Marco Buzzoni

This paper replies to objections that have been raised against my operational-Kantian account of thought experiments by Fehige 2012 and 2013. Fehige also sketches an alternative Neo-Kantian account that utilizes Michael Friedman’s concept of a contingent and changeable a priori. To this I shall reply, first, that Fehige’s objections not only neglect some fundamental points I had made as regards the realizability of TEs, but also underestimate the principle of empiricism, which was rightly defended by Kant. Secondly, in opposition to what he states, my account does not differ in a very essential way from the empiricist solutions either as regards the power of TEs to predict something new about empirical reality, or as regards the criteria for telling apart good from bad TEs. Thirdly, in the light of the Kantian definition of the a priori, Friedman’s corresponding notion is contrary both to the spirit and to the letter of Kant’s philosophy; moreover, from a theoretical point of view, a material a priori is theoretically untenable since, counter to Friedman’s own intentions, it leads to relativism.

The often-emphasized tension between the singularity of the patient and technical–scientific reproducibility in medicine cannot be resolved without a discussion of the epistemological and methodological status of the human sciences. On the one hand, the rules concerning human action are analogous to the scientific laws of nature. They are de facto sufficiently stable to allow predictions and explanations similar to those of experimental sciences. From this point of view, it is only a trivial truth, but still a methodological irrelevancy, that the patient and the doctor–patient relationship represent an ontologically irreproducible reality. On the other hand, however, one can never exclude that one can fail in the application of "laws" of the human sciences to the individual patient, for such laws are by no means wholly separated from a patient's personal-hermeneutic mediation, and can at any time be revoked by becoming aware of them. This requires a synergistic collaboration of clinical and statistical methods, and shows a methodologically relevant sense in which one cannot disregard the singularity of the patient. The reason for the crucial role of the patient's singularity in medicine is every individual patient's capacity to revoke, in principle, routines and quasi-automatisms, even though the personal mediation by the patient's consciousness de facto changes them in such a small degree that predictions and explanations modeled in experimental science remain possible.