Abstract

Abstract Twentieth century innovations in reasoning about health and medicine (randomized clinical trials, systematic reviews, and a growing list of other inventions) have dramatically changed what counts as good argumentation within this domain. Though these new forms are often highly specialized and highly technical, they are gradually becoming “norms of public argumentation” (Zenker, et al., 2024), spreading from esoteric discussion among medical scientists into other discourses (including interpersonal exchanges between doctors and patients). This pattern is not limited to health and medicine but affects so many domains that it has become ubiquitous in contemporary argumentative discourse. But innovations aimed at improving reasonableness, when successful, can disrupt preexisting normative frameworks. They can undermine and supplant prior bases for inference, abruptly change standards for argument criticism, and require adoption of different rules for argumentative engagement. The study reported here concerns the volatility that surrounds these innovations in a case study of debate over a controversial treatment for a controversial disease. Close examination of the debate from a normative pragmatic perspective shows much greater normative complexity than has been acknowledged within contemporary argumentation theory, including unexpected volatility in norms that arguers themselves must somehow manage.

Journal
Argumentation
Published
2026-04-27
DOI
10.1007/s10503-026-09705-3
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