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Clinical judgement and individual patients: Invited Commentary on … In Defence of Professional Judgement

  • Tim Thornton
Summary

Although in agreement with their conclusions about the importance of clinical judgement, this commentary criticises the way that Downie & Macnaughton defend it in their article. I argue that their defence is both overly limited in its account of the role of judgement and that it employs unnecessarily contentious arguments. I outline the ineliminable role that judgement plays in determining which general diagnostic concepts fit individual patients given their individuality and specificity.

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Copyright
Corresponding author
Tim Thornton, International School for Communities, Rights and Inclusion, University of Central Lancashire, Preston PR1 2HE, UK. Email: TThornton1@uclan.ac.uk
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Declaration of Interest

None.

Footnotes
References
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Bell, D (1987) The art of judgment. Mind; 96: 221–44.
Carroll, L (1895) What the tortoise said to Achilles. Mind; 4: 278–80.
Downie, R, Macnaughton, J (2009) In defence of professional judgement. Advances in Psychiatric Treatment; 15: 322–7.
Frege, G (1893) Grundgesetze der Arithmetik Band I/II . Reprinted (1964) in part in The Basic Laws of Arithmetic (volumes I/II) (trans M Furth). University of California Press.
Fulford, KWM, Thornton, T, Graham, G (2006) The Oxford Textbook of Philosophy and Psychiatry. Oxford University Press.
IDGA Workgroup, WPA (2003) IGDA. 8: Idiographic (personalised) diagnostic formulation. British Journal of Psychiatry; 182 (suppl 45): s557.
Jaspers, K (1913) Causal and ‘meaningful’ connexions between life history and psychosis. Reprinted (1974) in Themes and Variations in European Psychiatry: An Anthology (eds Hirsch, SR, Shepherd, M) 8093. John Wright.
Kant, I (1790) Critique of Judgment. Reprinted (1987; trans Pluhar, W. S.) Hackett.
Phillips, J (2005) Idiographic formulations, symbols, narratives, context and meaning. Psychopathology; 38: 180–4.
Sellars, W (1997) Empiricism and the Philosophy of Mind. Harvard University Press.
Thornton, T (2007) An aesthetic grounding for the role of concepts in experience in Kant, Wittgenstein and McDowell? Forum Philosophicum; 12: 227–45.
Thornton, T (2008a) Should comprehensive diagnosis include idiographic understanding? Medicine, Healthcare and Philosophy; 11: 293302.
Thornton, T (2008b) Does understanding individuals require idiographic judgement? European Archives of Psychiatry and Clinical Neuroscience; 258 (suppl 5): 104–9.
Thornton, T (2009) Idiographic versus narrative approaches to assessment. Psychopathology; in press.
Windelband, W (1980) History and natural science. History and Theory; 19: 169–85.
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BJPsych Advances
  • ISSN: 1355-5146
  • EISSN: 1472-1481
  • URL: /core/journals/bjpsych-advances
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Clinical judgement and individual patients: Invited Commentary on … In Defence of Professional Judgement

  • Tim Thornton
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