Case Report: What—or who—killed Frank Ramsey? Some reflections on cause of death and the nature of medical reasoning [version 1; peer review: 2 approved]

Abstract

Philosopher Frank Ramsey died in 1930 aged only 26. There has been much speculation about the nature of his final illness and the sequence of events which led to his death. To prepare this case report, we traced Ramsey’s medical records and combined them with an extensive and unique dataset of contemporaneous sources. We use these to evaluate three possible explanations for Ramsey’s illness and its unexpectedly fatal trajectory—infectious (Weil’s disease), autoimmune (primary sclerosing cholangitis) and obstructive (gallstones). We explore how uncertainty surrounding each of these possibilities might have influenced Ramsey’s doctors’ thoughts and actions, including their ill-fated decision to perform the emergency operation that appears to have precipitated his final decline. We then reflect on the unfinished opus on which Ramsey was working when he died—on the nature of truth and how humans reason under conditions of uncertainty. We end with some thoughts linking Ramsey’s death to his philosophy.

Keywords

• Weil's disease
• gallstones
• primary sclerosing cholangitis
• uncertainty
• Frank Ramsey
• eng