In this chapter, I first outline the public health workflow from assessment via goal definition and intervention to evaluation. Further, I discuss the types and subtypes of explanation used in public health research and practice: scientific, justificatory, methodological, and prospective. In doing this, I take the discussion far beyond the usual focus in philosophy of science as answers to “why?”-questions. The chapter ends with a few comments on my proposal.

Theory of illness causation is an important issue in all biomedical sciences, and solid etiological explanations are needed in order to develop therapeutic approaches in medicine and preventive interventions in public health. Until now, the literature about the theoretical underpinnings of illness causation research has been scarce and fragmented, and lacking a convenient summary. This interdisciplinary book provides a convenient and accessible distillation of the current status of research into this developing field, and adds a personal flavor to the discussion (...) by proposing the etiological stance as a comprehensive approach to identify modifiable causes of illness. (shrink)

In this essay, I argue that Ted Poston's theory of explanatory coherentism is well-suited as a tool for causal explanation in the health sciences, particularly in epidemiology. Coherence has not only played a role in epidemiology for more than half a century as one of Hill's viewpoints, it can also provide background theory for the development of explanatory systems by integrating epidemiologic evidence with a diversity of other error-independent data. I propose that computational formalization of Hill's viewpoints in an explanatory (...) coherentist framework would provide an excellent starting point for a formal epistemological (knowledge-theoretical) project designed to improve causal explanation in the health sciences. As an example, I briefly introduce Paul Thagard's ECHO system and offer my responses to possible objections to my proposal. (shrink)

Models of illness causation play a crucial role in medicine and public health. In their recent paper on this topic, Michael Kelly, Rachel Kelly, and Federica Russo state that the integration of social, biological, and behavioral causes in one and the same etiologic mechanism remains to be clarified. In particular, they think that current models of illness causation do not appreciate "the truly integrated nature of bio-social-behavioral pathogenesis". In brief, Kelly, Kelly, and Russo suggest that two levels of explanation are (...) at work in medicine and public health, biological and social; that integration is difficult because of resistance to including social determinants of disease in both the... (shrink)

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 (...) of epidemiological inference and provides a tractable model for inferring disease causation. We apply this model to three cases: the inference of a causal connection between the Zika virus and birth defects, the classic inference that smoking causes cancer, and John Snow’s inference about the cause of cholera. (shrink)

The search for causes of perinatal brain damage needs a solid theoretical foundation. Current theory apparently does not offer a unanimously accepted view of what constitutes a cause, and how it can be identified. We discuss nine potential theoretical misconceptions: (1) too narrow a view of what is a cause (causal production vs. facilitation), (2) extrapolating from possibility to fact (potential vs. factual causation), (3) if X, then invariably Y (determinism vs. probabilism), (4) co-occurrence in individuals vs. association in populations, (...) (5) one cause is all that is needed (single cause attribution vs. multicausal constellations), (6) drawing causal inferences from very small numbers of observations (the tendency to generalize), (7) unstated causal inferences, (8) ignoring heterogeneity, and (9) failing to consider alternative explanations for what is observed. We hope that our critical discussion will contribute to fruitful research and help reduce the burden of perinatal brain damage. (shrink)

This book covers the overlap between informatics, computer science, philosophy of causation, and causal inference in epidemiology and population health research. Key concepts covered include how data are generated and interpreted, and how and why concepts in health informatics and the philosophy of science should be integrated in a systems-thinking approach. Furthermore, a formal epistemology for the health sciences and public health is suggested. -/- Causation in Population Health Informatics and Data Science provides a detailed guide of the latest thinking (...) on causal inference in population health informatics. It is therefore a critical resource for all informaticians and epidemiologists interested in the potential benefits of utilising a systems-based approach to causal inference in health informatics. (shrink)

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 (...) a causal hypothesis. We suggest that mechanistic evidence holds untapped potential to add value to the assessment of evidence quality in EBM and propose initial recommendations for the integration of mechanistic and exposure-outcome evidence to improve EBM by robustly leveraging available evidence in support of good medical decisions. (shrink)

In order to support health interventions, biomedical and population health researchers need to collect solid evidence. This article asks what type of evidence this should be and expands on previous work that focused on etiological explanations, or causal-mechanical explanations of why and how illness occurs. The article proposes adding predictive evidence to the explanatory evidence, in order to form a joint evidence set, or JES = [A,B,C,D], which consists of four different types of evidence: association [A], biology [B], confirmation [C], (...) and difference-making [D]. The article discusses explanatory coherence as a backbone for this proposal, suggests criteria for each type of evidence, and offers a rubric for multi-evidence mapping. (shrink)

