Diagnostic frameworks and nursing diagnoses: a normative stance

Diagnostic frameworks are fundamental components of many scientific and technological activities and clinical practice. We investigated the main foundational aspects of diagnostic frameworks. Three necessary components associated to any diagnosis are identified and investigated, namely: the normative dimension, the tensed structure of the diagnostic process, and the teleological perspective. The normative dimension of a diagnosis is based on : a) epistemic values when associated to Hempel’s inductive risk concerning the balance between false positive and false negative outcomes, leading to a probabilistic judgment; b) non-epistemic values when related to ideas such as wellbeing, normality, illness, etc. as an idealized norm or an ideal points of reference. We point out that medical diagnoses are in accordance with the three necessary components, while some fundamental frameworks of diagnoses – namely Gordon and NANDA’s taxonomies - in nursing lack some components. The main lacking component is the normative one, since the most popular frameworks in nursing diagnosis seem to be descriptions of observed reality rather than normative and value-based judgements where both epistemic and non-epistemic values may coexist.