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The Philosophy of Evidence-Based Medicine

Wiley-Blackwell, Bmj Books (2011)

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  1. ‘One Mission Accomplished, More Important Ones Remain’: Commentary on Every-Palmer, S., Howick, J. How Evidence-Based Medicine is Failing Due to Biased Trials and Selective Publication. [REVIEW]Peter Wyer & Suzana Alves da Silva - 2015 - Journal of Evaluation in Clinical Practice 21 (3):518-528.
  • Corroborating Evidence-Based Medicine.Alexander Mebius - 2014 - Journal of Evaluation in Clinical Practice 20 (6):915-920.
    Proponents of evidence-based medicine have argued convincingly for applying this scientific method to medicine. However, the current methodological framework of the EBM movement has recently been called into question, especially in epidemiology and the philosophy of science. The debate has focused on whether the methodology of randomized controlled trials provides the best evidence available. This paper attempts to shift the focus of the debate by arguing that clinical reasoning involves a patchwork of evidential approaches and that the emphasis on evidence (...)
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  • The Relativity of ‘Placebos’: Defending a Modified Version of Grünbaum’s Definition.Jeremy Howick - 2017 - Synthese 194 (4):1363-1396.
    Debates about the ethics and effects of placebos and whether ‘placebos’ in clinical trials of complex treatments such as acupuncture are adequate rage. Yet there is currently no widely accepted definition of the ‘placebo’. A definition of the placebo is likely to inform these controversies. Grünbaum’s characterization of placebos and placebo effects has been touted by some authors as the best attempt thus far, but has not won widespread acceptance largely because Grünbaum failed to specify what he means by a (...)
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  • 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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  • Safe, or Sorry? Cancer Screening and Inductive Risk.A. Plutynski - unknown
    The general assumption behind cancer screening has been that early diagnosis and treatment is effective at reducing cancer-related mortality; this is broadly speaking true, for some cancer screening efforts, in some age groups. However, screening may in some cases do more harm than good. One source of harm is overdiagnosis and overtreatment, the diagnosis and treatment of indolent or slow-growing disease that may never lead to morbidity or mortality in the lifetime of the patient. Precaution in cancer screening is thus (...)
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  • Book Review. Philosophy of Epidemiology by A. Broadbent. [REVIEW]Jonathan Fuller - 2014 - Journal of Evaluation in Clinical Practice 20 (6):1002-1004.
  • An Epistemic Analysis of the Precautionary Principle.Barbara Osimani - unknown
    The paper addresses charges of risk and loss aversion as well as of irrationality directed against the precautionary principle, by providing an epistemic analysis of its specific role in the safety law system. In particular, I contend that: 1) risk aversion is not a form of irrational or biased behaviour; 2) both risk and loss aversion regard the form of the utility function, whereas PP rather regards the information on which to base the decision; 3) thus PP has formally nothing (...)
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  • Problematic Placebos in Physical Therapy Trials.Matthew Maddocks, Roger Kerry, Andrew Turner & Jeremy Howick - 2016 - Journal of Evaluation in Clinical Practice 22 (4):598-602.
    The function of a placebo control in a randomised trial is to permit blinding and reduce risk of bias. Adopting Grűnbaum’s definitional scheme of a placebo, all treatments must be viewed as packages consisting of characteristic and incidental features. An adequate placebo for an experimental treatment contains none of the characteristic features, all of the incidental features, and nothing more. For drug treatments, characteristic features can be readily identified, isolated, and separated. By contrast, physical therapy treatments often involve features such (...)
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  • On Pain Experience, Multidisciplinary Integration and the Level-Laden Conception of Science.Tudor Baetu - 2017 - Synthese:1-20.
    Multidisciplinary models aggregating ‘lower-level’ biological and ‘higher-level’ psychological and social determinants of a phenomenon raise a puzzle. How is the interaction between the physical, the psychological and the social conceptualized and explained? Using biopsychosocial models of pain as an illustration, I argue that these models are in fact level-neutral compilations of empirical findings about correlated and causally relevant factors, and as such they neither assume, nor entail a conceptual or ontological stratification into levels of description, explanation or reality. If inter-level (...)
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  • Placebo Use in the United Kingdom: Results From a National Survey of Primary Care Practitioners.Jeremy Howick - 2013 - PLoS 8 (3).
