Critical think

E A M RICA

American Medical Association
Physicians dedicated to the health of America

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MEDICA
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EVIDENCE-BASED PRACTICE

LOGIC AND CRITICAL THINKING IN MEDICINE
MILOS JENICEK
■

DAVID L. HITCHCOCK

ION AT

AMA Press Vice President, Business Products: Anthony J. Frankos Publisher: Michael Desposito Director, Production and Manufacturing: Jean Roberts SeniorAcquisitions Editor: Barry Bowlus Developmental Editor: Katharine Dvorak Copy Editor: Kathleen Louden Director, Marketing: J. D. Kinney Marketing Manager: Amy Postlewait Senior Production Coordinator: Rosalyn Carlton Senior Print Coordinator: Ronnie Summers © 2005 by the American Medical Association Printed in the United States of America. All rights reserved. Internet address: www.ama-assn.org Nopart of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the publisher. Additional copies of this book may be ordered by calling 800 621-8335 or from the secure AMA Press Web site at www.amapress.org. Refer to product number OP842204. ISBN1-57947-626-0 Library of Congress Cataloging-in-Publication Jenicek, Milos, 1935Evidence-based practice : logic and critical thinking in medicine / Milos Jenicek, David L. Hitchcock. p. ; cm. Includes bibliographical references and index. ISBN 1-57947-626-0 1. Evidence-based medicine. 2. Medical logic. 3. Critical thinking. 4. Medicine— Philosophy. [DNLM: 1. Evidence-Based Medicine. WB 102 J51e2005] I. Hitchcock, David, 1942- II. Title. R723.7.J463 2005 616—dc22 2004007858 The authors, editors, and publisher of this work have checked with sources believed to be reliable in their efforts to ensure that the information presented herein is accurate, complete, and in accordance with the standard practices accepted at the time of publication. However, neither the authors nor the publisher norany party involved in the creation and publication of this work warrant that the information is in every respect accurate and complete, and they are not responsible for any errors or omissions or for any consequences from application of the information in this book. “Tree Diagram” in Critical Thinking: An Introduction to the Basic Skills by William Hughes. Broadview Press, 2000 (3/e), p. 99. ISBN:1551112515. Copyright © 2000 William Hughes. Reprinted with permission of Broadview Press. BP87:04-P-032:09/04

CONTENTS
List of Illustrations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix Philosopher’s Foreword by Robert Ennis, PhD . . . . . . . . . . . . . . . . . . . xiii Physician’s Foreword by Suzanne Fletcher, MD . . . . . . . . . . . . . . . .. . . xv A Word From the Authors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xix Reader’s Bookshelf . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxiii

Part 1 Theory and Methodological Foundations
CHAPTER 1

From Philosophy to Logic, From Logic to Medicine: Fundamental Definitions and Objectives of this Book . . . . . . . . . 31.1 Why Are Logic and Critical Thinking Needed in Our Practice, Research, and Communication? Why Read This Book? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Medicine as Art and Science . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Philosophy in Medicine or Philosophy of Medicine?. . . . . . . . . . . 9 Philosophy of Science, Scientific Method,Evidence, and Evidence-based Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Thinking, Logic, Reasoning, and Critical Thinking . . . . . . . . . . . 15 Where in Medicine May We Find Practical Applications and Practical Uses of Philosophy, Logic, and Critical Thinking and Their Expected Benefits?. . . . . . . . . . . . . . . . . . . . . 17

1.2 1.3 1.4 1.5 1.6

References . ....