Beyond a shadow of a doubt legal definition10/17/2023 ![]() ![]() Osler also stated, “Probability guides us when certainty fails,” but he emphasized that uncertainty is unavoidable. Roberts, MD, approach every case with the question: “What is unusual about this case?” This variability among patients also is why experienced physicians, like William C. Such a statement is surprisingly timely in our era of personalized or precision medicine, in which targeted therapies are tailored to the individual genetics of a patient at the molecular level. This is the fundamental difficulty in the education of the physician” ( 2). However, as Osler pointed out, “Variability is the law of life and no two bodies are exactly alike, and no two individuals react alike under the abnormal conditions which we know as disease. This balancing of probabilities is integral to the day-to-day activities of the physician who produces a differential diagnosis and then systematically confirms or eliminates the various hypotheses. He further stated the extremely critical point that “errors in judgment are inevitable in the practicing of an art which consists largely of balancing probabilities” ( 2). The practice of medicine is an art based on science, but Osler believed that this was one of the most difficult arts in the world to acquire. ![]() In seeking absolute truth, we aim at the unattainable, and must be content with finding broken portions ( 3). ![]() A distressing feature in the life you are about to enter, a feature which will press hardly upon the finer spirits among you and ruffle their equanimity, is the uncertainty which pertains, not alone to our science and art, but to the very hopes and fears which make us men. ![]()
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