    Objectives -/- Surveys in various countries suggest 17% to 80% of doctors prescribe ‘placebos’ in routine practice, but prevalence of placebo use in UK primary care is unknown. Methods -/- We administered a web-based questionnaire to a representative sample of UK general practitioners. Following surveys conducted in other countries we divided placebos into ‘pure’ and ‘impure’. ‘Impure’ placebos are interventions with clear efficacy for certain conditions but are prescribed for ailments where their efficacy is unknown, such as antibiotics for suspected (...)
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  • A Framework for Understanding Medical Epistemologies.George Khushf - 2013 - Journal of Medicine and Philosophy 38 (5):461-486.
    What clinicians, biomedical scientists, and other health care professionals know as individuals or as groups and how they come to know and use knowledge are central concerns of medical epistemology. Activities associated with knowledge production and use are called epistemic practices. Such practices are considered in biomedical and clinical literatures, social sciences of medicine, philosophy of science and philosophy of medicine, and also in other nonmedical literatures. A host of different kinds of knowledge claims have been identified, each with different (...)
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  • Two Approaches to Reasoning From Evidence or What Econometrics Can Learn From Biomedical Research.Julian Reiss - 2015 - Journal of Economic Methodology 22 (3):373-390.
    This paper looks at an appeal to the authority of biomedical research that has recently been used by empirical economists to motivate and justify their methods. I argue that those who make this appeal mistake the nature of biomedical research. Randomised trials, which are said to have revolutionised biomedical research, are a central methodology, but according to only one paradigm. There is another paradigm at work in biomedical research, the inferentialist paradigm, in which randomised trials play no special role. I (...)
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  • Knowledge and Belief in Placebo Effect.Daniele Chiffi & Renzo Zanotti - 2017 - Journal of Medicine and Philosophy 42 (1):70-85.
    The beliefs involved in the placebo effect are often assumed to be self-fulfilling, that is, the truth of these beliefs would merely require the patient to hold them. Such a view is commonly shared in epistemology. Many epistemologists focused, in fact, on the self-fulfilling nature of these beliefs, which have been investigated because they raise some important counterexamples to Nozick’s “tracking theory of knowledge.” We challenge the self-fulfilling nature of placebo-based beliefs in multi-agent contexts, analyzing their deep epistemological nature and (...)
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  • Taking Facts Seriously: Judicial Intervention in Public Health Controversies.Leticia Morales - 2015 - Public Health Ethics 8 (2):185-195.
    Courts play a key role in deciding on public health controversies, but the legitimacy of judicial intervention remains highly controversial. In this article I suggest that we need to carefully distinguish between different reasons for persistent disagreement in the domain of public health. Adjudicating between public health controversies rooted in factual disagreements allows us to investigate more closely the epistemic capacities of the judicial process. While the critics typically point out the lack of appropriate expertise of judges—in particular with respect (...)
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  • Courts, Expertise and Resource Allocation: Is There a Judicial 'Legitimacy Problem'?Keith Syrett - 2014 - Public Health Ethics 7 (2):112-122.
    Courts are increasingly obliged to adjudicate upon challenges to allocative decisions in healthcare, but their involvement continues to be regarded with unease, imperilling the legitimacy of the judicial role in this context. A central reason for this is that judges are perceived to lack sufficient expertise to determine allocative questions. This article critically appraises the claim of lack of judicial expertise through an examination of the various components of a limit-setting decision. It is argued that the inexpertise argument is weak (...)
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  • Causation and Evidence-Based Practive - an Ontological Review.Roger Kerry, Thor Eirik Eriksen, Svein Anders Noer Lie, Stephen D. Mumford & Rani Lill Anjum - 2012 - Journal of Evaluation in Clinical Practice 18 (5):1006-1012.
    We claim that if a complete philosophy of evidence-based practice is intended, then attention to the nature of causation in health science is necessary. We identify how health science currently conceptualises causation by the way it prioritises some research methods over others. We then show how the current understanding of what causation is serves to constrain scientific progress. An alternative account of causation is offered. This is one of dispositionalism. We claim that by understanding causation from a dispositionalist stance, many (...)
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  • Problems with Using Mechanisms to Solve the Problem of Extrapolation.Jeremy Howick, Paul Glasziou & Jeffrey K. Aronson - 2013 - Theoretical Medicine and Bioethics 34 (4):275-291.
