{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T08:06:14Z","timestamp":1767773174151,"version":"build-2065373602"},"reference-count":74,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T00:00:00Z","timestamp":1734912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Philosophies"],"abstract":"<jats:p>The evolution of medical reasoning is deeply intertwined with philosophical thought, beginning with Aristotle\u2019s foundational work in deductive logic. Aristotle\u2019s principles significantly influenced early medical practice, shaping the works of Galen and Avicenna, who made empirical observations that expanded clinical knowledge. During the Enlightenment, both inductive reasoning, as advocated by Francis Bacon, and deductive methods, as stressed by Ren\u00e9 Descartes, significantly advanced medical reasoning. These approaches proved insufficient when it came to handling uncertainty and variability in medical outcomes. Nineteenth-century figures like William Osler advanced a probabilistic understanding of medicine. Karl Popper\u2019s 20th-century hypothetico-deductive method, which introduced the concept of falsifiability and transformed scientific inquiry into a rigorous process of hypothesis testing, is a fundamental aspect of evidence-based medicine (EBM). EBM emerged as the dominant paradigm, combining empirical research, clinical expertise, and statistical inference to guide medical decisions. Looking forward, Bayesian reasoning offers a further refinement in medical reasoning. By incorporating prior knowledge and continuously updating probabilities with new evidence, Bayesianism addresses the limitations of frequentist methods and offers a more dynamic and adaptable framework for clinical decision making. As medical reasoning evolves, understanding this philosophical lineage is essential to navigating the future of patient care, where evidence must be both rigorously tested and individually tailored.<\/jats:p>","DOI":"10.3390\/philosophies9060189","type":"journal-article","created":{"date-parts":[[2024,12,24]],"date-time":"2024-12-24T02:50:56Z","timestamp":1735008656000},"page":"189","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A Journey Through Philosophy and Medicine: From Aristotle to Evidence-Based Decisions"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3835-6067","authenticated-orcid":false,"given":"Jos\u00e9 Nunes","family":"de Alencar","sequence":"first","affiliation":[{"name":"Department of Bioethics, Universidade do Porto, 4099-002 Porto, Portugal"}]},{"given":"Marcio Henrique de Jesus","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Department of Medicine, Universidade Federal de Uberl\u00e2ndia, Uberl\u00e2ndia 38408-100, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2650-6811","authenticated-orcid":false,"given":"Maria Catarina Nunes","family":"Sampaio","sequence":"additional","affiliation":[{"name":"Department of Medicine, University Center INTA\u2014UNINTA, Sobral 62050-100, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8083-7895","authenticated-orcid":false,"given":"Maria Francisca","family":"Rego","sequence":"additional","affiliation":[{"name":"Department of Bioethics, Universidade do Porto, 4099-002 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1377-9899","authenticated-orcid":false,"given":"Rui","family":"Nunes","sequence":"additional","affiliation":[{"name":"Department of Bioethics, Universidade do Porto, 4099-002 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,23]]},"reference":[{"key":"ref_1","unstructured":"(2019). Nicomachean Ethics, Hackett Publishing."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Kulicki, P. (2020). Aristotle\u2019s Syllogistic as a Deductive System. Axioms, 9.","DOI":"10.3390\/axioms9020056"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1136\/pgmj.2007.057521","article-title":"The \u201cDirty Tricks\u201d Experience Can Play on Us","volume":"83","author":"Ernst","year":"2007","journal-title":"Postgrad. Med. J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1080\/01445340.2022.2107382","article-title":"A Logic for Aristotle\u2019s Modal Syllogistic","volume":"44","author":"Protin","year":"2023","journal-title":"Hist. Philos. Log."},{"key":"ref_5","unstructured":"(1923). Hippocrates: With an English Translation by W.H.S. Jones and E.T. Withington, Heinemann."},{"key":"ref_6","unstructured":"Mattern, S.P. (2013). The Prince of Medicine: Galen in the Roman Empire, OUP Oxford."},{"key":"ref_7","unstructured":"and Bakhtiar, L. (2014). The Canon of Medicine (al-Q\u0101n\u016bn F\u012b\u2019l-\u1e6cibb), Great Books of the Islamic World, Chapman & Hall."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Bacon, F. (2000). Francis Bacon: The New Organon, Cambridge University Press.","DOI":"10.1017\/CBO9781139164030"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1097\/ACM.0000000000003093","article-title":"The Positivism Paradigm of Research","volume":"95","author":"Park","year":"2020","journal-title":"Acad. Med."