Lloyd (2009) contends that climate models are confirmed by various instances of fit between their output and observational data. The present paper argues that what these instances of fit might confirm are not climate models themselves, but rather hypotheses about the adequacy of climate models for particular purposes. This required shift in thinking—from confirming climate models to confirming their adequacy-for-purpose—may sound trivial, but it is shown to complicate the evaluation of climate models considerably, both in principle and in practice.

As the federal government distributed remdesivir to some of the states COVID-19 hit hardest, policymakers scrambled to develop criteria to allocate the drug to their hospitals. Our state, Michigan, was among those states to receive an initial quantity of the drug from the U.S. government. The disparities in burden of disease in Michigan are striking. Detroit has a death rate more than three times the state average. Our recommendation to the state was that it should prioritize the communities that bear (...) a disproportionate burden of suffering in the allocation of the new potential treatment. This recommendation is justified not only for new drugs with uncertain effects, but also for drugs of certain benefit or vaccines. For states with significant health disparities, such as Michigan, this allocation priority may help to repair them. In fact, any other allocation strategy may make them worse. (shrink)

Two potentially lifesaving protocols, emergency preservation and resuscitation and uncontrolled donation after circulatory determination of death, currently implemented in some U.S. emergency departments, have similar eligibility criteria and initial technical procedures, but critically different goals. Both follow unsuccessful cardiopulmonary resuscitation and induce hypothermia to “buy time”: one in trauma patients suffering cardiac arrest, to enable surgical repair, and the other in patients who unexpectedly die in the ED, to enable organ donation. This article argues that to fulfill patient-focused fiduciary obligations (...) and maintain community trust, institutions implementing both protocols should adopt and publicize policies to guide ED physicians to utilize either protocol for particular patients, in order to address the appearance of conflict of interest arising from the protocols' similarities. It concludes by analyzing ethical implications of incentives that may influence institutions to develop the expertise required for uDCDD but not EPR. (shrink)

Patient and public involvement (PPI) has gained widespread support in health research and health policy circles, but there is little consensus on the precise meaning or justifications of PPI. We argue that an important step towards clarifying the meaning and justification for PPI is to split apart the familiar acronym and draw a distinction between patient and public involvement. Specifically, we argue that patient involvement should refer to the practice of involving individuals in health research or policy on the basis (...) of their experience with a particular condition, while public involvement should refer to the practice of involving individuals in health policy or research based on their status as members of a relevant population. Analyzing cases from the UK, Australia, and the USA, we show how our proposed distinction can deliver much needed clarity to conversations on PPI, while guiding the development and evaluation of future PPI‐based policies. (shrink)

According to an adequacy-for-purpose view, models should be assessed with respect to their adequacy or fitness for particular purposes. Such a view has been advocated by scientists and philosophers...

As a device used by scientists in the course of performing research, the digital computer might be considered a scientific instrument. But if so, what is it an instrument for? This paper explores a number of answers to this question, focusing on the use of computers in a simulating mode.

A number of recent discussions comparing computer simulation and traditional experimentation have focused on the significance of “materiality.” I challenge several claims emerging from this work and suggest that computer simulation studies are material experiments in a straightforward sense. After discussing some of the implications of this material status for the epistemology of computer simulation, I consider the extent to which materiality (in a particular sense) is important when it comes to making justified inferences about target systems on the basis (...) of experimental results. (shrink)

This paper illustrates a role that bioethics should play in developing and criticizing protocols for breast cancer genetic screening. It demonstrates how a critical bioethics, using approaches and reflecting concerns of contemporary philosophy of science and science studies, may critically interrogate the normative and conceptual schemes within which ethical considerations about such screening protocols are framed. By exploring various factors that influence the development of such protocols, including politics, cultural norms, and conceptions of disease, this paper and the critical bioethics' (...) approach it endorses illuminate and critically assess some of the competing worldviews informing protocol development. One of the frequently neglected worldviews in traditional bioethics' treatment of protocols concerning breast care is constituted by women's own views of their breasts and breast cancer, both within the technologically-oriented social practice of American medicine and in light of the social construction of their breasted experience in American society. This paper attempts to redress and critically assess this neglect on the part of traditional bioethics. Finally, in contrast to traditional bioethics, critical bioethics critically interrogates its own normative and conceptual commitments. In this final capacity, a critical bioethics' approach makes a valuable contribution to the evolution of bioethics. (shrink)