    Proponents of evidence-based medicine and some philosophers of science seem to agree that knowledge of mechanisms can help solve the problem of applying results of controlled studies to target populations (‘the problem of extrapolation’). We describe the problem of extrapolation, characterize mechanisms, and outline how mechanistic knowledge might be used to solve the problem. Our main thesis is that there are four often overlooked problems with using mechanistic knowledge to solve the problem of extrapolation. First, our understanding of mechanisms is (...)
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  • Has Evidence-Based Medicine Ever Been Modern? A Latour-Inspired Understanding of a Changing EBM.Sietse Wieringa, Eivind Engebretsen, Kristin Heggen & Trish Greenhalgh - 2017 - Journal of Evaluation in Clinical Practice 23 (5):964-970.
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  • Evidence Based or Person Centered? An Ontological Debate.Rani Lill Anjum - 2016 - European Journal for Person Centered Healthcare 4 (2):421-429.
    Evidence based medicine (EBM) is under critical debate, and person centered healthcare (PCH) has been proposed as an improvement. But is PCH offered as a supplement or as a replacement of EBM? Prima facie PCH only concerns the practice of medicine, while the contended features of EBM also include methods and medical model. I here argue that there are good philosophical reasons to see PCH as a radical alternative to the existing medical paradigm of EBM, since the two seem committed (...)
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  • Prediction in Epidemiology and Medicine.Jonathan Fuller, Alex Broadbent & Luis J. Flores - 2015 - Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences.
  • Herding QATs: Quality Assessment Tools for Evidence in Medicine.Jacob Stegenga - forthcoming - In Huneman, Silberstein & Lambert (eds.), Herding QATs: Quality Assessment Tools for Evidence in Medicine.
    Medical scientists employ ‘quality assessment tools’ (QATs) to measure the quality of evidence from clinical studies, especially randomized controlled trials (RCTs). These tools are designed to take into account various methodological details of clinical studies, including randomization, blinding, and other features of studies deemed relevant to minimizing bias and error. There are now dozens available. The various QATs on offer differ widely from each other, and second-order empirical studies show that QATs have low inter-rater reliability and low inter-tool reliability. This (...)
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  • New Directions in Philosophy of Medicine.Jacob Stegenga, Ashley Kennedy, Serife Tekin, Saana Jukola & Robyn Bluhm - forthcoming - In James Marcum (ed.), Bloomsbury Companion to Contemporary Philosophy of Medicine. Bloomsbury Academic. pp. 343-367.
    The purpose of this chapter is to describe what we see as several important new directions for philosophy of medicine. This recent work (i) takes existing discussions in important and promising new directions, (ii) identifies areas that have not received sufficient and deserved attention to date, and/or (iii) brings together philosophy of medicine with other areas of philosophy (including bioethics, philosophy of psychiatry, and social epistemology). To this end, the next part focuses on what we call the “epistemological turn” in (...)
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  • Effectiveness of Medical Interventions.Jacob Stegenga - 2015 - Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences 54:34-44.
    To be effective, a medical intervention must improve one's health by targeting a disease. The concept of disease, though, is controversial. Among the leading accounts of disease-naturalism, normativism, hybridism, and eliminativism-I defend a version of hybridism. A hybrid account of disease holds that for a state to be a disease that state must both (i) have a constitutive causal basis and (ii) cause harm. The dual requirement of hybridism entails that a medical intervention, to be deemed effective, must target either (...)
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  • Values-Based Practice and Phenomenological Psychopathology: Implications of Existential Changes in Depression.Anthony Vincent Fernandez & Sarah Wieten - 2015 - Journal of Evaluation in Clinical Practice 21 (3):508-513.
    Values-based practice (VBP), developed as a partner theory to evidence-based medicine (EBM), takes into explicit consideration patients’ and clinicians’ values, preferences, concerns and expectations during the clinical encounter in order to make decisions about proper interventions. VBP takes seriously the importance of life narratives, as well as how such narratives fundamentally shape patients’ and clinicians’ values. It also helps to explain difficulties in the clinical encounter as conflicts of values. While we believe that VBP adds an important dimension to the (...)
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  • Un Análisis Epistémico Del Principio de Precaución.Barbara Osimani - 2013 - Dilemata 11:149-167.
    The paper addresses charges of risk and loss aversion as well as of irrationality directed against the precautionary principle (PP), by providing an epistemic analysis of its specific role in the safety law system. In particular, I contend that: 1) risk aversion is not a form of irrational or biased behaviour; 2) both risk and loss aversion regard the form of the utility function, whereas PP rather regards the information on which to base the decision; 3) thus PP has formally (...)
