Exposing the Vanities—and a Qualified Defense—of Mechanistic Reasoning in Health Care Decision Making

Philosophy of Science 78 (5):926-940 (2011)
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Abstract

Philosophers of science have insisted that evidence of underlying mechanisms is required to support claims about the effects of medical interventions. Yet evidence about mechanisms does not feature on dominant evidence-based medicine “hierarchies.” After arguing that only inferences from mechanisms (“mechanistic reasoning”)—not mechanisms themselves—count as evidence, I argue for a middle ground. Mechanistic reasoning is not required to establish causation when we have high-quality controlled studies; moreover, mechanistic reasoning is more problematic than has been assumed. Yet where the problems can be overcome, mechanistic reasoning can and should be used as evidence.

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Jeremy Howick
University of Oxford

Citations of this work

Establishing Causal Claims in Medicine.Jon Williamson - 2019 - International Studies in the Philosophy of Science 32 (1):33-61.
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.
Mechanistic Evidence: Disambiguating the Russo–Williamson Thesis.Phyllis McKay Illari - 2011 - International Studies in the Philosophy of Science 25 (2):139-157.
Down with the Hierarchies.Jacob Stegenga - 2014 - Topoi 33 (2):313-322.

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References found in this work

Thinking about mechanisms.Peter Machamer, Lindley Darden & Carl F. Craver - 2000 - Philosophy of Science 67 (1):1-25.
Explanation: a mechanist alternative.William Bechtel & Adele Abrahamsen - 2005 - Studies in History and Philosophy of Biological and Biomedical Sciences 36 (2):421-441.
Interpreting causality in the health sciences.Federica Russo & Jon Williamson - 2007 - International Studies in the Philosophy of Science 21 (2):157 – 170.

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