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  1. Conceptual Engineering of Medical Concepts.Elisabetta Lalumera - forthcoming - In Manuel Gustavo Isaac, Kevin Scharp & Steffen Koch (eds.), New Perspectives on Conceptual Engineering. Synthese Library.
    There is a lot of conceptual engineering going on in medical research. I substantiate this claim with two examples, the medical debate about cancer classification and about obesity as a disease I also argue that the proper target of conceptual engineering in medical research are experts’ conceptions. These are explicitly written down in documents and guidelines, and they bear on research and policies. In the second part of the chapter, I propose an externalist framework in which conceptions have both the (...)
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  2. Against Evidential Pluralism in Pharmaceutical Regulation.Doohyun Sung & Bennett Holman - forthcoming - Philosophy of Science:1-16.
    We examine arguments regarding the use of mechanistic evidence in assessing treatment efficacy and find that advocates and critics of EBM+ have largely been talking past each other due to a difference in focus. We explore aducanumab for the treatment of Alzheimer’s disease as a case which may speak to the role of EBM+ in pharmaceutical regulation. The case suggests the debate may be more fruitful if philosophers confine debates to particular domains of medicine and weigh in prospectively instead of (...)
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  3. Tıbbi, Dini ve Etik Boyutlarıyla Genetik.Maide Baris & Orhan Onder (eds.) - 2024 - Istanbul: İsar Yayinlari.
    Genetics: Medical, Theological and Ethical Aspects Tibbi, Dini ve Etik Boyutlariyla Genetik -/- Genetik bilimi biyolojinin botanik ve zooloji alanındaki uygulamalarını aşarak, sınırlarını önce antropolojiye sonra tıbba doğru hızla genişletmiştir. Öyle ki artık biyokimyadan onkolojiye kadar neredeyse tüm biyomedikal disiplinler, genetiğin kavramları, ilkeleri ve metodolojisi ile aşılanmıştır. Modern tıbbın uygulama alanında geniş bir yer tutan genetik bilimi, bir hastalığa dair risk analizi, teşhis ve tedavi seçeneklerinin belirlenmesi, prognozun değerlendirilmesi gibi klinik uygulamanın farklı evrelerinde söz sahibi olmaktadır. İçinde bulunduğumuz 21. yüzyılda (...)
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  4. Navigating pharmacoeconomics in Libya: Our current landscape.Ramadan M. Elkalmi - 2024 - Mediterranean Journal of Pharmacy and Pharmaceutical Sciences 4 (3):39-40.
    Pharmacoeconomics (PE) is a relatively newly developed and fast-changing discipline [1]. PE plays a crucial role in healthcare decision-making by evaluating the costs and outcomes of different treatment options. In Libya, however, the implementation of PE evaluations faces various challenges that hinder its effective integration into healthcare systems. This communication analyses the current needs and prospects of PE by examining the challenges in its implementation, the benefits of integrating it into healthcare decision-making, and strategies to enhance its utilization in the (...)
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  5. Bodies of evidence: The ‘Excited Delirium Syndrome’ and the epistemology of cause-of-death inquiry.Enno Fischer & Saana Jukola - 2024 - Studies in History and Philosophy of Science 104 (C):38-47.
    “Excited Delirium Syndrome” (ExDS) is a controversial diagnosis. The supposed syndrome is sometimes considered to be a potential cause of death. However, it has been argued that its sole purpose is to cover up excessive police violence because it is mainly used to explain deaths of individuals in custody. In this paper, we examine the epistemic conditions giving rise to the controversial diagnosis by discussing the relation between causal hypotheses, evidence, and data in forensic medicine. We argue that the practitioners’ (...)
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  6. Unveiling the interplay between evidence, values and cognitive biases. The case of the failure of the AstraZeneca COVID‐19 vaccine.Cristina Amoretti & Elisabetta Lalumera - 2023 - Journal of Evaluation in Clinical Practice 1.
  7. Consideraciones sobre la relación mente-cuerpo en el proceso del parto.Virginia Ballesteros - 2023 - Eikasia Revista de Filosofía 114:57-73.