The central claim of this paper is that American states’ use of so-called “triggering conditions” to regulate surrogate decision-making authority in end-of-life care leaves unresolved a number of important ethical and legal considerations regarding the scope of that authority. The paper frames the issue with a case set in a jurisdiction in which surrogate authority to withdraw life-sustaining treatment is triggered by two specific clinical conditions. The case presents a quandary insofar as the clinical facts do not satisfy the triggering (...) conditions, and yet both the appropriate surrogates and the care team agree that withdrawal of life-sustaining treatment is in the best interest of the patient. The paper surveys applicable law across the 50 states and weighs the arguments for and against the inclusion of such triggering conditions in relevant legal regimes. The paper concludes by assessing the various legal and policy options states have for regulating surrogate decision-making authority in light of the moral considerations, and notes the possibility for conflict within ethics teams arising from the potential tension between prudence, risk-aversion, and moral obligation. (shrink)

This article explores some of the roles of computer simulation in measurement. A model-based view of measurement is adopted and three types of measurement—direct, derived, and complex—are distinguished. It is argued that while computer simulations on their own are not measurement processes, in principle they can be embedded in direct, derived, and complex measurement practices in such a way that simulation results constitute measurement outcomes. Atmospheric data assimilation is then considered as a case study. This practice, which involves combining information (...) from conventional observations and simulation-based forecasts, is characterized as a complex measuring practice that is still under development. The case study reveals challenges that are likely to resurface in other measuring practices that embed computer simulation. It is also noted that some practices that embed simulation are difficult to classify; they suggest a fuzzy boundary between measurement and non-measurement. 1 Introduction2 A Contemporary View of Measurement3 Three Types of Measurement4 Can Computer Simulations Measure Real-World Target Systems?5 Case Study: Atmospheric Data Assimilation5.1 Why data assimilation?5.2 A complex measuring practice under development5.3 Epistemic iteration6 The Boundaries of Measurement7 Epistemology, Not Terminology. (shrink)

This article identifies conditions under which robust predictive modeling results have special epistemic significance---related to truth, confidence, and security---and considers whether those conditions hold in the context of present-day climate modeling. The findings are disappointing. When today’s climate models agree that an interesting hypothesis about future climate change is true, it cannot be inferred---via the arguments considered here anyway---that the hypothesis is likely to be true or that scientists’ confidence in the hypothesis should be significantly increased or that a claim (...) to have evidence for the hypothesis is now more secure. (shrink)

We call attention to an underappreciated way in which non-epistemic values influence evidence evaluation in science. Our argument draws upon some well-known features of scientific modeling. We show that, when scientific models stand in for background knowledge in Bayesian and other probabilistic methods for evidence evaluation, conclusions can be influenced by the non-epistemic values that shaped the setting of priorities in model development. Moreover, it is often infeasible to correct for this influence. We further suggest that, while this value influence (...) is not particularly prone to the problem of wishful thinking, it could have problematic non-epistemic consequences in some cases. (shrink)

Recently a number of scientists have proposed substantial changes to the practice of climate modeling, though they disagree over what those changes should be. We provide an overview and critical examination of three leading proposals: the unified approach, the hierarchy approach and the pluralist approach. The unified approach calls for an accelerated development of high-resolution models within a seamless prediction framework. The hierarchy approach calls for more attention to the development and systematic study of hierarchies of related models, with the (...) aim of advancing understanding. The pluralist approach calls for greater diversity in modeling efforts, including, on some of its variants, more attention to empirical modeling. After identifying some of the scientific and institutional challenges faced by these proposals, we consider their expected gains and costs, relative to a business-as-usual modeling scenario.We find the proposals to be complementary, having valuable synergies. But since resource limitations make it unlikely that all three will be pursued, we offer some reflections on more limited changes in climate modeling that seem well within reach and that can be expected to yield substantial benefits. (shrink)

The theoretical foundations of climate science have received little attention from philosophers thus far, despite a number of outstanding issues. We provide a brief, non-technical overview of several of these issues – related to theorizing about climates, climate change, internal variability and more – and attempt to make preliminary progress in addressing some of them. In doing so, we hope to open a new thread of discussion in the emerging area of philosophy of climate science, focused on theoretical foundations.

