinical possibility.…”

Nursing knowledge: hints from the placebo effect

“…Nursing consequently has a special role in enhancing the placebo effect, given its target. Nursing aims to assess and promote patients’ ‘health potential’ vis‐à‐vis their ongoing state of health (Chiffi & Zanotti, ). A given patient's health potential indicates the maximal possible enhancement of their quality of life relating to their capacity for self‐care, given their current condition.…”