In his book “Medical Philosophy: Conceptual issues in Medicine”, Mario Bunge provides a unique account of medical philosophy that is deeply rooted in a realist ontology he calls “systemism”. According to systemism, the world consists of systems and their parts, and systems possess emergent properties that their parts lack. Events within systems may form causes and effects that are constantly conjoined via particular mechanisms. Bunge supports the views of the evidence-based medicine movement that randomized controlled trials (RCTs) provide the best (...) evidence to establish the truth of causal hypothesis; in fact, he argues that _only_ RCTs have this ability. Here, we argue that Bunge neglects the important feature of patients being open systems which are in steady interaction with their environment. We show that accepting this feature leads to counter-intuitive consequences for his account of medical hypothesis testing. In particular, we point out that (i) the confirmation of hypotheses is inherently stochastic and affords a probabilistic account of both confirmation and evidence which we provide here; (ii) RCTs are neither necessary nor sufficient to establish the truth of a causal claim; (iii) testing of causal hypotheses requires taking into account background knowledge and the context within which an intervention is applied. We conclude that there is no “best” research methodology in medicine, but that different methodologies should coexist in a complementary fashion. (shrink)

Probabilistic models have much to offer to philosophy. We continually receive information from a variety of sources: from our senses, from witnesses, from scientific instruments. When considering whether we should believe this information, we assess whether the sources are independent, how reliable they are, and how plausible and coherent the information is. Bovens and Hartmann provide a systematic Bayesian account of these features of reasoning. Simple Bayesian Networks allow us to model alternative assumptions about the nature of the information sources. (...) Measurement of the coherence of information is a controversial matter: arguably, the more coherent a set of information is, the more confident we may be that its content is true, other things being equal. The authors offer a new treatment of coherence which respects this claim and shows its relevance to scientific theory choice. Bovens and Hartmann apply this methodology to a wide range of much discussed issues regarding evidence, testimony, scientific theories, and voting. Bayesian Epistemology is an essential tool for anyone working on probabilistic methods in philosophy, and has broad implications for many other disciplines. (shrink)

It can be demonstrated in a very straightforward way that confirmation and evidence as spelled out by us can vary from one case to the next, that is, a hypothesis may be weakly confirmed and yet the evidence for it can be strong, and conversely, the evidence may be weak and the confirmation strong. At first glance, this seems puzzling; the puzzlement disappears once it is understood that confirmation is of single hypotheses, in which there is an initial degree of (...) belief which is adjusted up or down as data accumulate, whereas evidence always has to do with a comparison of one hypothesis against another with respect to the data and is belief-independent. Confusing them is, we suggest, a plausible source of the so-called “base-rate fallacy” identified by Kahneman and Tversky which leads most of us to make mistaken statistical inferences. It is also in the background, or so we argue in some detail, of the important policy controversies concerning human-induced global warming. (shrink)

We argue that the health sciences make causal claims on the basis of evidence both of physical mechanisms, and of probabilistic dependencies. Consequently, an analysis of causality solely in terms of physical mechanisms or solely in terms of probabilistic relationships, does not do justice to the causal claims of these sciences. Yet there seems to be a single relation of cause in these sciences - pluralism about causality will not do either. Instead, we maintain, the health sciences require a theory (...) of causality that unifies its mechanistic and probabilistic aspects. We argue that the epistemic theory of causality provides the required unification. (shrink)

I argue that Bayesians need two distinct notions of probability. We need the usual degree-of-belief notion that is central to the Bayesian account of rational decision. But Bayesians also need a separate notion of probability that represents the degree to which evidence supports hypotheses. Although degree-of-belief is well suited to the theory of rational decision, Bayesians have tried to apply it to the realm of hypothesis confirmation as well. This double duty leads to the problem of old evidence, a problem (...) that, we will see, is much more extensive than usually recognized. I will argue that degree-of-support is distinct from degree-of-belief, that it is not just a kind of counterfactual degree-of-belief, and that it supplements degree-of-belief in a way that resolves the problems of old evidence and provides a richer account of the logic of scientific inference and belief. (shrink)

The notion of a severe test has played an important methodological role in the history of science. But it has not until recently been analyzed in any detail. We develop a generally Bayesian analysis of the notion, compare it with Deborah Mayo’s error-statistical approach by way of sample diagnostic tests in the medical sciences, and consider various objections to both. At the core of our analysis is a distinction between evidence and confirmation or belief. These notions must be kept separate (...) if mistakes are to be avoided; combined in the right way, they provide an adequate understanding of severity. Those who think that the weight of the evidence always enables you to choose between hypotheses “ignore one of the factors (the prior probability) altogether, and treat the other (the likelihood) as though it ...meant something other than it actually does. This is the same mistake as is made by someone who has scruples about measuring the arms of a balance (having only a tape measure at his disposal ...), but is willing to assert that the heavier load will always tilt the balance (thereby implicitly assuming, although without admitting it, that the arms are of equal length!). (Bruno de Finetti, Theory of Probability)2. (shrink)