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Outram, D. (2019). The Enlightenment, Cambridge University Press.","DOI":"10.1017\/9781108341233"},{"key":"ref_11","unstructured":"Ladyman, J. (2001). Understanding Philosophy of Science, Routledge."},{"key":"ref_12","first-page":"999","article-title":"Evidence-Based Medicine and Reteplase: Inductive Arguments over Deductive Reasoning","volume":"15","author":"Massel","year":"1999","journal-title":"Can. J. Cardiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1215\/00318108-114-1-118","article-title":"Descartes\u2019s Concept of Mind; Descartes\u2019s Theory of Mind","volume":"114","author":"Jolley","year":"2005","journal-title":"Philos. Rev."},{"key":"ref_14","unstructured":"Descartes, R. (1998). Discourse on Method, Hackett Publishing."},{"key":"ref_15","first-page":"941","article-title":"Beyond the Scientific Method: Model-Based Inquiry as a New Paradigm of Preference for School Science Investigations","volume":"92","author":"Windschitl","year":"2008","journal-title":"Sci. Educ."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1590\/0100-6045.2020.v43n2.vr","article-title":"Passionate Descartes: A reinterpretation of the body\u2019s role in cartesian thought","volume":"43","year":"2020","journal-title":"Manuscrito"},{"key":"ref_17","unstructured":"Descartes, R. (1972). Treatise of Man, Harvard University Press."},{"key":"ref_18","unstructured":"Hume, D. (2004). An Enquiry Concerning Human Understanding, Courier Corporation."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Kant, I. (1998). Critique of Pure Reason, Cambridge University Press.","DOI":"10.1017\/CBO9780511804649"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"35","DOI":"10.5152\/jtgga.2013.08","article-title":"Medicine in Stamps-Ignaz Semmelweis and Puerperal Fever","volume":"14","author":"Ataman","year":"2013","journal-title":"J. Turk. Ger. Gynecol. Assoc."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"100036","DOI":"10.1016\/j.patter.2020.100036","article-title":"Florence Nightingale (1820\u20131910): An Unexpected Master of Data","volume":"1","author":"Bradshaw","year":"2020","journal-title":"Patterns"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1097\/PRS.0b013e3181c2bb89","article-title":"Evidence-Based Medicine and Hospital Reform: Tracing Origins Back to Florence Nightingale","volume":"125","author":"Aravind","year":"2010","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1136\/ebn.4.3.68","article-title":"Florence Nightingale and the Early Origins of Evidence-Based Nursing","volume":"4","author":"McDonald","year":"2001","journal-title":"Evid.-Based Nurs."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.profnurs.2016.05.009","article-title":"The History of Evidence-Based Practice in Nursing Education and Practice","volume":"33","author":"Mackey","year":"2017","journal-title":"J. Prof. Nurs."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e20200228","DOI":"10.1590\/1983-1447.2021.20200228","article-title":"The Florence Nightingale\u2019s Nursing Theoretical Model: A Transmission of Knowledge","volume":"42","author":"Peres","year":"2021","journal-title":"Rev. Ga\u00facha Enferm."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1150","DOI":"10.1016\/j.jclinepi.2006.02.012","article-title":"Claude Bernard Was a 19th Century Proponent of Medicine Based on Evidence","volume":"59","author":"Morabia","year":"2006","journal-title":"J. Clin. Epidemiol."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Habert, R. (2022). Claude Bernard, the Founder of Modern Medicine. Cells, 11.","DOI":"10.3390\/cells11101702"},{"key":"ref_28","unstructured":"Gracia, D. (2000). Medicina basada en la evidencia: Aspectos \u00e9ticos. Rev. Bio\u00e9tica, 8, Available online: https:\/\/revistabioetica.cfm.org.br\/revista_bioetica\/article\/view\/263."},{"key":"ref_29","unstructured":"Bernard, C. (1865). Introduction a l\u2019\u00c9tude de la M\u00e9decine Exp\u00e9rimentale, J.B. Bailli\u00e8re."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1177\/1049732313519707","article-title":"A Forerunner of Qualitative Health Research: Risueno\u2019s Report against the Use of Statistics","volume":"24","author":"Torralbo","year":"2014","journal-title":"Qual. Health Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"231","DOI":"10.3163\/1536-5050.101.3.018","article-title":"Sir William Osler: The Man and His Books","volume":"101","author":"Rowan","year":"2013","journal-title":"J. Med. Libr. Assoc."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1177\/1203475417695078","article-title":"Medicine Is a Science of Uncertainty and an Art of Probability\/La M\u00e9decine Est Une Science de l\u2019incertitude et Un Art de La Probabilit\u00e9","volume":"21","author":"Barber","year":"2017","journal-title":"J. Cutan. Med. Surg."