For many decades, access to human biological samples, such as cells, tissues, organs, blood, and sub-cellular materials such as DNA, for use in biomedical research, has been central in understanding the nature and transmission of diseases across the globe. However, the limitations of current ethical and regulatory frameworks in sub-Saharan Africa to govern the collection, export, storage and reuse of these samples have resulted in inconsistencies in practice and a number of ethical concerns for sample donors, researchers and research ethics (...) committees. This paper examines stakeholders’ perspectives of and responses to the ethical issues arising from these research practices. (shrink)

Can computer simulation results be evidence for hypotheses about real-world systems and phenomena? If so, what sort of evidence? Can we gain genuinely new knowledge of the world via simulation? I argue that evidence from computer simulation is aptly characterized as higher-order evidence: it is evidence that other evidence regarding a hypothesis about the world has been collected. Insofar as particular epistemic agents do not have this other evidence, it is possible that they will gain genuinely new knowledge of the (...) world via simulation. I illustrate with examples inspired by uses of simulation in meteorology and astrophysics. (shrink)

Today’s most sophisticated simulation studies of future climate employ not just one climate model but a number of models. I explain why this “ensemble” approach has been adopted—namely, as a means of taking account of uncertainty—and why a comprehensive investigation of uncertainty remains elusive. I then defend a middle ground between two camps in an ongoing debate over the transformation of ensemble results into probabilistic predictions of climate change, highlighting requirements that I refer to as ownership, justification, and robustness.

Simulation-based weather and climate prediction now involves the use of methods that reflect a deep concern with uncertainty. These methods, known as ensemble prediction methods, produce multiple simulations for predictive periods of interest, using different initial conditions, parameter values and/or model structures. This paper provides a non-technical overview of current ensemble methods and considers how the results of studies employing these methods should be interpreted, paying special attention to probabilistic interpretations. A key conclusion is that, while complicated inductive arguments might (...) be given for the trustworthiness of probabilistic weather forecasts obtained from ensemble studies, analogous arguments are out of reach in the case of long-term climate prediction. In light of this, the paper considers how predictive uncertainty should be conveyed to decision makers. (shrink)

This paper critically examines Weisberg’s weighted feature matching account of model-world similarity. A number of concerns are raised, including that Weisberg provides an account of what underlies scientific judgments of relative similarity, when what is desired is an account of the sorts of model-target similarities that are necessary or sufficient for achieving particular types of modeling goal. Other concerns relate to the details of the account, in particular to the content of feature sets, the nature of shared features and the (...) assumed independence of feature weightings. (shrink)

Candidate evaluation for breast implantation presents a more important obstacle to the fulfillment of the normative requirements of informed consent than do the social roles of women or cultural norms governing female beauty. I argue that women's decisions to receive breast implants may indeed be informed, competently made, and substantially voluntary, but that the cultural construction of beauty may undermine women's autonomy by influencing the evaluation of surgical candidates and risk disclosure during informed consent.

