Medical Uncertainty and Paradox, and the Quality-of-Care Crisis

By James A. Marcum.

Published by The International Journal of Health, Wellness and Society

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Medical uncertainty and the paradox it engenders represent persistent anxieties in clinical practice and can often lead to poor quality healthcare, a principal crisis in the American healthcare system. In this paper, I discuss the relationship between uncertainty and paradox, particularly with respect to the quality-of-care crisis, along with how paradox exacerbates the crisis. I first explore the nature of medical uncertainty and its various types and sources, followed by discussion of the medical paradoxes uncertainty produces. I use the play “Wit” to illustrate clinical uncertainty and paradox, as well as the poor quality-of-care associated with them. I conclude with an analysis of the quality-of-care crisis and efforts to resolve it, along with a proposed resolution based on the compound virtue of compassionate wisdom.

Keywords: Medical Uncertainty, Medical Paradox, Quality Health Care

The International Journal of Health, Wellness and Society, Volume 2, Issue 1, pp.21-32. Article: Print (Spiral Bound). Article: Electronic (PDF File; 330.927KB).

James A. Marcum

Professor, Deaprtment of Philosophy, Baylor University, Waco, Texas, USA

James A. Marcum is professor of philosophy and director of the Medical Humanities Program at Baylor University in the USA. He received doctorates in philosophy from Boston College and in physiology from the University of Cincinnati Medical College. He was a postdoctoral fellow at Harvard Medical School and Massachusetts Institute of Technology, and a faculty member of Harvard Medical School before coming to Baylor University. He has received grants from several funding agencies including the National Institutes of Health, National Science Foundation, and the American Heart Association. His research interests include philosophical and historical issues in science and medicine. Examples of his recent publications include articles in Theoretical Medicine and Bioethics, Synthese, Medicine, Health Care and Philosophy, International Studies in the Philosophy of Science, Perspectives on Science, Annals of Science, and History and Philosophy of the Life Sciences. His most recent book is An Introductory Philosophy of Medicine: Humanizing Modern Medicine. (Philosophy and Medicine Series, volume 99, New York: Springer, 2008)