The germs of the ideas in this book became implanted in me during my
experience as a resident in clinical pathology at Boston University
Medical Center. At the time, I had inklings that the test results
churned out by our laboratories were more than scientific facts. As a
philosophically unsophisticated young physician, however, I had no
language or framework to analyze what I saw as a deep philosophical
problem, a problem largely unrecognized by most physicians. The test
results provided by our laboratories were accurate and of great
practical importance for patient care. However, most of the physicians
who relied on our test results to diagnose and treat their patients
either did not have the time or interest to consider the philosophical
issues inherent in diagnosis, or, like me, had inadequate means to
further analyze them. It was more than ten years later that I began
doctoral studies in philosophy, and I was fortunate to find a faculty
that was supportive of my efforts to address the problem. This book
began as my doctoral dissertation in the Department of Philosophy at
Georgetown University. I would like to acknowledge the assistance of my
mentor, Robert Veatch, Ph. D. Our conversations during my Georgetown
years led me in new and often fascinating directions. I would also like
to acknowledge the help of Kenneth Schaffner, M. D., Ph. D.