The Role of Metaphor

Abstract

Metaphor use in medical decisions and research is ubiquitous. Use of treatments for “off-label” indications follows as a metaphor to approved indications. Fundamentally, reasoning from a sample of patients in a clinical study to an individual patient is a form of metaphor. Hypothesis generation for hypothetico-deduction medical decisions and for the scientific method often arises from metaphors. However, metaphors are the Fallacy of Pseudotransitivity, which risks the Fallacy of Four Terms. The associated risks can be estimated from the epistemic risk in terms of epistemic distance and epistemic degrees of freedom. Metaphors can be nonlinguistic, and a particular form is the process metaphor. The source domain to explicate the target domain is a process that may never be fully realized, and thus the certainty of the metaphor stems from the process itself. Examples of process metaphors include allopathic reductionism, scientific reductionism, the Large Number Theorem of statistics, and others.