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Subjective uncertainty and casualità

Let us imagine asking Mary Poppins which of the two medical colleagues — the dentist or the neurologist — is right.

The question would create a kind of agitation based on inner uncertainty; therefore, the notions of certainty and uncertainty refer to subjective epistemic states of human beings and not to states of the external world, because there is no certainty or uncertainty in that world. In this sense, as we have mentioned, there are an inner world and a world outside ourselves that both do not respond to canons of uncertainty, yet of probability.

Mary Poppins may be subjectively certain or uncertain as to whether she is suffering from TMDs or a neuropathic or neuromuscular form of OP: this because "uncertainty" is a subjective, epistemic state below the threshold of knowledge and belief; hence the term.

Subjective uncertainty

Without a doubt the term ‘subjective’ scares many, especially those who intend to practice science by pursuing the healthy ideal of ‘objectivity’, as this term is perceived by common sense. It is, therefore, appropriate to make some clarifications on the use of this term in this context:

• ‘Subjective’ indicates that the probability assessment depends on the information status of the individual who performs it.

• ‘Subjective’ does not mean arbitrary.

The so-called ‘objectivity’, as perceived by those outside scientific research, is defined when a community of rational beings shares the same state of information. But even in this case, one should speak more properly of ‘intersubjectivity’ (i.e. the sharing, by a group, of subjective opinions).

In clinical cases — precisely because patients rarely possess advanced notions of medicine — subjective uncertainty must be considered. Living with uncertainty requires us to use a probabilistic approach.

Casuality

The casuality indicates the lack of a certain connection between cause and effect. The uncertainty of a close union between the source and the phenomenon is among the most adverse problems in determining a diagnosis.

In a clinical case a phenomenon $A(x)$ (such as for example a malocclusion, a crossbite, an openbite, etc ...) is randomly associated with another phenomenon $B(x)$ (such as TMJ bone degeneration); when there are exceptions for which the logical proposition $A(x)\rightarrow B(x)$ it's not always true (but it is most of the time), we will say that the relation $A(x)\rightarrow B(x)$ is not always true but it is probable.

«We are moving from a deterministic condition to a stochastic one.»