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Egenis · People

Dr. Nicholas Binney

Egenis research student

Telephone

01392 725142

Fax

01392 724676

Email

nb357@exeter.ac.uk

Room

FF10

Building

Byrne House

Biography

My professional training is as a veterinary surgeon, and I graduated from the Royal Veterinary College in 2006. Since then I have worked in mixed and small animal practice in England and completed the equine neonatal internship at the Marion DuPont Scott Equine Medical Center, Virginia U.S.A.. While practising I had the opportunity to work with a number of excellent diagnosticians, and I developed a keen interest in the diagnostic process. I have left clinical practice to explore more closely certain problems I have encountered with diagnostic reasoning, particularly with the justification of diagnostic practices. In particular my research looks at how knowledge of the historical development of diagnostic practices can inform the evaluation of those practices in the present. To this end, I completed a Masters degree in the history of science, medicine and technology, jointly hosted by Imperial College and University College London in 2011. I began my doctoral studies into the justification of diagnostic practices at the University of Exeter in 2012.

Publications

Conference Presentations

'Using Integrated History and Philosophy to Inform Diagnostic Medicine: The Case of Heart Failure' – International Society for the History, Philosophy and Social Studies of Biology Conference, 8th July 2013, Montpelier (France).

'The Use of Integrated History and Philosophy to inform Diagnostic Medicine: The Case of Heart Failure' – International Advanced Seminar in the Philosophy of Medicine, “Unity and autonomy in the philosophy of medical science”, 20th June 2013, Paris (France).

'Using iHPS to Inform Diagnostic Medicine: The Case of Heart Failure' – 8th Annual Integrated HPS Workshop, University of Aberdeen, 12 April 2013.

'Using Integrated History and Philosophy to inform Diagnostic Medicine: The Case of Heart Failure' – SSIS Postgraduate Conference, University of Exeter, 10 May 2013.

'History of Diagnostic Criteria for Congestive Heart Failure' – BSHS Postgraduate Conference, University of Manchester, 6 January 2011.

Poster Presentation'Using History to Inform Diagnostic Practices: The Case of Heart Failure' – ESRC Series Series. The role of diagnosis in health and wellbeing: Asocial science perspective on the social, economic and political costs and consequences of diagnosis. Seminar 2: Theorising Diagnosis, University of East Anglia, 23 May 2013

Research Interests

I left veterinary practice to explore more closely problems with the diagnosis of disease which I have encountered. I am interested in many aspects of the diagnostic process, including the ontology of disease; the processes by which knowledge of disease and diagnostics have been produced; the formation and use of lists of differential diagnoses; the problem oriented method of diagnosis; the use of conditional probability in diagnostic reasoning and structures of diagnostic arguments themselves.

The main problems I have encountered while practising medicine relate to the justification of diagnostic practices. I see diagnosis as an act of classification, and determining which diagnostic practices would classify patients appropriately struck me as problematic. In my experience, the value of certain diagnostic practices is not fully determined by either empirical evidence or theoretical considerations about the diseases in question. Consequently, I have not been able to justify my diagnostic decisions using empirical evidence about the sensitivities and specificities of diagnostic practices or knowledge of the pathophysiology of disease.

My doctoral research focuses on exploring the role historical research into the development of diagnostic practices may be able to play in the evaluation of those same diagnostic practices. My principle case study is of the disease 'heart failure' in human medicine. I focus my research on the late nineteenth century work the physician James Mackenzie, but I am also keen to tell a story about how the diagnosis of heart failure has developed from the early nineteenth century to the present day.

My work is inherently interdisiplinary. As I wish to use historical knowledge to inform philosophical conclusions about the justification of diagnostic practices, my work is an example of integrated history and philosophy of medicine. As I wish to use my work to inform medical practice, I see it as an example of philosophy of science in practice. Even though my research focuses mostly on human medicine, as a veterinary surgeon I am interested in how it relates to veterinary practice. My work is therefore also at the intersection of human and veterinary medical practice.

I am also keenly interested in the philosophical topic of pluralism, particularly as it relates to diagnosis and nosology.