At the core of medicine is the idea to help fellow human beings by improving or even restoring their health. Let us call this the auxiliary stance of medicine—the motivation of medical intervention by reference to a moral obligation to guide our peers in their attempt to live a healthy and productive life. In parallel, the auxiliary stance is also central to public health, with a focus on prevention and health promotion. Taken together, we can view medicine and public health (...) as the two main human auxiliary endeavors to protect individuals and populations from health risks and help them to heal when sick. (shrink)

Agent-based models (ABMs) are one type of simulation model used in the context of the COVID-19 pandemic. In contrast to equation-based models, ABMs are algorithms that use individual agents and attribute changing characteristics to each one, multiple times during multiple iterations over time. This paper focuses on three philosophical aspects of ABMs as models of causal mechanisms, as generators of emergent phenomena, and as providers of explanation. Based on my discussion, I conclude that while ABMs cannot help much with causal (...) inference, they can be viewed as etio-prognostic explanations of illness occurrence and outcome. (shrink)

Thinking about illness causation has a long and rich history in medicine. After a hiatus in the 1990s, the last one-and-a-half decades have seen a surge of publications on causality in the biomedical sciences. Interestingly, this surge is visible not only in the medical, epidemiological, bioinformatics, and public health literatures, but also among philosophical publications. In this essay, I review and discuss one most recent addition to the literature, "Causality: Philosophical Theory Meets Scientific Practice" written by philosophers Phyllis Illari and (...) Federica Russo about causality in the sciences, and particularly about the health sciences. (shrink)

My goal in this paper is twofold. First, I want to analyze two early texts by Vilém Flusser in order to explore what may have been his conceptualization of the relationship between science and philosophy. My analysis suggests that Flusser thought of both as tools to analyze reality by analyzing language. While he saw science as a (sometimes too vigorous) force forward, he viewed philosophy as what can prevent some of the negative consequences of such progress. In direct comparison, Flusser (...) thought of science as a discourse with the purpose to provide novel information and of philosophy as what can keep objective science in check by moving the discourse into the realm of the subjective. It remains to be explored whether these results also apply to Flusser’s later writings. My second goal is to show the relationship between three aspects of modern science (crisis, contrast, and trying out) and what I see as Flusser’s early (mid 1960s) view of science in relation to philosophy and poetry. -/- . (shrink)

Dieser Aufsatz beschreibt und erörtert fünf Aspekte der gegenwärtigen Wissenschaft: Verfahren, Zwiespalt, Schweigen, Hoffnung, und Probieren.

Explaining the causal mechanisms that contribute to autism spectrum disorder occurrence remains a conundrum in developmental medicine, neuroscience, and child psychiatry. Recent research has resulted in agreement on behavioral definitions and their underlying cognitive processes, early diagnosis and standardized assessments, evidence-based interventions, systems-level approaches to neurobiology, and identification of genetic variants and their interaction with epigenetic and environmental factors. However, an explanatory model of autism causation remains elusive.Perhaps..

In this paper, we build upon the model of authenticity proposed by Lehman and colleagues, which includes the dimensions consistency, conformity, and connection. We expand this “3C-view” by adding a fourth dimension, continuity, which results in what we have come to call “4C-view of authenticity.” We discuss our proposal from a process perspective and emphasize that congruence might be a reasonable candidate for a concept that unifies the four dimensions of authenticity.

Retinopathy of prematurity (ROP) is a complex neonatal disorder with multiple contributing factors. In this paper we have mounted the evidence in support of the proposal that neonatal sepsis meets all requirements for being a cause of ROP (not a condition, mechanism, or even innocent bystander) by means of initiating the early stages of the pathomechanism of ROP occurrence, systemic inflammation. We use the model of etiological explanation, which distinguishes between two overlapping processes in ROP causation. It can be shown (...) that sepsis can initiate the early stages of the pathomechanism via systemic inflammation (causation process) and that systemic inflammation can contribute to growth factor aberrations and the retinal characteristics of ROP (disease process). The combined contribution of these factors with immaturity at birth (as intrinsic risk modifier) and prenatal inflammation (as extrinsic facilitator) seems to provide a cogent functional framework of ROP occurrence. Finally, we apply the Bradford Hill heuristics to the available evidence. Taken together, the above suggests that neonatal sepsis is a causal inducer of ROP. (shrink)

Biomedical research and study design have recently been examined in detail by philosophers of science, who, like biomedical researchers, are concerned with the ability to accurately represent causal relationships through scientific study and apply these relationships to improve the health of individuals and populations. Epistemology—defined by the OED as "the theory of knowledge, especially with regard to its methods, validity, and scope, and the distinction between justified belief and opinion"—is fundamental to these concerns. In particular, philosophers of science and biomedical (...) researchers have discussed the epistemological value of randomized-controlled trials in regards to their individual components.... (shrink)

