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== 📌 Epistemological Premise: Language Before Complex Systems ==
<blockquote>Even before addressing the definition of ''complex systems'' in medicine, it is necessary to reconsider the way we use and interpret medical language, both on the semantic and formal levels.</blockquote>In particular, the epistemic structure of medical language presents deep conceptual ambiguities: concepts such as ''disease'', ''normality'', ''function'' and ''adaptation'' are often assumed to be invariant, despite being historically and culturally determined.

As '''Kazem Sadegh-Zadeh''' emphasizes in his monumental work ''Handbook of Analytic Philosophy of Medicine'', the language of medicine is intrinsically fuzzy: many of its definitions operate on gradual and non-binary categories, where semantic imprecision is not a limitation, but a structural component of clinical knowledge.{{Tooltip|<sup>[30]</sup>|<ref>{{cita libro|autore=Sadegh-Zadeh Kazem|titolo=Handbook of Analytic Philosophy of Medicine|url=https: //link.springer.com/book/10.1007/978-94-007-2260-6|anno=2012|editore=Springer|ISBN=978-94-007-2259-0}}</ref>|<small>🧠 Medical practice is practiced morality and clinical research belongs to normative ethics. This book clarifies and develops this thesis: 1. analyzing the structure of medical language, knowledge, and theories; 2. investigating the foundations of the clinical encounter; 3. introducing the logic and methodology of clinical decision-making; 4. suggesting comprehensive theories on organism, life, and psyche; on health, disease, and pathology; on etiology, diagnosis, prognosis, prevention, and therapy; and 5. investigating the central moral and metaphysical issues in medical practice and research.</small>}}

Similarly, '''Eric Cassell''' has shown that the concept of disease cannot be reduced to either a biological dysfunction or a mere statistical deviation: it is rather the result of a semantic negotiation between patient, clinician, and cultural context.{{Tooltip|<sup>[31]</sup>|<ref>Cassell EJ. "The Nature of Suffering and the Goals of Medicine." ''The New England Journal of Medicine'', 1982. doi:10.1056/NEJM198203183061204.</ref>|<small>🧠 The issue of suffering and its relationship to organic diseases has rarely been addressed in the medical literature. This article offers a description of the nature and causes of suffering in patients undergoing medical treatment. A distinction is made, based on clinical observations, between suffering and physical discomfort. Suffering is experienced by people, not just bodies, and originates from challenges that threaten the integrity of the person as a complex social and psychological entity. Suffering can include physical pain, but it is not limited to it. The relief of suffering and the cure of disease must be considered as two complementary duties of a medical profession truly dedicated to the care of the sick. The inability of physicians to understand the nature of suffering can lead to medical intervention that (although technically adequate) not only fails to relieve suffering but becomes itself a source of suffering.</small>}}

Finally, the biopsychosocial model of '''George Engel''' proposes to interpret every clinical event within a multi-level network of meanings—biological, psychological, social, and semantic—anticipating that systemic and complex vision that is now at the center of contemporary medicine.{{Tooltip|<sup>[32]</sup>|<ref>Engel GL. "The need for a new medical model: a challenge for biomedicine." ''Science'', 1977;196(4286):129–136. doi:10.1126/science.847460.</ref>|<Small>The dominant model of disease today is biomedical, and it leaves no room within tis framework for the social, psychological, and behavioral dimensions of illness. A biopsychosocial model is proposed that provides a blueprint for research, a framework for teaching, and a design for action in the real world of health care.>/Small>}}

{{q2|Thus, only after clarifying the ''meta-linguistic'' and ''meta-conceptual'' nature of the terms we use, can we coherently and productively address the theoretical and clinical challenge of complex systems in medicine.}}

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