Terminology matters in medical ethics: on the use of ‘diagnosis’ in philosophical analysis

Bair’s recent article ( J Med Ethics , 2026) offers a thoughtful Wittgensteinian analysis of ‘understanding’ in informed consent which proposes that comprehension should be evaluated through demonstrated capacity rather than passive reception. However, the author’s choice to frame this conceptual clarification as a ‘Wittgensteinian diagnosis’ introduces significant terminological confusion. In clinical medicine, a ‘diagnosis’ represents a rigorous, empirical and consequential judgement derived from systematic assessment and differential analysis, with consequences for subsequent management. Borrowing this clinical term as an unmarked metaphorical transfer of clinical terminology for philosophical conceptual analysis risks misleading clinician-readers into expecting a novel diagnostic instrument, psychological scale or psychiatric evaluation framework. In an interdisciplinary journal dedicated to medical ethics like the Journal of Medical Ethics , precision in terminology is essential. Humanistic inquiries intersecting with clinical medicine must respect the specific weight and established operational definitions of clinical vocabulary. This response argues that referring to a purely philosophical clarification as a ‘diagnosis’ undermines clear communication between philosophers and clinicians. Conceptual errors are best designated as conceptual errors—not medical conditions requiring ‘diagnosis.’

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Publication Details

Journal
Journal of Medical Ethics
Published
2026-09-15
DOI
https://doi.org/10.1136/jme-2026-112540
Primary Topic
Mental Health and Psychiatry
Type
article
Field-Weighted Citation Impact
0.00
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article

Terminology matters in medical ethics: on the use of ‘diagnosis’ in philosophical analysis

Takeo Saio
Journal of Medical Ethics
Mental Health and Psychiatry
article

Terminology matters in medical ethics: on the use of ‘diagnosis’ in philosophical analysis

Takeo Saio
article en

Abstract

Bair’s recent article ( J Med Ethics , 2026) offers a thoughtful Wittgensteinian analysis of ‘understanding’ in informed consent which proposes that comprehension should be evaluated through demonstrated capacity rather than passive reception. However, the author’s choice to frame this conceptual clarification as a ‘Wittgensteinian diagnosis’ introduces significant terminological confusion. In clinical medicine, a ‘diagnosis’ represents a rigorous, empirical and consequential judgement derived from systematic assessment and differential analysis, with consequences for subsequent management. Borrowing this clinical term as an unmarked metaphorical transfer of clinical terminology for philosophical conceptual analysis risks misleading clinician-readers into expecting a novel diagnostic instrument, psychological scale or psychiatric evaluation framework. In an interdisciplinary journal dedicated to medical ethics like the Journal of Medical Ethics , precision in terminology is essential. Humanistic inquiries intersecting with clinical medicine must respect the specific weight and established operational definitions of clinical vocabulary. This response argues that referring to a purely philosophical clarification as a ‘diagnosis’ undermines clear communication between philosophers and clinicians. Conceptual errors are best designated as conceptual errors—not medical conditions requiring ‘diagnosis.’

Journal of Medical Ethics
Toranomon Hospital (JP)
Openalex Percentile: Top 2%
Mental Health and Psychiatry
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Terminology matters in medical ethics: on the use of ‘diagnosis’ in philosophical analysis — Takeo Saio · Journal of Medical Ethics (2026) | TGRS Research Map | TGRS