ABSTRACT:Drawing on insights from feminist epistemology and experience in genomics-related bioethics research, this essay offers three suggestions that may enable bioethics to contribute more persuasively to urgent issues affecting the health and well-being of individuals, communities, and the world they inhabit. First, it suggests that bioethics pay more attention to people's feelings, particularly those that help constitute their self-identities, and to the role of those feelings in their health-relevant behaviors. Further, it proposes conceiving of health-relevant behaviors expansively. Second, it suggests (...) that bioethics advocate for a longer time horizon for the conduct of empirical bioethics research and other types of research addressing complex, systemic factors influencing health. Third, it suggests that bioethics play a larger role in illuminating and applauding the evolving nature of scientific knowledge. (shrink)

After showing how Deborah Mayo’s error-statistical philosophy of science might be applied to address important questions about the evidential status of computer simulation results, I argue that an error-statistical perspective offers an interesting new way of thinking about computer simulation models and has the potential to significantly improve the practice of simulation model evaluation. Though intended primarily as a contribution to the epistemology of simulation, the analysis also serves to fill in details of Mayo’s epistemology of experiment.

Allan Franklin has identified a number of strategies that scientists use to build confidence in experimental results. This paper shows that Franklin's strategies have direct analogues in the context of computer simulation and then suggests that one of his strategies—the so-called 'Sherlock Holmes' strategy—deserves a privileged place within the epistemologies of experiment and simulation. In particular, it is argued that while the successful application of even several of Franklin's other strategies (or their analogues in simulation) may not be sufficient for (...) justified belief in results, the successful application of a slightly elaborated version of the Sherlock Holmes strategy is sufficient. (shrink)

Climate change fingerprint studies investigate the causes of recent climate change. I argue that these studies have much in common with Steel’s (2008) streamlined comparative process tracing, illustrating a mechanisms-based approach to extrapolation in which the mechanisms of interest are simulated rather than physically instantiated. I then explain why robustness and variety-of-evidence considerations turn out to be important for understanding the evidential value of climate change fingerprint studies.

Aims: To describe individuals’ perceptions of the activities that take place within the cancer genetics clinic, the relationships between these activities and how these relationships are sustained. Design: Qualitative interview study. Participants: Forty individuals involved in carrying out cancer genetics research in either a clinical (n = 28) or research-only (n = 12) capacity in the UK. Findings: Interviewees perceive research and clinical practice in the subspecialty of cancer genetics as interdependent. The boundary between research and clinical practice is described (...) as vague or blurred, and this ambiguity is regarded as being sustained by a range of methodological, ethical and economic factors. The implications of these findings for the “therapeutic misconception” are explored. It is argued that while research participation is seen as having therapeutic benefit for individual patients, the interviewees are not labouring under any misconceptions about the relationship between research and clinical care. It is suggested that concepts such as the “therapeutic misconception” may have less relevance in highly technological specialities that are characterised by a developing evidence base. (shrink)

In 1904, Norwegian physicist Vilhelm Bjerknes published what would become a landmark paper in the history of meteorology. In that paper, he proposed that daily weather forecasts could be made by calculating later states of the atmosphere from an earlier state using the laws of hydrodynamics and thermodynamics (Bjerknes 1904). He outlined a set of differential equations to be solved and advocated the development of graphical and numerical solution methods, since analytic solution was out of the question. Using these theory-based (...) equations to produce daily forecasts, however, turned out to be more difficult than anticipated. Graphical solution techniques had limited success, and a first attempt to use .. (shrink)

Design: Qualitative interview study. Participants: Fifty-nine patients with a family history of cancer who attend a regional cancer genetics clinic in the UK were interviewed about their current and previous research experiences. Findings: Interviewees gave a range of explanations for research participation. These were categorised as social—research participation benefits the wider society by progressing science and improving treatment for everyone; familial—research participation may improve healthcare and benefit current or future generations of the participant’s family; and personal—research participation provides therapeutic or (...) non-therapeutic benefits for oneself. Conclusions: We discuss the distinction drawn between motives for research participation focused upon self and others, and observe that personal, social and familial motives can be seen as interdependent. For example, research participation that is undertaken to benefit others, particularly relatives, may also offer a number of personal benefits for self, such as enabling participants to feel that they have discharged their social or familial obligations. We argue for the need to move away from simple, static, individualised notions of research participation to a more complex, dynamic and inherently social account. (shrink)