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Comte, A. (2009). The Positive Philosophy of Auguste Comte, Cosimo, Inc.","DOI":"10.1017\/CBO9780511701450"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"14","DOI":"10.7748\/nr.2018.e1466","article-title":"Introduction to Positivism, Interpretivism and Critical Theory","volume":"25","author":"Ryan","year":"2018","journal-title":"Nurse Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1097\/ACM.0000000000003089","article-title":"Postpositivism in Health Professions Education Scholarship","volume":"95","author":"Young","year":"2020","journal-title":"Acad. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2621","DOI":"10.1016\/j.socscimed.2005.11.031","article-title":"On Evidence and Evidence-Based Medicine: Lessons from the Philosophy of Science","volume":"62","author":"Goldenberg","year":"2006","journal-title":"Soc. Sci. Med."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Richardson, A., and Uebel, T. (2007). The Vienna Circle: Context, Profile, and Development. The Cambridge Companion to Logical Empiricism, Cambridge University Press.","DOI":"10.1017\/CCOL0521791782"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Webb, W.M. (2018). Rationalism, Empiricism, and Evidence-Based Medicine: A Call for a New Galenic Synthesis. Medicines, 5.","DOI":"10.3390\/medicines5020040"},{"key":"ref_39","unstructured":"Popper, K.R. (2002). Conjectures and Refutations: The Growth of Scientific Knowledge, Psychology Press."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Kuhn, T.S. (2012). The Structure of Scientific Revolutions, University of Chicago Press.","DOI":"10.7208\/chicago\/9780226458144.001.0001"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Evidence-Based Medicine Working Group (1992). Evidence-Based Medicine. A New Approach to Teaching the Practice of Medicine. JAMA, 268, 2420\u20132425.","DOI":"10.1001\/jama.268.17.2420"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"5","DOI":"10.5172\/hesr.2002.11.1-2.5","article-title":"Positivism Resurgent: The Epistemological Foundations of Evidence-Based Medicine","volume":"11","author":"White","year":"2014","journal-title":"Health Sociol. Rev."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1136\/bmj.312.7023.71","article-title":"Evidence Based Medicine: What It Is and What It Isn\u2019t","volume":"312","author":"Sackett","year":"1996","journal-title":"BMJ"},{"key":"ref_44","unstructured":"Sackett, D.L. (1997). Evidence-Based Medicine: How to Practice and Teach EBM, Churchill Livingstone."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1023\/A:1025969303573","article-title":"Evidence-Based Medicine: A New Tool for Resource Allocation?","volume":"6","author":"Nunes","year":"2003","journal-title":"Med. Health Care Philos."},{"key":"ref_46","unstructured":"de Alencar, J.N.D. (2021). Manual de Medicina Baseada Em Evid\u00eancias: Como Interpretar Artigos Cient\u00edficos?, Chapman & Hall."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Altman, D.G. (1990). Practical Statistics for Medical Research, CRC Press.","DOI":"10.1201\/9780429258589"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1093\/bjps\/axm024","article-title":"Why There\u2019s No Cause to Randomize","volume":"58","author":"Worrall","year":"2007","journal-title":"Br. J. Philos. Sci."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1017\/S1745855207005029","article-title":"Are RCTs the Gold Standard?","volume":"2","author":"Cartwright","year":"2007","journal-title":"BioSocieties"},{"key":"ref_50","unstructured":"Higgins, J.P.T., and Cochrane Collaboration (2019). Cochrane Handbook for Systematic Reviews of Interventions, Wiley-Blackwell. [2nd ed.]."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/j.shpsc.2011.07.003","article-title":"Is Meta-Analysis the Platinum Standard of Evidence?","volume":"42","author":"Stegenga","year":"2011","journal-title":"Stud. Hist. Philos. Biol. Biomed. Sci."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1046\/j.1365-2753.1997.00103.x","article-title":"Evidence-Based Medicine: Why All the Fuss? This Is Why","volume":"3","author":"Miles","year":"1997","journal-title":"J. Eval. Clin. Pract."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1111\/j.1365-2753.1998.tb00085.x","article-title":"Evidence-Based Medicine: A Kuhnian Perspective of a Transvestite Non-Theory","volume":"4","author":"Couto","year":"1998","journal-title":"J. Eval. Clin. Pract."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1365-2753.1996.tb00022.x","article-title":"Evidence-Based Medicine: Reference? Dogma? Neologism? New Orthodoxy?","volume":"2","author":"Polychronis","year":"1996","journal-title":"J. Eval. Clin. Pract."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1023\/A:1021116516342","article-title":"Whither Our Art? Clinical Wisdom and Evidence-Based Medicine","volume":"5","author":"Parker","year":"2002","journal-title":"Med. Health Care Philos."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"332","DOI":"10.5694\/j.1326-5377.2000.tb123981.x","article-title":"Medicine for the Millennium: The Challenge of Postmodernism","volume":"172","author":"Chan","year":"2000","journal-title":"Med. J. Aust."