Healthcare and Medicine Reference
Thesis or theses are essential to build and evaluate the extent to which an
argument is grounded in evidence, the setting and the reality of the prob-
lem. An argument may be formally valid per se, but not necessarily solid,
meaningful, and evidence-grounded.
Essential building blocks already exist, but are somehow “hidden” in
various medical articles and in clinical reasoning in medical practice as
well. As might be expected, the thesis may be found in the Introduction,
grounds in Material, Methods, and Results sections, backing and warrant
in the Review of the literature and Discussion, rebuttals in Discussion as
well, and the claim often appears in the Title itself and in the Conclusions
of the article. 21-23 Table 2.3 represents an overview of Toulmin's original
argument building blocks (“organs within a living system of argument,” as
he calls them) and indicates a possible location of these building blocks
in medical argumentation. 20 Currently, there is no formal rule regarding
where they should be found. In the literature, they are usually scattered
in bits and pieces across the IMRAD (Introduction, Material and Methods,
Results, and Discussion) medical article sections and worded in natural
language. Statements in natural language, in italics in the following 10-item
list (Table 2.2), are and should be supported by argument building blocks.
In any dialogue or written message, consider stating, explaining, and
Table 2.3 shows how argumentation is “hidden” in the natural language
of communication between clinicians in daily life on hospital floors.
Table 2.2 Connectors and Indicators of Argument Building Blocks behind
Argument Building Block Indicator
Building Block to Which You Refer
1. … What's on our mind: …
Refer briefly to your “Problem in
2. … Given this reality of …
Present your “Grounds” represented
by the internal evidence; data;
essence drawn from the study itself.
3. … since as we see it …
A “Warrant” reflects your overall view of
the problem under study, your
understanding of the problem based on
external evidence (outside the study).
4. … because what we know …
It's your “Backing”—you have tackled it
already in part in your literature review.
( Continued )