Abstract

CAMPOS, Alberto. The surgeon and underdetermination in breast cancer. The mammogram, from epistemic to moral dilemma. Cir. gen [online]. 2016, vol.38, n.4, pp.217-222.  Epub Apr 16, 2020. ISSN 1405-0099.

When confronted to mammographic images suggestive of malignancy, surgeons face a double dilemma, epistemic and moral. When they do not find coherence in the clinical guides and official norms, they make decisions on their own and solve both dilemmas pragmatically. Different organizations differ in the criteria of the recommendations and guidelines for breast cancer screening mammograms. Given that the underdetermination between theory and evidence makes it impossible for the thesis of these recommendations to be verified in isolation, they are also made using pragmatic but unconvincing criteria. In such a way, surgeons must first solve an epistemic dilemma, then a moral dilemma, and act on their intuitions. They use a defeasible reasoning, rationally convincing but epistemologically invalid. The effect is that their actions can be iatrogenic and go from the epistemically problematic to the morally problematic.

Keywords : Breast cancer; mammogram; underdetermination; moral dilemma; bioethics.

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