Epistemology of causal inference in pharmacology: Towards a framework for the assessment of harms

European Journal for Philosophy of Science 8 (1):3-49 (2018)
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Abstract

Philosophical discussions on causal inference in medicine are stuck in dyadic camps, each defending one kind of evidence or method rather than another as best support for causal hypotheses. Whereas Evidence Based Medicine advocates the use of Randomised Controlled Trials and systematic reviews of RCTs as gold standard, philosophers of science emphasise the importance of mechanisms and their distinctive informational contribution to causal inference and assessment. Some have suggested the adoption of a pluralistic approach to causal inference, and an inductive rather than hypothetico-deductive inferential paradigm. However, these proposals deliver no clear guidelines about how such plurality of evidence sources should jointly justify hypotheses of causal associations. We here develop such guidelines by first giving a philosophical analysis of the underpinnings of Hill’s viewpoints on causality. We then put forward an evidence-amalgamation framework adopting a Bayesian net approach to model causal inference in pharmacology for the assessment of harms. Our framework accommodates a number of intuitions already expressed in the literature concerning the EBM vs. pluralist debate on causal inference, evidence hierarchies, causal holism, relevance, and reliability.

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Citations of this work

Variety of Evidence.Jürgen Landes - 2020 - Erkenntnis 85 (1):183-223.
Meta-Research Evidence for Evaluating Therapies.Jonathan Fuller - 2018 - Philosophy of Science 85 (5):767-780.
On the Assessed Strength of Agents’ Bias.Jürgen Landes & Barbara Osimani - 2020 - Journal for General Philosophy of Science / Zeitschrift für Allgemeine Wissenschaftstheorie 51 (4):525-549.

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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.
Inference to the Best Explanation.Peter Lipton - 1991 - London and New York: Routledge/Taylor and Francis Group.

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