Dispositions and the unique patient

Abstract

In this chapter we argue that a genuine revision of the norms and practices in clinical work needs to start from a revision of the way we think about the world, and in particular the way we think about the most foundational concepts, such as causality. We present the dispositionalist theory of causality and explain why this theory is better suited for the clinic than the orthodox Humean theory which motivated the EBM framework. We argue that causality ought to be understood as something singular and intrinsic rather than as a pattern of regularity across different contexts. From a dispositionalist perspective, causal knowledge ought to start from the single case. In the clinic, this means that the more we know about the multiple dispositions that are involved and how they interact in this specific context, the better equipped we will be to make good and relevant explanations, predictions and decisions for the individual seeking care.