title: Differential diagnosis and the suspension of judgment.
abstract: In this paper I argue that ethics and evidence are intricately intertwined within the clinical practice of differential diagnosis. Too often, when a disease is difficult to diagnose, a physician will dismiss it as being "not real" or "all in the patient's head." This is both an ethical and an evidential problem. In the paper my aim is two-fold. First, via the examination of two case studies (late-stage Lyme disease and Addison's disease), I try to elucidate why this kind of dismissal takes place. Then, I propose a potential solution to the problem. I argue that instead of dismissing a patient's illness as "not real," physicians ought to exercise a compassionate suspension of judgment when a diagnosis cannot be immediately made. I argue that suspending judgment has methodological, epistemic, and ethical virtues and therefore should always be preferred to patient dismissal in the clinical setting.
authors.affiliation: *University of South Carolina, Center for Bioethics, 1600 Hampton Street, Suite 409, Columbia, SC 29208, USA. ashleygrahamkennedy@gmail.com.
authors.forename: Ashley Graham
authors.initials: AG
authors.lastname: Kennedy
mesh_terms: D000224:Addison Disease / Q000175:diagnosis / Q000523:psychology; D003657:Decision Making; D003933:Diagnosis; D003937:Diagnosis, Differential; D004992:Ethics, Medical; D006801:Humans; D007600:Judgment; D008193:Lyme Disease / Q000175:diagnosis / Q000523:psychology; D010686:Philosophy, Medical; D010817:Physician-Patient Relations
keywords: diagnosis; epistemology; ethics; evidence; physician-patient relationship; respect; virtues