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Mechanisms in clinical practice: use and justification

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Abstract

While the importance of mechanisms in determining causality in medicine is currently the subject of active debate, the role of mechanistic reasoning in clinical practice has received far less attention. In this paper we look at this question in the context of the treatment of a particular individual, and argue that evidence of mechanisms is indeed key to various aspects of clinical practice, including assessing population-level research reports, diagnostic as well as therapeutic decision making, and the assessment of treatment effects. We use the pulmonary condition bronchiectasis as a source of examples of the importance of mechanistic reasoning to clinical practice.

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Authors and Affiliations

  1. University of Washington, Box 356522, 1959 NE Pacific St., Seattle, WA, 98195-6522, USA

    Mark R. Tonelli

  2. University of Kent, Canterbury, UK

    Jon Williamson

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  1. Mark R. Tonelli
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  2. Jon Williamson
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Correspondence to Mark R. Tonelli.

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Tonelli, M.R., Williamson, J. Mechanisms in clinical practice: use and justification. Med Health Care and Philos 23, 115–124 (2020). https://doi.org/10.1007/s11019-019-09915-5

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