    Analizo algunos aspectos clave del modelo médico del parto, centrándome especialmente en los presupuestos que parece albergar sobre la relación mente-cuerpo. En primer lugar, examino las visiones del modelo médico como un modelo dualista ontológico. En contra de las críticas habituales a este dualismo, que sostienen que ha llevado a tratar el cuerpo de parto como una máquina, defiendo que el problema no reside en el propio dualismo, sino en que se obvia la interacción mente-cuerpo: son las propias personas de (...)
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  8. Probability and Informed Consent.Nir Ben-Moshe, Benjamin A. Levinstein & Jonathan Livengood - 2023 - Theoretical Medicine and Bioethics 44 (6):545-566.
    In this paper, we illustrate some serious difficulties involved in conveying information about uncertain risks and securing informed consent for risky interventions in a clinical setting. We argue that in order to secure informed consent for a medical intervention, physicians often need to do more than report a bare, numerical probability value. When probabilities are given, securing informed consent generally requires communicating how probability expressions are to be interpreted and communicating something about the quality and quantity of the evidence for (...)
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  9. Defining Function in Medicine: Bridging the Gap between Biology and Clinical Practice.Alberto Molina-Pérez - 2023 - American Journal of Bioethics Neuroscience 14 (3):282-285.
    The classification of preserved hypothalamic activity in brain death and brainstem death as functional or non-functional has become a subject of debate. While proponents of the neurological criterion claim that these activities lack functional significance (Shemie et al. 2014), Nair-Collins and Joffe (2023) argue for their functional physiological role. However, the interpretation of the term "function" within the medico-legal framework, where death is characterized by the irreversible cessation of all brain functions, remains unclear. -/- My intention here is not to (...)
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  10. Approaching diagnostic messiness through spiderweb strategies: Connecting epistemic practices in the clinic and the laboratory.Helene Scott-Fordsmand & Karin Tybjerg - 2023 - Studies in History and Philosophy of Science Part A 102 (C):12-21.
    Scientific and medical practice both relate to and differ from each other, as do discussions of how to handle decisions under uncertainty in the laboratory and clinic respectively. While studies of science have pointed out that scientific practice is more complex and messier than dominant conceptions suggest, medical practice has looked to the rigour of scientific and statistical methods to address clinical uncertainty. In this article, we turn to epistemological studies of the laboratory to highlight how clinical practice already has (...)
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  11. Simulation of Trial Data to Test Speculative Hypotheses about Research Methods.Hamed Tabatabaei Ghomi & Jacob Stegenga - 2023 - In Kristien Hens & Andreas de Block (eds.), Advances in experimental philosophy of medicine. New York: Bloomsbury Academic. pp. 111-128.
  12. Reviewing the Reproduction Number R in Covid-19 Models.Maria Cristina Amoretti & Elisabetta Lalumera - 2022 - Philosophy of Medicine 3 (1).
    Most of the epidemiological models of the Covid-19 pandemic contain the reproduction number as a parameter. In this article we focus on some shortcomings regarding its role in driving health policies and political decisions. First, we summarize what R is and what it is used for. Second, we introduce a three-question matrix for the evaluation of any construct or parameter within a model. We then review the main literature about R to highlight some of its shortcomings and apply to them (...)
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  13. Specificity of association in epidemiology.Thomas Blanchard - 2022 - Synthese 200 (6).
    The epidemiologist Bradford Hill famously argued that in epidemiology, specificity of association (roughly, the fact that an environmental or behavioral risk factor is associated with just one or at most a few medical outcomes) is strong evidence of causation. Prominent epidemiologists have dismissed Hill’s claim on the ground that it relies on a dubious `one-cause one effect’ model of disease causation. The paper examines this methodological controversy, and argues that specificity considerations do have a useful role to play in causal (...)
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  14. Holism and Reductionism in the Illness/Disease Debate.Marco Buzzoni, Luigi Tesio & Michael T. Stuart - 2022 - In Shyam Wuppuluri & Ian Stewart (eds.), From Electrons to Elephants and Elections: Saga of Content and Context. Springer. pp. 743-778.
    In the last decades it has become clear that medicine must find some way to combine its scientific and humanistic sides. In other words, an adequate notion of medicine requires an integrative position that mediates between the analytic-reductionist and the normative-holistic tendencies we find therein. This is especially important as these different styles of reasoning separate “illness” (something perceived and managed by the whole individual in concert with their environment) and “disease” (a “mechanical failure” of a biological element within the (...)