Selbst wenn die traditionellen Beweise der immateriellen Seele (von Platon bis Descartes) zu wünschen übrig lassen, muss uns das nicht davon abhalten, sie mit den Mitteln der modernen analytischen Philosophie neu zu fassen und wasserdicht zu machen. Ich werde (ohne eigene Diskussion der bereits vorliegenden Beweise) eine neue Version vorschlagen, die von Swinburne angeregt wurde, sich an wesentlichen Stellen von seinem Ansatz unterscheidet und auf zwei verblüffend schwachen Prämissen beruht: Einerseits auf der konsistenten Vorstellbarkeit von Gedankenspielen, in die irgend eine (...) beliebige Wahrheit über meine augenblickliche Situation integriert ist und denen zufolge ich meinen Tod seelisch, aber ohne Körper überlebe; diese Prämisse ergibt sich der virtuosen Macht unseres Möglichkeitssinns. Andererseits beruht der Beweis auf einer Voraussetzung, die sich (ohne exegetische Garantie) als Echo aristotelischer Substanz-Konzeptionen verstehen, aber ohne großen ontologischen Überbau begründen lässt – dem zufolge folgt aus der materialistischen Analyse meiner augenblicklichen Situation, dass diese Analyse während meiner gesamten Existenz gilt (einmal Körper, immer Körper). Die Logik des Beweises ist bodenständig und setzt keine strittigen modallogischen Prinzipien voraus. Und die Konklusion des Beweises besagt, dass ich jetzt eine immaterielle Seele habe, aber nichts über deren Unsterblichkeit. (shrink)

Die Skeptikerin fragt, wie wir ausschließen können, dass all unsere Erlebnisse auf einem umfassenden Traum beruhen. Träfe ihre Befürchtung zu, dann wären alle unsere Meinungen über die äußere Welt falsch, und da wir das nicht ausschließen können, haben wir (so folgert sie) keinerlei Wissen über die Welt. Um dem zu begegnen, könnte man der Skeptikerin vorwerfen, dass sie unsere gemeinsame Sprache missbraucht. Welche Wörter missbraucht sie? Welche Wörter gebraucht sie so anders, dass wir uns um ihre Überlegung nicht scheren müssen? (...) Ich spiele das sprachkritische Manöver gegen die Skeptikerin zunächst anhand des Wissensbegriffs durch (und komme zu dem Ergebnis, dass wir nicht klar genug sagen können, worin die unstrittige Bedeutung des Wortes "Wissen" besteht). Dann versuche ich es mit weniger tiefsinnigen Wörtern wie "Tiger". Wer stets träumt, gebraucht solche Wörter anders als wir, so die Überlegung. Dieser Gedanke funktioniert nur, wenn wir die Existenz von Außenwelt-Dingen voraussetzen dürfen; und diese Voraussetzung bestreitet die Skeptikerin. Daher spiele ich das sprachkritische Manöver zuguterletzt anhand des Traumbegriffs durch. Jemand kann das Wort "Traum" überhaupt nur dann gelernt haben, wenn er manchmal, aber nicht immer geträumt hat. Ergebnis: Entweder ich verstehe das Wort "Traum". Dann träume ich nicht seit jeher. Oder ich verstehe das Wort nicht. Dann brauche ich mich vom Traum-Argument auch nicht an meinen Wissens-Ansprüchen irre machen zu lassen. (shrink)

Wenn ausgerechnet Pazifisten bei der Verfechtung ihrer Position aggressiv werden, so finden wir das besonders verstörend – jedenfalls verstörender als bei anderen Spannungen zwischen Theorie und Praxis. Woran liegt das? Meiner Ansicht nach kommen in diesem Fall drei Elemente zusammen, deren Mischung die pazifistische Position von innen bedroht: Während sich der hasserfüllte Pazifist schon beim Diskutieren schnell von negativen Emotionen fortreißen lässt, also alles andere als Willensstärke dokumentiert, verlangt er in seiner Theorie ein Höchstmaß an Willensstärke, und zwar gerade im (...) Umgang mit Emotionen. Dass er das nicht schafft, wirft nicht nur ein negatives Licht auf seine Person, sondern liefert Gründe gegen seine Theorie. Lektion: Der Pazifist ist gut beraten, vorbildlich mit seinen Emotionen umzugehen. (shrink)

