The paper attempts to clarify a fundamental similarity and some relevant differences between empirical-scientific and fictional thought experiments. For this purpose, the second section of the paper provides a brief outline of a quasi-Kantian account of thought experiments (TE) in the empirical sciences from the viewpoint of a radically functional, strictly not material, a priori. On the basis of this account, a fundamental similarity and two main differences between empirical-scientific and narrative thought experiments are brought to the fore: the counterfactual construction of idealised scenarios is a fundamental characteristic that is shared by scientific and fictional thought experiments (and, more generally, by science and art). The differences depend on the different intentionalities to which this construction is subordinated. Fictional TEs, instead of resolving the dimension of counterfactuality in real empirical facts or processes, use it to transpose certain cultural contents (thoughts, feelings, possible courses of action, etc.) into a dimension outside any particular space and time, which are able to produce a symbolic shelter that protects us from the particular adverse events of concrete life. This, on the one hand, generates in us the feeling of pleasure or enjoyment that tradition has so often linked to artistic enjoyment and, on the other, urges us, implicitly or explicitly, to re-enact those contents in the first person and to take an evaluative stance towards them.

Despite the innovation that evidence-based medicine (henceforth EBM) represents for biomedical sciences today, we argue that its strict evidential hierarchies do not faithfully represent the epistemic and practical reality of the evidence that should be used to make appropriate clinical decisions. We defend that it is necessary to make modifications to the methodology and models of clinical decision-making proposed by EBM and make them more sensitive to the use of different types of evidence and reasoning. Since various types of evidence and reasoning, and medical expertise still play an irreducible role in clinical decision-making, rather than continuing with their strict hierarchies, we argue that those who subscribe to the EBM paradigm should discuss in much greater detail different types of evidence and reasoning. Admitting and advocating the role of other types of evidence and reasoning in clinical decision-making will also be necessary to introduce other types of inference and evaluation, as this generates conclusions that do not rely solely on induction or deduction. Both clinical judgment and the clinical eye play a prominent role in this context, particularly in diagnosis, as uncertainty inherently influences the process. If we hit the nail on the head, effective EBM practice requires other types of reasoning beyond biostatistical reasoning. With this in mind, we characterize clinical judgment based on abductive inference.

AbstractThis paper addresses the relatively overlooked field of rehabilitation and physical medicine, offering an epistemological perspective on clinical reasoning in these disciplines, focusing on three different domains: diagnosis, prognosis, and treatment. Rehabilitation sciences, often overshadowed by medicine and nursing, present unique challenges in terms of clinical reasoning. We explore these challenges, highlighting the distinctive features that set rehabilitation apart from clinical medicine. Notably, rehabilitation focuses on functions, aiming to improve an individual’s quality of life, setting it apart from disease-centered medicine. Drawing also from philosophical insights in nursing literature, we offer a multidisciplinary perspective on the epistemological dimensions of rehabilitation and physical medicine, shedding light on their placement within healthcare disciplines.

The aim of this paper is to address the problem known as “the puzzle of imaginative” use, related to the ambiguities of an imagination that sometimes distances us from reality, but at other times, as for example in the use of scientific thought experiments, is used to understand some important aspects of the real world. The problem is closely related to that of imaginative constraints. It will be shown how, particularly in the scientific enterprise, the epistemic value of imagination depends on the embodiment of imagination itself. The work of scientific imagination, understood as an ability, will be re-read through the most recent studies on Embodied Simulation. This will make it possible to grasp in the imaginative act the link between creativity and method that is essential in the scientific enterprise.

AbstractGriffiths and Matthewson (2018) employ the selected effects theory to contend that disease involves the impairment of the normal functioning of biological items. Since the selected effects theory focuses on the past effects of those items, I refer to their proposal as “aetiological naturalism”. In this paper, I argue that aetiological naturalism cannot constitute an adequate theory of disease. This is due to the fact that the selected effects theory, which lies at the heart of aetiological naturalism, is flawed. One promise of the selected effects theory is indeed that it is able to account for our normative intuitions about dysfunctional biological items by grounding them on the concept of natural selection incorporated in the selected effects theory itself, where this promise rests upon its claim that appealing to the fitness-enhancing effect of biological items can always explain why they persisted in a population. However, I contend that the naturalisation of normativity cannot be cashed out in terms of biological items’ past effects by discussing two biological phenomena: phenotypic plasticity and negative frequency-dependent selection. I illustrate that in both cases the selected effects theory cannot recognise adaptive items as having a selected effects function, therefore preventing the possibility to assign them any dysfunction. The normative force of the selected effects theory is consequently much diminished, leading in turn to a weakening of aetiological naturalism, given that such project actually relies on the assumed normative force of the selected effects theory itself.