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  • Evidence, Illness, and Causation: An Epidemiological Perspective on the Russo–Williamson Thesis.Alexander R. Fiorentino & Olaf Dammann - 2015 - Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences 54:1-9.
    According to the Russo-Williamson Thesis, causal claims in the health sciences need to be supported by both difference-making and mechanistic evidence. In this article, we attempt to determine whether Evidence-based Medicine can be improved through the consideration of mechanistic evidence. We discuss the practical composition and function of each RWT evidence type and propose that exposure-outcome evidence provides associations that can be explained through a hypothesis of causation, while mechanistic evidence provides finer-grained associations and knowledge of entities that ultimately explains (...)
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  • The Risk GP Model: The Standard Model of Prediction in Medicine.Jonathan Fuller & Luis J. Flores - 2015 - Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences 54:49-61.
  • The Confounding Question of Confounding Causes in Randomized Trials.Jonathan Fuller - 2019 - British Journal for the Philosophy of Science 70 (3):901-926.
    It is sometimes thought that randomized study group allocation is uniquely proficient at producing comparison groups that are evenly balanced for all confounding causes. Philosophers have argued that in real randomized controlled trials this balance assumption typically fails. But is the balance assumption an important ideal? I run a thought experiment, the CONFOUND study, to answer this question. I then suggest a new account of causal inference in ideal and real comparative group studies that helps clarify the roles of confounding (...)
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  • Measuring Effectiveness.Jacob Stegenga - 2015 - Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences 54:62-71.
    Measuring the effectiveness of medical interventions faces three epistemological challenges: the choice of good measuring instruments, the use of appropriate analytic measures, and the use of a reliable method of extrapolating measures from an experimental context to a more general context. In practice each of these challenges contributes to overestimating the effectiveness of medical interventions. These challenges suggest the need for corrective normative principles. The instruments employed in clinical research should measure patient-relevant and disease-specific parameters, and should not be sensitive (...)
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  • Down with the Hierarchies.Jacob Stegenga - 2014 - Topoi 33 (2):313-322.
    Evidence hierarchies are widely used to assess evidence in systematic reviews of medical studies. I give several arguments against the use of evidence hierarchies. The problems with evidence hierarchies are numerous, and include methodological shortcomings, philosophical problems, and formal constraints. I argue that medical science should not employ evidence hierarchies, including even the latest and most-sophisticated of such hierarchies.
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  • Philosophy of Population Health: Philosophy for a New Public Health Era.Sean A. Valles - 2018 - Abingdon OX14, UK: Routledge.
    Population health has recently grown from a series of loosely connected critiques of twentieth-century public health and medicine into a theoretical framework with a corresponding field of research—population health science. Its approach is to promote the public’s health through improving everyday human life: affordable nutritious food, clean air, safe places where children can play, living wages, etc. It recognizes that addressing contemporary health challenges such as the prevalence of type 2 diabetes will take much more than good hospitals and public (...)
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  • Hierarchies of Evidence in Evidence-Based Medicine.Christopher J. Blunt - 2015 - Dissertation, London School of Economics
    Hierarchies of evidence are an important and influential tool for appraising evidence in medicine. In recent years, hierarchies have been formally adopted by organizations including the Cochrane Collaboration [1], NICE [2,3], the WHO [4], the US Preventive Services Task Force [5], and the Australian NHMRC [6,7]. The development of such hierarchies has been regarded as a central part of Evidence-Based Medicine, a movement within healthcare which prioritises the use of epidemiological evidence such as that provided by Randomised Controlled Trials. Philosophical (...)
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  • Inference to the Best Explanation in the Catch-22: How Much Autonomy for Mill’s Method of Difference?Raphael Scholl - 2015 - European Journal for Philosophy of Science 5 (1):89-110.
    In his seminal Inference to the Best Explanation, Peter Lipton adopted a causal view of explanation and a broadly Millian view of how causal knowledge is obtained. This made his account vulnerable to critics who charged that Inference to the Best Explanation is merely a dressed-up version of Mill’s methods, which in the critics’ view do the real inductive work. Lipton advanced two arguments to protect Inference to the Best Explanation against this line of criticism: the problem of multiple differences (...)