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  15. Reframing the environment in data-intensive health sciences.Stefano Canali & Sabina Leonelli - 2022 - Studies in History and Philosophy of Science Part A 93:203-214.
    In this paper, we analyse the relation between the use of environmental data in contemporary health sciences and related conceptualisations and operationalisations of the notion of environment. We consider three case studies that exemplify a different selection of environmental data and mode of data integration in data-intensive epidemiology. We argue that the diversification of data sources, their increase in scale and scope, and the application of novel analytic tools have brought about three significant conceptual shifts. First, we discuss the EXPOsOMICS (...)
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  16. Inconvenient Truth and Inductive Risk in Covid-19 Science.Eli I. Lichtenstein - 2022 - Philosophy of Medicine 3 (1):1-25.
    To clarify the proper role of values in science, focusing on controversial expert responses to Covid-19, this article examines the status of (in)convenient hypotheses. Polarizing cases like health experts downplaying mask efficacy to save resources for healthcare workers, or scientists dismissing “accidental lab leak” hypotheses in view of potential xenophobia, plausibly involve modifying evidential standards for (in)convenient claims. Societies could accept that scientists handle (in)convenient claims just like nonscientists, and give experts less political power. Or societies could hold scientists to (...)
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  17. Brain Death Debates: From Bioethics to Philosophy of Science.Alberto Molina-Pérez - 2022 - F1000Research 11:195.
    50 years after its introduction, brain death remains controversial among scholars. The debates focus on one question: is brain death a good criterion for determining death? This question has been answered from various perspectives: medical, metaphysical, ethical, and legal or political. Most authors either defend the criterion as it is, propose some minor or major revisions, or advocate abandoning it and finding better solutions to the problems that brain death was intended to solve when it was introduced. Here I plead (...)
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  18. 143 An ethical analysis of evidence-based medicine.Wesley J. Park - 2022 - BMJ Evidence-Based Medicine 27 (Suppl 2):A12.
    Evidence-based medicine is a clinical decision making framework which makes claims about what physicians ought to do. Though heralded as the cutting edge of medical science evidence-based medicine is a value laden normative theory which implicitly depends on substantive views regarding what is morally good or right. In this paper, I provide an ethical analysis of evidence-based medicine. I consider its normative underpinnings in three ethical theories: utilitarianism, Kantian deontology, and virtue ethics. In the face of uncertainty, evidence-based medicine endorses (...)
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  19. Relaxing Mask Mandates in New Jersey: A Tale of Two Universities.Wesley J. Park - 2022 - Voices in Bioethics 8.
    The ethical question is whether university mask mandates should be relaxed. I argue that the use of face masks by healthy individuals has uncertain benefits, which potential harms may outweigh, and should therefore be voluntary. Systematic reviews by the World Health Organization (WHO) and Cochrane Acute Respiratory Infections concluded that the use of face masks by healthy individuals in the community lacks effectiveness in reducing viral transmission based on moderate-quality evidence. The only two randomized controlled trials of face masks published (...)
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  20. 16 The logic of lockdowns: a game of modeling and evidence.Wesley J. Park - 2022 - BMJ Evidence-Based Medicine 27 (Suppl 1):A59.
    Lockdowns, or modern quarantines, involve the use of novel restrictive non-pharmaceutical interventions (NPIs) to suppress the transmission of COVID-19. In this paper, I aim to critically analyze the emerging history and philosophy of lockdowns, with an emphasis on the communication of health evidence and risk for informing policy decisions. I draw a distinction between evidence-based and modeling-based decision-making. I argue that using the normative framework of evidence-based medicine would have recommended against the use of lockdowns. I first review the World (...)
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  21. COVID-19 and the unseen pandemic of child abuse.Wesley J. Park & Kristen A. Walsh - 2022 - BMJ Paediatrics Open 6 (1).
    For children, the collateral damage of the COVID-19 pandemic response has been considerable. In this paper, we use the framework of evidence-based medicine to argue that child abuse is another negative side effect of COVID-19 lockdowns. While it was certain that school closures would have profound social and economic costs, it remains uncertain whether they have any effect on COVID-19 transmission. There is emerging evidence that lockdowns significantly worsened child abuse on a global scale. Low-income and middle-income countries are particularly (...)
