MeST talk by Renata Arruda: 'OVERDIAGNOSIS: The Pandora’s box of epistemology '

"Though she hastened to close the container, only one thing was left behind – usually translated as Hope, though it could also have the pessimistic meaning of "deceptive expectation".
Brill's Companion to Hesiod, Leiden NL 2009, p.77

Knowing is the fundamental motivation of philosophy and science. However, conceiving diagnosis as a special subset of the general concept of knowledge clashes with how we intuitively value epistemic practices. This is evident when we are faced with the problem of overdiagnosis, which occurs when a condition is identified that would not have caused any symptoms or harm if it had not been diagnosed. In other words, no symptoms or harm would have occurred had the knowledge about that condition not been acquired. But does the act of diagnosing, which shares characteristics embedded in our quest for knowledge, allow us to conceive these concepts symmetrically? In other words, can we think about overknowledge in the same way we think about overdiagnosis? Does it make any sense to conceive of knowledge as being excessive or potentially harmful?

Given the recognition of undesired consequences in diagnosing, is it appropriate to extrapolate the philosophy and science perspective on the quest for knowledge to all domains? What are the limits of the right to know in science beyond its practice at the laboratory workbench or the philosopher’s armchair? In this talk, I explore the benefits and harms involved in diagnosing, in an effort to take into account the perspectives of healthcare professionals and patients.