The Role of Prognosis in Cardiology Practice: A Pragmatist Perspective

• In Event: 497 - Regular Session. Sociology of Knowledge

Abstract

Drawing on preliminary results from ongoing fieldwork at a teaching hospital, this paper examines the role of prognosis in cardiology practice. It is inspired by a paradox in the literature: despite the well-documented de-emphasis of prognosis in modern medical thought and training, there is evidence to suggest that prognostic still plays an ever-present role in clinical decision-making. To explain this apparent paradox, I enlist a conceptualization of the process of decision-making, which, consistent with pragmatist theory, views prognosis as preceding and guiding diagnostic action. The overarching role of prognosis and its heuristic significance for illuminating the process of medical decision-making is thus made explicit and empirically accessible. Hence, I argue, the persisting role of prognosis in clinical practice offers a promising lens through which to study medical decision-making as it actually happens. Rather than analytically privileging the de-emphasis of prognostic cognition, I attend to the wide range of prognostication practices that persist in spite of it. The ultimate goal is to offer a number of specific recommendations for revising medical training and practice toward a more explicit, systematic, situationally-specific and patient-centered integration of prognostic judgments in how doctors make decisions.

Author

• Phaedra Daipha, State University of New Jersey-Rutgers