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  22. Evidence of effectiveness.Jacob Stegenga - 2022 - Studies in History and Philosophy of Science Part A 91 (C):288-295.
    There are two competing views regarding the role of mechanistic knowledge in inferences about the effectiveness of interventions. One view holds that inferences about the effectiveness of interventions should be based only on data from population-level studies (often statistical evidence from randomised trials). The other view holds that such inferences must be based in part on mechanistic evidence. The competing views are local principles of inference, the plausibility of which can be assessed by a more general normative principle of inference. (...)
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  23. Red herrings about relative measures: A response to Hoefer and Krauss.Jacob Stegenga - 2022 - Studies in History and Philosophy of Science Part A 92 (C):56-59.
  24. Broadening the scope of our understanding of mechanisms: lessons from the history of the morning-after pill.Christopher ChoGlueck - 2021 - Synthese 198 (3):2223-2252.
    Philosophers of science and medicine now aspire to provide useful, socially relevant accounts of mechanism. Existing accounts have forged the path by attending to mechanisms in historical context, scientific practice, the special sciences, and policy. Yet, their primary focus has been on more proximate issues related to therapeutic effectiveness. To take the next step toward social relevance, we must investigate the challenges facing researchers, clinicians, and policy makers involving values and social context. Accordingly, we learn valuable lessons about the connections (...)
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  25. Causal Inference from Noise.Nevin Climenhaga, Lane DesAutels & Grant Ramsey - 2021 - Noûs 55 (1):152-170.
    "Correlation is not causation" is one of the mantras of the sciences—a cautionary warning especially to fields like epidemiology and pharmacology where the seduction of compelling correlations naturally leads to causal hypotheses. The standard view from the epistemology of causation is that to tell whether one correlated variable is causing the other, one needs to intervene on the system—the best sort of intervention being a trial that is both randomized and controlled. In this paper, we argue that some purely correlational (...)
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  26. Wishful Intelligibility, Black Boxes, and Epidemiological Explanation.Marina DiMarco - 2021 - Philosophy of Science 88 (5):824-834.
    Epidemiological explanation often has a “black box” character, meaning the intermediate steps between cause and effect are unknown. Filling in black boxes is thought to improve causal inferences by making them intelligible. I argue that adding information about intermediate causes to a black box explanation is an unreliable guide to pragmatic intelligibility because it may mislead us about the stability of a cause. I diagnose a problem that I call wishful intelligibility, which occurs when scientists misjudge the limitations of certain (...)
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  27. Questioning the Consensus on Placebo and Nocebo Effects.Doug Hardman, Phil Hutchinson & Giulio Ongaro - 2021 - Psychotherapy and Psychosomatics 90 (3):211–212.
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  28. Philosophy of Advanced medical Imaging.Elisabetta Lalumera & Stefano Fanti - 2021 - Springer International.
    This is the first book to explore the epistemology and ethics of advanced imaging tests, in order to improve the critical understanding of the nature of knowledge they provide and the practical consequences of their utilization in healthcare. Advanced medical imaging tests, such as PET and MRI, have gained center stage in medical research and in patients’ care. They also increasingly raise questions that pertain to philosophy: What is required to be an expert in reading images? How are standards for (...)
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  29. Reliability of molecular imaging diagnostics.Elisabetta Lalumera, Stefano Fanti & Giovanni Boniolo - 2021 - Synthese (S23):5701-5717.
    Advanced medical imaging, such as CT, fMRI and PET, has undergone enormous progress in recent years, both in accuracy and utilization. Such techniques often bring with them an illusion of immediacy, the idea that the body and its diseases can be directly inspected. In this paper we target this illusion and address the issue of the reliability of advanced imaging tests as knowledge procedures, taking positron emission tomography in oncology as paradigmatic case study. After individuating a suitable notion of reliability, (...)
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  30. Causation and Causal Selection in the Biopsychosocial Model of Health and Disease.Hane Htut Maung - 2021 - European Journal of Analytic Philosophy 17 (2):5-27.