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  • What Counts as 'What Works': Expertise, Mechanisms and Values in Evidence-Based Medicine.Sarah Wieten - 2018 - Dissertation, Durham University
    My doctoral project is a study of epistemological and ethical issues in Evidence-Based Medicine, a movement in medicine which emphasizes the use of randomized controlled trials. Much of the research on EBM suggests that, for a large part of the movement's history, EBM considered expertise, mechanisms, and values to be forces contrary to its goals and has sought to remove them, both from medical research and from the clinical encounter. I argue, however, that expertise, mechanisms and values have important epistemological (...)
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  • Prediction, Understanding, and Medicine.Alex Broadbent - 2018 - Journal of Medicine and Philosophy 43 (3):289-305.
    What is medicine? One obvious answer in the context of the contemporary clinical tradition is that medicine is the process of curing sick people. However, this “curative thesis” is not satisfactory, even when “cure” is defined generously and even when exceptions such as cosmetic surgery are set aside. Historian of medicine Roy Porter argues that the position of medicine in society has had, and still has, little to do with its ability to make people better. Moreover, the efficacy of medicine (...)
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  • On the Conditions for Objectivity : How to Avoid Bias in Socially Relevant Research.Saana Jukola - unknown
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  • Mechanisms in Medicine.Phyllis Illari - unknown
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  • Assigning Functions to Medical Technologies.Alexander Mebius - 2017 - Philosophy and Technology 30 (3):321-338.
    Modern health care relies extensively on the use of technologies for assessing and treating patients, so it is important to be certain that health care technologies perform their professed functions in an effective and safe manner. Philosophers of technology have developed methods to assign and evaluate the functions of technological products, the major elements of which are described in the ICE theory. This paper questions whether the standard of evidence advocated by the ICE theory is adequate for ascribing and assessing (...)
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  • Philosophical Controversies in the Evaluation of Medical Treatments : With a Focus on the Evidential Roles of Randomization and Mechanisms in Evidence-Based Medicine.Alexander Mebius - 2015 - Dissertation, KTH Royal Institute of Technology
    This thesis examines philosophical controversies surrounding the evaluation of medical treatments, with a focus on the evidential roles of randomised trials and mechanisms in Evidence-Based Medicine. Current 'best practice' usually involves excluding non-randomised trial evidence from systematic reviews in cases where randomised trials are available for inclusion in the reviews. The first paper challenges this practice and evaluates whether adding of evidence from non-randomised trials might improve the quality and precision of some systematic reviews. The second paper compares the alleged (...)
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  • The Importance of Values in Evidence-Based Medicine.Michael P. Kelly, Iona Heath, Jeremy Howick & Trisha Greenhalgh - 2015 - BMC Medical Ethics 16 (1):69.
    Evidence-based medicine has always required integration of patient values with ‘best’ clinical evidence. It is widely recognized that scientific practices and discoveries, including those of EBM, are value-laden. But to date, the science of EBM has focused primarily on methods for reducing bias in the evidence, while the role of values in the different aspects of the EBM process has been almost completely ignored.
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  • Establishing Causal Claims in Medicine.Jon Williamson - 2019 - International Studies in the Philosophy of Science 32 (1):33-61.
    ABSTRACTRusso and Williamson [2007. “Interpreting Causality in the Health Sciences.” International Studies in the Philosophy of Science 21: 157–170] put forward the following thesis: in order to establish a causal claim in medicine, one normally needs to establish both that the putative cause and putative effect are appropriately correlated and that there is some underlying mechanism that can account for this correlation. I argue that, although the Russo–Williamson thesis conflicts with the tenets of present-day evidence-based medicine, it offers a better (...)
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  • The Precautionary Principle Meets the Hill Criteria of Causation.Daniel Steel & Jessica Yu - 2019 - Ethics, Policy and Environment 22 (1):72-89.
    ABSTRACTThis article examines the relationship between the precautionary principle and the well-known Hill criteria of causation. Some have charged that the Hill criteria are anti-precautionary because they are strongly inclined towards false negatives in multi-causal contexts typical of environmental and public health issues. However, we argue that without guidance on how to interpret and weight the criteria, no such claims can be supported. Using a case study of tuberculosis among South African goldmine workers, we consider the implications of different weightings (...)
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  • On the Epistemic Legitimacy of Government Paternalism.Johan Brännmark - 2018 - Public Health Ethics 11 (1):27-34.
    Some contemporary paternalists argue in favor of government interventions based on how experimental psychologists and behavioral economists have found that our behavior often diverges from what would be predicted by rational-choice models. In this article it is argued that these findings can, more specifically, be used to identify decisional trouble spots where paternalist interventions may be legitimate. It is further argued that since the epistemic legitimacy of government paternalism ultimately rests on centralized decision-making having a comparative advantage, it also depends (...)
