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at your red throat, patched tonsils, tender cervical nodes and fever, and posi-
tive results of our rapid laboratory test (grounds).… a treatment with penicil-
lin may be the best choice in your case (warrant) … All our past experience
and clinical studies show that we must do this to spare you from serious
complications of such an infection (backing) … so, let us definitely proceed
this way (qualifier), if you agree, and unless you are allergic to penicillin
(rebuttals), in which case we should choose another kind of treatment …,” a
new claim to be supported by alternative premises or statements applying to
a different condition. Figure 2.6 represents a graphical structure of this kind
of modern argument.
Table 2.1 illustrates this type of argument as it might be (and is) used in
medicine and other health sciences. The flowchart was originally proposed
for medical article understanding and writing, with particular attention given
to the discussion section. 21,22 Its principles apply to any other argument and
argumentation in health sciences research and practice, communication of
both pinpoint and broader experience and research experience as well.
The claim (already appearing as building block 3) reappears now again
and represents the result of the argument.
Figure 2.7 represents, then, Toulmin's model of argument with the
addition of thesis and adducts entities. 23,24 It is redrawn from left right
orientation to the top bottom one, as flowcharts usually appear in health
Conclusion (claim)
is patient has
streptococcal pharyngitis.
He (she) should be treated
with penicillin.
Given that
He (she) has a known
allergy to penicillin or
another contraindication
Best available evidence from
clinical trials and other
observational analytical studies
and all past experience
(including narratives) shows
the penicillin eectiveness in the
treatment of bacterial infections,
And because
Penicillin is, in overall practice,
the treatment of choice for
streptococcal pharyngitis
Figure 2.6
Toulmin's modern argument model. A medical example.
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