    In The Biopsychosocial Model of Health and Disease, Derek Bolton and Grant Gillett argue that a defensible updated version of the biopsychosocial model requires a metaphysically adequate account of disease causation that can accommodate biological, psychological, and social factors. This present paper offers a philosophical critique of their account of biopsychosocial causation. I argue that their account relies on claims about the normativity and the semantic content of biological information that are metaphysically contentious. Moreover, I suggest that these claims are (...)
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  31. Being Seen by the Doctor: A Meditation on Power, Institutional Racism, and Medical Ethics.Bryan Mukandi - 2021 - Journal of Bioethical Inquiry 18 (1):33-44.
    The following pages sketch the outlines of “a Canaanite reading” of the health system. Beginning with the Black person—African, Afro-diasporic, Aboriginal, and Torres Strait Islander—who is seen by a health professional, the functions and effects of the racializing gaze are examined. I wrestle with Al Saji’s understanding of “colonial disregard,” Whittaker’s insights into the extractive disposition of settler institutions vis-à-vis Indigenous peoples, and Saidiya Hartman and Fred Moten’s struggle with the spectacular. This leads me to conclude that the situation of (...)
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  32. Evidence, Defeasibility, and Metaphors in Diagnosis and Diagnosis Communication.Pietro Salis & Francesca Ervas - 2021 - Topoi 40 (2):327–341.
    The paper investigates the epistemological and communicative competences the experts need to use and communicate evidence in the reasoning process leading to diagnosis. The diagnosis and diagnosis communication are presented as intertwined processes that should be jointly addressed in medical consultations, to empower patients’ compliance in illness management. The paper presents defeasible reasoning as specific to the diagnostic praxis, showing how this type of reasoning threatens effective diagnosis communication and entails that we should understand diagnostic evidence as defeasible as well. (...)
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  33. The Quest for System-Theoretical Medicine in the COVID-19 Era.Felix Tretter, Olaf Wolkenhauer, Michael Meyer-Hermann, Johannes W. Dietrich, Sara Green, James Marcum & Wolfram Weckwerth - 2021 - Frontiers in Medicine 8:640974.
    Precision medicine and molecular systems medicine (MSM) are highly utilized and successful approaches to improve understanding, diagnosis, and treatment of many diseases from bench-to-bedside. Especially in the COVID-19 pandemic, molecular techniques and biotechnological innovation have proven to be of utmost importance for rapid developments in disease diagnostics and treatment, including DNA and RNA sequencing technology, treatment with drugs and natural products and vaccine development. The COVID-19 crisis, however, has also demonstrated the need for systemic thinking and transdisciplinarity and the limits (...)
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  34. Were Lockdowns Justified? A Return to the Facts and Evidence.Philippe van Basshuysen & Lucie White - 2021 - Kennedy Institute of Ethics Journal 31 (4):405-428.
    Were governments justified in imposing lockdowns to contain the spread of the COVID-19 pandemic? We argue that a convincing answer to this question is to date wanting, by critically analyzing the factual basis of a recent paper, “How Government Leaders Violated Their Epistemic Duties During the SARS-CoV-2 Crisis” (Winsberg et al. 2020). In their paper, Winsberg et al. argue that government leaders did not, at the beginning of the pandemic, meet the epistemic requirements necessitated to impose lockdowns. We focus on (...)
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  35. The Epistemic Duties of Philosophers: An Addendum.Philippe van Basshuysen & Lucie White - 2021 - Kennedy Institute of Ethics Journal 31 (4):447-451.
    We were slightly concerned, upon having read Eric Winsberg, Jason Brennan and Chris Surprenant’s reply to our paper “Were Lockdowns Justified? A Return to the Facts and Evidence”, that they may have fundamentally misunderstood the nature of our argument, so we issue the following clarification, along with a comment on our motivations for writing such a piece, for the interested reader.
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  36. The case as a travelling genre.Maria Böhmer - 2020 - History of the Human Sciences 33 (3-4):111-128.
    This contribution explores how Forrester’s work on cases has opened up an arena that might be called ‘the medical case as a travelling genre’. Although usually focused on the course of disease in an individual patient and authored mostly by one medical author, medical case histories have a social dimension: Once published, they often circulate in networks of scholars. Moreover, scholars of the history of literature have shown that numerous medical cases seem to travel easily beyond the context of medical (...)