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  • Hunting Side Effects and Explaining Them: Should We Reverse Evidence Hierarchies Upside Down?Barbara Osimani - 2014 - Topoi 33 (2):295-312.
    Philosophical discussions have critically analysed the methodological pitfalls and epistemological implications of evidence assessment in medicine, however they have mainly focused on evidence of treatment efficacy. Most of this work is devoted to statistical methods of causal inference with a special attention to the privileged role assigned to randomized controlled trials in evidence based medicine. Regardless of whether the RCT’s privilege holds for efficacy assessment, it is nevertheless important to make a distinction between causal inference of intended and unintended effects, (...)
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  • The Structure of Causal Evidence Based on Eliminative Induction.Wolfgang Pietsch - 2014 - Topoi 33 (2):421-435.
    It is argued that in deterministic contexts evidence for causal relations states whether a boundary condition makes a difference or not to a phenomenon. In order to substantiate the analysis, I show that this difference/indifference making is the basic type of evidence required for eliminative induction in the tradition of Francis Bacon and John Stuart Mill. To this purpose, an account of eliminative induction is proposed with two distinguishing features: it includes a method to establish the causal irrelevance of boundary (...)
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  • Negative Mechanistic Reasoning in Medical Intervention Assessment.Jesper Jerkert - 2015 - Theoretical Medicine and Bioethics 36 (6):425-437.
    Traditionally, mechanistic reasoning has been assigned a negligible role in standard EBM literature, although some recent authors have argued for an upgrade. Even so, the mechanistic reasoning that has received attention has almost exclusively been positive—both in an epistemic sense of claiming that there is a mechanistic chain and in a health-related sense of there being claimed benefits for the patient. Negative mechanistic reasoning has been neglected, both in the epistemic and in the health-related sense. I distinguish three main types (...)
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  • Making the Improbable Probable: Communication Across Models of Medical Practice.Stephen Buetow - 2014 - Health Care Analysis 22 (2):160-173.
    Cooperation and conversation in the public sphere may overcome historical and other barriers to rational argumentation. As an alternative to evidence-based medicine (EBM) and patient-centered care (PCC), the recent development of a modern version of person-centered medicine (PCM) signals an opportunity for a conversational pluralogue to replace parallel monologues between EBM and its critics, and the calls to EBM to debate its critics. This article draws upon elements of Habermas’s theory of communicative action in order to suggest the kind of (...)
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  • Science and Proven Experience : A Swedish Variety of Evidence Based Medicine and a Way to Better Risk Analysis?Johannes Persson, Niklas Vareman, Annika Wallin, Lena Wahlberg & Nils-Eric Sahlin - forthcoming - Journal of Risk Research.
    A key question for evidence-based medicine is how best to model the way in which EBM should‘[integrate] individual clinical expertise and the best external evidence’. We argue that the formulations and models available in the literature today are modest variations on a common theme and face very similar problems when it comes to risk analysis, which is here understood as a decision procedure comprising a factual assessment of risk, the risk assessment, and the decision what to do based on this (...)
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  • Science and Proven Experience : A Swedish Variety of Evidence-Based Medicine?Johannes Persson, Niklas Vareman, Annika Wallin, Lena Wahlberg & Nils-Eric Sahlin - unknown
    A key question for evidence-based medicine is how best to model the way in which EBM should “[integrate] individual clinical expertise and the best external evidence”. We argue that the formulations and models available in the literature today are modest variations on a common theme and face very similar problems. For example, both the early and updated models of evidence-based clinical decisions presented in Haynes, Devereaux and Guyatt assume that EBM consists of, among other things, evidence from clinical research and (...)
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  • Just How Wide Should ‘Wide Reading’ Be?Martin Lipscomb - 2015 - Nursing Philosophy 16 (4):187-202.
    Educationalists introduce students to literature search strategies that,with rare exceptions, focus chiefly on the location of primary research reports and systematic reviews of those reports. These sources are, however, unlikely to adequately address the normative and/or metaphysical questions that nurses frequently and legitimately interest themselves in. To meet these interests, non-research texts exploring normative and/or metaphysical topics might and perhaps should, in some situations, be deemed suitable search targets. This seems plausible and, moreover, students are encouraged to ‘read widely’. Yet (...)
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