KINDS OF PATIENTS

The basic goal of health outcomes research is to identify the kinds of patients who do (or do not) benefit substantially from specified medi cal or surgical treatments and procedures. Similarly, clinicians must determine whether particular patients are the kinds of patients who do (or do not) benefit from specified interventions. Such a kinds-based approach to clinical practice is often resisted, however, when physici ans are asked to standardize their practices based on the results of h ealth outcome data. In such settings, clinicians often assert that ''e very patient is unique''. The present paper explores the coherence of this claim. In particular, I examine the applicability of the philosop hical notion of natural kinds to a kinds-based approach to clinical re search and practice. I conclude that the claim of patient uniqueness i s misguided. Two key difficulties with a kinds-based approach are exam ined: the problems associated with (1) assigning single-case probabili ties and (2) stereotyping and discrimination.