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  37. Making evidential claims in epidemiology: Three strategies for the study of the exposome.Stefano Canali - 2020 - Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences 82:101248.
    How is scientific data used to represent phenomena and as evidence for claims about phenomena? In this paper, I propose that a specific type of claims – evidential claims – is involved in data practices to define and restrict the representational and evidential content of a dataset. I present an account of data practices in the epidemiology of the exposome based on the notion of evidential claims, which helps unpack the approaches, assumptions and warrants that connect different stages of research. (...)
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  38. Clinical Reasoning: Knowledge, Uncertainty, and Values in Health Care.Daniele Chiffi - 2020 - Cham: Springer.
    This book offers a philosophically-based, yet clinically-oriented perspective on current medical reasoning aiming at 1) identifying important forms of uncertainty permeating current clinical reasoning and practice 2) promoting the application of an abductive methodology in the health context in order to deal with those clinical uncertainties 3) bridging the gap between biomedical knowledge, clinical practice, and research and values in both clinical and philosophical literature. With a clear philosophical emphasis, the book investigates themes lying at the border between several disciplines, (...)
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  39. Scientific Perspectivism and psychiatric diagnoses: respecting history and constraining relativism.Sam Fellowes - 2020 - European Journal for Philosophy of Science 11 (1):1-24.
    Historians and sociologists of psychiatry often claim that psychiatric diagnoses are discontinuous. That is, a particular diagnoses will be described in one way in one era and described quite differently in a different era. Historians and sociologists often draw epistemic consequences from such discontinuities, claiming that truth is pluralistic, provisional and historicised. These arguments do not readily fit in with how analytical philosophers of science approach scientific realism. I show how the pessimistic meta induction does not capture the point which (...)
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  40. If p 0, then 1: The impossibility of thinking out cases.Michael J. Flexer - 2020 - History of the Human Sciences 33 (3-4):175-197.
    Forrester’s proposed seventh style of reasoning – thinking in cases – functions as an analogous, dyadic relationship that, whilst indebted philosophically to the logical reasoning and semiotics of Charles Peirce, is prone to creating feedback loops between induction and deduction, precluding novel abductive hypotheses from advancing medical knowledge. Reasoning with a Peircean triadic model opens up the contexts and methods of meaning-making and reasoning through medical cases, and the potent influence of their genre conventions, to intellectual critical scrutiny. Vitally, it (...)
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  41. Medical Nihilism by Jacob Stegenga: What is the right dose? [REVIEW]Jonathan Fuller - 2020 - Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences 81.
  42. The Role of Evidence in Chronic Care Decision-Making.Fabrizio Macagno & Sarah Bigi - 2020 - Topoi 40 (2):343-358.
    In the domain of medical science, factual evidence is usually considered as the criterion on which to base decisions and construct hypotheses. Evidence-based medicine is the translation of this approach into the field of patient care, and it means providing only the type of care that is based on evidence that proves its effectiveness and appropriateness. However, while the literature has focused on the types and force of evidence used to establish the recommendation and treatment guidelines, the problem of how (...)
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  43. Death Determination and Clinicians’ Epistemic Authority.Alberto Molina-Pérez & Gonzalo Díaz-Cobacho - 2020 - American Journal of Bioethics 20 (6):44-47.
    Requiring family authorization for apnea testing subtracts health professionals control over death determination, a procedure that has traditionally been considered a matter of clinical expertise alone. In this commentary, we first provide evidence showing that health professionals’ (HPs) disposition to act on death determination without family’s prior consent could be much lower than that referred to by Berkowitz and Garrett (2020). We hypothesize that HPs may have reservations about their own expertise as regards death, and may thus hesitate to impose (...)
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  44. COVID-19 and Control: An Essay from a Pragmatic Perspective on Science.Tuomas K. Pernu - 2020 - Multidisciplinary Perspectives on the COVID-19 Pandemic.
