Causality and dispositionality in medical practice

Abstract

In this chapter, Ivor Ralph Edwards shares his reflections based on more than 20 years of international experience, both in clinical practice and in drug safety monitoring. Crucial for Edward’s work is the dispositionalist view that outlier cases and deviations from the norm have a great potential in advancing causal understanding, as discussed in the first part of this book. Through a number of examples drawn from his professional experience, Edwards here provides some advice on how the dispositionalist approach presented in Part I of this book can improve clinicians’ daily practice and can assist the process of differential diagnosis. Despite the time and other constraints placed upon practicing clinicians today, the urgency of taking causal complexity properly into account demands that a more personal and contextual approach be taken. This chapter highlights the urgency of the call for a new framework for medical practice, one that fully acknowledges patient narratives as evidential and emphasises the importance of understanding rare symptoms and responses as being nonetheless part of a larger pattern of dispositions and manifestations.