My philosophical case study concerns textbook presentations of the theory of demand. Does this theory contain anything more than just a collection of tautologies? In order to determine its empirical content, it must be viewed holistically. But then, the theory implies false factual claims. We can avoid this result by embracing the theory’s normative character. The resulting consequences will be illuminated with the new autodetermination thesis recently proposed in the philosophy of physics by Oliver Timmer. Applying his ideas to the (...) theory of demand reveals that the statements of this discipline simultaneously concern both values and facts. (shrink)

In vielen Debatten werden spezifische Vorstellungen über die Geschichte, Kultur oder Werteordnung ›Europas‹ für die Erklärung oder Legitimierung politischer Verhältnisse und Projekte herangezogen. Die vorliegende Studie prüft die Berechtigung solcher Konstruktionen, indem sie der Frage nachgeht, seit wann und warum überhaupt von ›Europa‹ gesprochen wird. Die Analyse der historischen Semantik des Europabegriffs muss, um identitätspolitisch motivierte Anachronismen zu vermeiden, seine materiellen, kulturellen und diskursiven Konstitutionsbedingungen einbeziehen. ›Europa‹ verliert dadurch seinen transhistorischen Charakter, den es erhält, wenn man ihm im Bestreben, es (...) als politische und kulturelle Entität auszuzeichnen und fungibel zu machen, eine mythische Geschichte und Struktur zuschreibt. Demgegenüber zeigt die kritische Analyse: Als politische und kulturelle ›Idee‹ wie als gelebte und erfahrene ›Wirklichkeit‹ gründet Europa nicht in Antike oder Mittelalter, sondern ist das Produkt der Entstehung der modernen Welt seit der frühen Neuzeit. (shrink)

The Aesthetic Mind breaks new ground in bringing together empirical sciences and philosophy to enhance our understanding of aesthetics and the experience of art.

In this article the authors focus on the emergence, or disappearance, of notions of responsibility in social dynamic processes. Hence, the starting point in this article is concrete behavior within organisational settings. This article presents a systematic overview of mechanisms related to acting upon a sense of moral responsibility. Some of these mechanisms are based on individual characteristics, others are embedded in the social context wherein responsible behaviour emerges or disappears. In this article, various mechanisms are identified and labelled in (...) order to analyse what types of processes are behind the mechanisms. In this way, the article yields important understandings for the conscious use of these mechanisms to strengthen responsible behavior within organisations. (shrink)

Goethe's objections to Newton's theory of light and colours are better than often acknowledged. You can accept the most important elements of these objections without disagreeing with Newton about light and colours. As I will argue, Goethe exposed a crucial weakness of Newton's methodological self-assessment. Newton believed that with the help of his prism experiments, he could prove that sunlight was composed of variously coloured rays of light. Goethe showed that this step from observation to theory is more problematic than (...) Newton wanted to admit. By insisting that the step to theory is not forced upon us by the phenomena, Goethe revealed our own free, creative contribution to theory construction. And Goethe's insight is surprisingly significant, because he correctly claimed that all of the results of Newton's prism experiments fit a theoretical alternative equally well. If this is correct, then by suggesting an alternative to a well-established physical theory, Goethe developed the problem of underdete... (shrink)

Goethes Protest gegen Newtons Theorie des Lichts und der Farben ist besser, als man gemeinhin denkt. Man kann diesem Protest in den wichtigsten Elementen folgen, ohne Newton in der physikalischen Sache unrecht zu geben. Laut meiner Interpretation hat Goethe in Newtons wissenschaftsphilosophischer Selbsteinschätzung eine entscheidende Schwäche aufgedeckt: Newton glaubte, mithilfe prismatischer Experimente beweisen zu können, dass das Licht der Sonne aus Lichtstrahlen verschiedener Farben zusammengesetzt sei. Goethe zeigt, dass dieser Übergang vom Beobachtbaren zur Theorie problematischer ist, als Newton wahrhaben wollte. (...) Wenn Goethe darauf beharrt, dass uns der Übergang zur Theorie nicht von den Phänomenen aufgezwungen wird, dann kommt dadurch unser eigener, freier und kreativer Beitrag zur Theorie-Bildung ans Tageslicht. Und diese Einsicht Goethes gewinnt eine überraschende Schärfe, weil Goethe plausibel machen kann, dass sich alle entscheidenden prismatischen Experimente Newtons ebenso gut mit einer alternativen Theorie vereinbaren lassen. Wenn ich recht sehe, war Goethe der erste Wissenschaftsphilosoph, der mindestens eine empirisch äquivalente Alternative zu einer wohletablierten physikalischen Theorie gesehen hat: Damit war Goethe seiner Zeit um ein gutes Jahrhundert voraus. (shrink)