    The COVID-19 pandemic has demonstrated how different (even conflicting) interventions on nature can be scientifically justified: interventions can be deemed "effective" only in relation to specific target variables - in relation to variables the values of which we seek to control. Choosing the "right" target variables, in turn, depends on our values and pragmatic aims. This essay is based on a presentation given at the symposium "Multidisciplinary Perspectives on the COVID-19 Pandemic", organised at the Helsinki Collegium for Advanced Studies on (...)
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  45. Experiential knowledge in clinical medicine: use and justification.Mark R. Tonelli & Devora Shapiro - 2020 - Theoretical Medicine and Bioethics 41 (2):67-82.
    Within the evidence-based medicine construct, clinical expertise is acknowledged to be both derived from primary experience and necessary for optimal medical practice. Primary experience in medical practice, however, remains undervalued. Clinicians’ primary experience tends to be dismissed by EBM as unsystematic or anecdotal, a source of bias rather than knowledge, never serving as the “best” evidence to support a clinical decision. The position that clinical expertise is necessary but that primary experience is untrustworthy in clinical decision-making is epistemically incoherent. Here (...)
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  46. Evidence amalgamation, plausibility, and cancer research.Marta Bertolaso & Fabio Sterpetti - 2019 - Synthese 196 (8):3279-3317.
    Cancer research is experiencing ‘paradigm instability’, since there are two rival theories of carcinogenesis which confront themselves, namely the somatic mutation theory and the tissue organization field theory. Despite this theoretical uncertainty, a huge quantity of data is available thanks to the improvement of genome sequencing techniques. Some authors think that the development of new statistical tools will be able to overcome the lack of a shared theoretical perspective on cancer by amalgamating as many data as possible. We think instead (...)
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  47. Drug Labels and Reproductive Health: How Values and Gender Norms Shape Regulatory Science at the FDA.Christopher ChoGlueck - 2019 - Dissertation, Indiana University
    The US Food and Drug Administration (FDA) is fraught with controversies over the role of values and politics in regulatory science, especially with drugs in the realm of reproductive health. Philosophers and science studies scholars have investigated the ways in which social context shapes medical knowledge through value judgments, and feminist scholars and activists have criticized sexism and injustice in reproductive medicine. Nonetheless, there has been no systematic study of values and gender norms in FDA drug regulation. I focus on (...)
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  48. Moral Normative Force and Clinical Ethics Expertise.Parker Crutchfield - 2019 - American Journal of Bioethics 19 (11):89-91.
    Brummett and Salter propose a useful and timely taxonomy of clinical ethics expertise (2019). As the field becomes further “professionalized” this taxonomy is important, and the core of it is right. It needs some refinement around the edges, however. In their conclusion, Brummett and Salter rightly point out that there is a significant difference between the ethicist whose recommendations are procedure- and process-heavy, consensus-driven, and dialogical and the authoritarian ethicist whose recommendations flow from “private moral views” (Brummett and Salter, 2019). (...)
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  49. How do medical researchers make causal inferences?Olaf Dammann, Ted Poston & Paul Thagard - 2019 - In Kevin McCain (ed.), What is Scientific Knowledge?: An Introduction to Contemporary Epistemology of Science. New York: Routledge.
    Bradford Hill (1965) highlighted nine aspects of the complex evidential situation a medical researcher faces when determining whether a causal relation exists between a disease and various conditions associated with it. These aspects are widely cited in the literature on epidemiological inference as justifying an inference to a causal claim, but the epistemological basis of the Hill aspects is not understood. We offer an explanatory coherentist interpretation, explicated by Thagard's ECHO model of explanatory coherence. The ECHO model captures the complexity (...)
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  50. Fanti, S., Oyen, W., & Lalumera, E. (2019). Consensus Procedures in Oncological Imaging: The Case of Prostate Cancer.Stefano Fanti, Wim Oyen & Elisabetta Lalumera - 2019 - Cancers 11:1178-1190.
    Recently, there has been increasing interest in methodological aspects of advanced imaging, including the role of guidelines, recommendations, and experts’ consensus, the practice of self-referral, and the risk of diagnostic procedure overuse. In a recent Delphi study of the European Association for Nuclear Medicine (EANM), panelists were asked to give their opinion on 47 scientific questions about imaging in prostate cancer. Nine additional questions exploring the experts’ attitudes and opinions relating to the procedure of consensus building itself were also included. (...)
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