An uncertainty report describes the extent of an agent’s uncertainty about some matter. We identify two basic requirements for uncertainty reports, which we call faithfulness and completeness. We then discuss two pitfalls of uncertainty assessment that often result in reports that fail to meet these requirements. The first involves adopting a one-size-fits-all approach to the representation of uncertainty, while the second involves failing to take account of the risk of surprises. In connection with the latter, we respond to the objection (...) that it is impossible to account for the risk of genuine surprises. After outlining some steps that both scientists and the bodies who commission uncertainty assessments can take to help avoid these pitfalls, we explain why striving for faithfulness and completeness is important. (shrink)

This chapter identifies conditions under which robust predictive modeling results have special epistemic significance—related to truth, confidence, and security—and considers whether those conditions are met in the context of climate modeling today. The findings are disappointing. When today’s climate models agree that an interesting hypothesis about future climate change is true, it cannot be inferred, via the arguments considered here anyway, that the hypothesis is likely to be true, nor that confidence in the hypothesis should be significantly increased, nor that (...) a claim to have evidence for the hypothesis is now more secure. In some other modeling contexts, the prospects for such arguments are brighter. (shrink)

Only a decade ago, the topic of scientific understanding remained one that philosophers of science largely avoided. Earlier discussions by Hempel and others had branded scientific understanding a mere subjective state or feeling, one to be studied by psychologists perhaps, but not an important or fruitful focus for philosophers of science. Even as scientific explanation became a central topic in philosophy of science, little attention was given to understanding. Over the last decade, however, this situation has changed. Analyses of scientific (...) understanding that do not treat it as a subjective state or feeling have been offered and debated, and both the epistemic value and the pitfalls of purported psychological .. (shrink)

In late December 1998, Renada Daniel-Patterson's father offered to donate a kidney to his daughter and ignited a controversy in the bioethics community. Renada had been born with only one kidney, which began to fail early in her childhood. At age 6, Renada had to receive dialysis three times a week. She was unable to attend school or venture very far from home. This pattern continued until Renada was 13, when Mr. Patterson called from prison to offer her his kidney. (...) Renada was surprised to hear from her father, who was serving 12 years at California State Prison for burglary and drug convictions. Mr. Patterson was determined to be a compatible donor, and the family proceeded with the transplant operation. As a result of this surgery, Renada was able to live the life of a healthy girl for 2 years. Because the medication to prevent rejection of the transplanted organ made her feel ill and bloated and caused her to develop a hump on her back, Renada gradually began to skip doses. As a result, her donated kidney began to fail. It was under these circumstances that David Patterson offered to donate his second kidney to his daughter in 1998. (shrink)

Aims: To assess patient receipt of written information. To ensure patients understand the written information about a resuscitation policy and to determine whether they disapproved of or had concerns about the policy. Methods: All admissions to four wards of the hospital were approached for an interview. A set questionnaire was asked by one of 2 interviewers. Results: 72% of 572 admissions were interviewed. Refusal accounted for only 2 of the people not interviewed. 11% were unable to advocate for themselves by (...) reason of mental incompetence, inability to communicate or impairment secondary to their illness. Of the 401 interviewed only 49% recalled receiving the patient information booklet. Few patients (17%) recalled reading the information in the patient information booklet. They were all then given the paragraph about the hospital’s resuscitation policy. 352 were asked their understanding and only 61% demonstrated that they understood the paragraph. 91% of all 401 patients approved of the hospital having the option of DNR orders. 31% of people however had concerns related to DNR orders. These are discussed. Conclusions: Many acutely unwell patients are unable to advocate for themselves. Written information is a poor method of communicating with patients. There was limited receipt of the information and many misunderstood the paragraph about the hospitals resuscitation policy. There was a wide range of patient thoughts and concerns expressed. (shrink)

Implementation of guidelines regarding breaches of electronic health information requires an anticipatory stance and physician and patient education regarding security and monitoring measures and methods of redress. Adopting a preventive ethics, rather than a crisis management, model may also increase physician awareness of how the information they choose to include and privilege within the health record may expose patients to added harms if not done mindfully.