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1111\/j.1365-2753.2009.01327.x","article-title":"Epistemology and Ethics of Evidence-Based Medicine: Putting Goal-Setting in the Right Place","volume":"16","author":"Sestini","year":"2010","journal-title":"J. Eval. Clin. Pract."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1111\/j.1365-2753.2010.01389.x","article-title":"From Popperian Science to Normal Science. Commentary on Sestini (2009) \u2018Epistemology and Ethics of Evidence-Based Medicine\u2019","volume":"16","author":"Goldenberg","year":"2010","journal-title":"J. Eval. Clin. Pract."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1007\/s11019-017-9773-2","article-title":"What\u2019s in a Gold Standard? In Defence of Randomised Controlled Trials","volume":"20","author":"Backmann","year":"2017","journal-title":"Med. Health Care Philos."},{"key":"ref_60","unstructured":"Grattan-Guinness, I., Cooke, R., Corry, L., Cr\u00e9pel, P., and Guicciardini, N. (2005). Thomas Bayes, An Essay towards Solving a Problem in the Doctrine of Chances (1764). Landmark Writings in Western Mathematics 1640\u20131940, Elsevier Science."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1007\/s10654-016-0149-3","article-title":"Statistical Tests, P Values, Confidence Intervals, and Power: A Guide to Misinterpretations","volume":"31","author":"Greenland","year":"2016","journal-title":"Eur. J. Epidemiol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.newideapsych.2018.06.004","article-title":"Frequentist and Bayesian Inference: A Conceptual Primer","volume":"51","year":"2018","journal-title":"New Ideas Psychol."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Berger, J.O., and Wolpert, R.L. (1988). The Likelihood Principle, IMS.","DOI":"10.1214\/lnms\/1215466210"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"235","DOI":"10.2307\/2343787","article-title":"Repeated Significance Tests on Accumulating Data","volume":"132","author":"Armitage","year":"1969","journal-title":"J. R. Stat. Soc. Ser. A (Gen.)"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1037\/a0022790","article-title":"Why Psychologists Must Change the Way They Analyze Their Data: The Case of Psi: Comment on Bem (2011)","volume":"100","author":"Wagenmakers","year":"2011","journal-title":"J. Pers. Soc. Psychol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1177\/1745691611406920","article-title":"Bayesian Versus Orthodox Statistics: Which Side Are You On?","volume":"6","author":"Dienes","year":"2011","journal-title":"Perspect. Psychol. Sci."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.jmp.2015.10.003","article-title":"How Bayes Factors Change Scientific Practice","volume":"72","author":"Dienes","year":"2016","journal-title":"J. Math. Psychol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1111\/j.2044-8317.2011.02037.x","article-title":"Philosophy and the Practice of Bayesian Statistics","volume":"66","author":"Gelman","year":"2013","journal-title":"Br. J. Math. Stat. Psychol."},{"key":"ref_69","first-page":"234","article-title":"The Estimation of Probabilities: An Essay on Modern Bayesian Methods","volume":"16","author":"Good","year":"1966","journal-title":"Synthese"},{"key":"ref_70","unstructured":"Harper, W.L., and Hooker, C.A. (1976). The Bayesian Influence, or How to Sweep Subjectivism under the Carpet. Foundations of Probability Theory, Statistical Inference, and Statistical Theories of Science: Proceedings of the International Research Colloquium held at the University of Western Ontario, London, ON, Canada, 10\u201313 May 1973, Springer."},{"key":"ref_71","unstructured":"Earman, J. (1992). Bayes or Bust?: A Critical Examination of Bayesian Confirmation Theory, MIT Press."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1177\/2515245918770407","article-title":"The Epistemic Importance of Establishing the Absence of an Effect","volume":"1","author":"Fidler","year":"2018","journal-title":"Adv. Methods Pract. Psychol. Sci."},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Ioannidis, J.P.A. (2005). Why Most Published Research Findings Are False. PLoS Med., 2.","DOI":"10.1371\/journal.pmed.0020124"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1093\/ije\/dyi312","article-title":"Bayesian Perspectives for Epidemiological Research: I. Foundations and Basic Methods","volume":"35","author":"Greenland","year":"2006","journal-title":"Int. J. Epidemiol."}],"container-title":["Philosophies"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2409-9287\/9\/6\/189\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:58:51Z","timestamp":1760115531000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2409-9287\/9\/6\/189"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,23]]},"references-count":74,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["philosophies9060189"],"URL":"https:\/\/doi.org\/10.3390\/philosophies9060189","relation":{},"ISSN":["2409-9287"],"issn-type":[{"type":"electronic","value":"2409-9287"}],"subject":[],"published":{"date-parts":[[2024,12,23]]}}}