On the indiciary nature of the clinical method: an anthropological view of a published case study

https://doi.org/10.18294/sc.2014.219

Published 1 August 2014 Open Access


Doctora en Salud Pública. Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Río de Janeiro, Brasil , Historiadora. Doctora en Salud del Niño y de la Mujer. Investigadora, Centro de Genética Médica José Carlos Cabral de Almeida. Departamento de Genética, Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira (IFF), Fundação Oswaldo Cruz, Río de Janeiro, Brasil , Médico. Doctor en Salud Pública. Investigador, Departamento de Epidemiologia e Métodos Quantitativos em Saúde, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Río de Janeiro, Brasil.



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Keywords:

Anthropology, Clinical Medicine, Medical Genetics.

Abstract


In this article we present a published case study as an object of reflection. On this basis, we carried out a partial reconstruction of the process of study and diagnostic elaboration of the Uruguay syndrome, showing the circumstances of the case, the selection and interpretation of "clues," and some of the details relevant to the clinical reasoning. Our starting point is the recognition of the narrative nature of clinical knowledge and of the clinical method as an indiciary method. The manuscript of the Uruguay syndrome has a narrative structure adjusted to the conventions of a scientific article, which gives lesser importance to the clinical method. We carried out diverse methodical encounters, mainly involving in-depth interviews with the authors of the manuscript and observation in their workplace. The text seeks to recover the histories of work based on the indiciary or semiotic model of knowledge, and recognize the importance of this model in medical practice.