Medical decision making as a "historical" combination of art, statistics, experimentalism and evidence based practice

"Decision making" in many fields of human activity is often carried out in typically stressful situations and in a brief space of time. The basis of decision making has been studied under different aspects, taking mainly into account the uncertainty underlying the decision, and all the risks that every decision implies. Less attention has been paid to the criteria governing decision making. It is generally retained that decisions should be taken in the best interests of the individual, as in the medical field. With specific reference to this field, physicians are continuously urged to take decisions, in various and different contexts, with ever-present subjective evaluations, sometimes with limited health statistics, sometimes with conflicting biomedical experimentation, sometimes even without supporting scientific evidence. It is precisely for these reasons that medical decision making cannot be considered a straightforward process. By means of the elements described in this paper, and discussed using historically documented evidence, current medical decision making is here presented as a simultaneously subjective and objective complex combination of different components varying in quantity and quality: artistic, statistical, experimental and evidence based.