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November 17, 1978

Rhyme and Reason

JAMA. 1978;240(21):2287. doi:10.1001/jama.1978.03290210069034

If medicine is an art as well as a science, then surely it is not an art for art's sake. Tracing the philosophical roots of medicine to humanism and scientific determinism, Robin (p 2273) concludes that the proper concern of man is man and that of the physician is to help his patient toward a contented and self-sufficient life. Although there does not seem to be anything startling in this conclusion, it carries practical implications that are not obvious at first sight. For instance, it may not be apparent, as Robin points out, that diagnosis is not an end in itself but a means to good treatment. The latter can sometimes be achieved without making a minutely precise diagnosis, particularly if the diagnostic technology is expensive, bothersome, and perhaps even hazardous. The diagnosis may not even be relevant to the patient's central problem. Treatment, too, may be irrelevant to contentment