Personalised medicine has been discussed as a medical paradigm shift that will improve health while reducing inefficiency and waste. At the same time, it raises new practical, regulatory, and ethical challenges. In this paper, we examine PM strategies epistemologically in order to develop capacities to address these challenges, focusing on a recently proposed strategy for developing patient-specific models from induced pluripotent stem cells so as to make individualised treatment predictions. We compare this strategy to two main PM strategies—stratified medicine and (...) computational models. Drawing on epistemological work in the philosophy of medicine, we explain why these two methods, while powerful, are neither truly personalised nor, epistemologically speaking, novel strategies. Both are forms of correlational black box. We then argue that the iPSC models would count as a new kind of black box. They would not rely entirely on mechanistic knowledge, and they would utilise correlational evidence in a different way from other strategies—a way that would enable personalised predictions. In arguing that the iPSC models would present a novel method of gaining evidence for clinical practice, we provide an epistemic analysis that can help to inform the practical, regulatory, and ethical challenges of developing an iPSC system. (shrink)

This paper argues that there is an important connection between Inference to the Best Explanation and Bayesianism, in the medical context of the interplay between mechanisms and population studies. It is argued that the criteria for evaluating mechanistic evidence can be used in Inference to the Best Explanation and such use thereby increases the resilience of probabilities in a Bayesian framework. This point grows out of the emerging literature on evidence-based medicine and naturally strengthens McCain and Poston's proposal that explanatory (...) information is evidentially relevant. (shrink)

Inference to the Best Explanation is usually employed in the Scientific Realism debates. As far as particular scientific theories are concerned, its most ready usage seems to be that of a theory of confirmation. There are however more uses of IBE, namely as an epistemological theory of testimony and as a means of categorising and justifying the sources of evidence. In this paper, I will present, develop and exemplify IBE as a theory of the quality of evidence - taking examples (...) from medicine and showing that IBE can thereby provide the epistemological underpinning and justify the criteria of grading quality of mechanistic evidence that have been recently provided in the Clarke et al. paper on how evidence of medical mechanisms is to be construed alongside population studies. (shrink)

RESUMEN Un experimento mental en ciencias fácticas consiste en la representación de un escenario imaginario. A partir de la presentación de condiciones iniciales y la postulación de una situación hipotética o contrafáctica, se solicita al lector que realice mentalmente alguna operación, manipule ciertas variables o ponga en funcionamiento algún aparato o instrumento. En virtud de este ejercicio sería posible, en principio, obtener nuevo conocimiento acerca de algún aspecto del mundo natural. El debate acerca de las funciones de los experimentos mentales (...) en las ciencias fácticas está centrado en establecer la validez del conocimiento acerca del mundo empírico que estos dispositivos son capaces de proporcionar. La propuesta interpretativa de Brown da sustento a la idea de que, en casos excepcionales, los experimentos mentales pueden cumplir funciones probatorias. Los denominados “experimentos mentales platónicos” permiten intuir leyes de la naturaleza y justificar a priori las hipótesis propuestas. Sostenemos que la conexión trazada por Brown entre los experimentos mentales y leyes naturales exhibe un aspecto problemático de su filosofía: el compromiso injustificado con una metafísica inflacionaria. Mostramos que es posible explicar el mecanismo a través del cual estos dispositivos proporcionan conocimiento nuevo y dar cuenta tanto de su poder heurístico cómo de su valor evidencial a partir compromisos metafísicos más modestos. ABSTRACT Thought experiments in factual science consists on the representation of an imaginary scenario. Starting with the presentation of a hypothetical or counterfactual situation and the description of initial conditions, the reader is asked to mentally perform some operation, to manipulate certain variables or to put into operation some apparatus or instrument. In virtue of this exercise, it would be possible to obtain new knowledge about the natural world. The debate on the functions of thought experiments in physics is focused on determining the validity of the empirical knowledge that these devices are capable of providing. Brown supports the idea that, in exceptional cases, thought experiments can perform probative functions. The so-called “Platonic Thought Experiments” allow us to intuit laws of nature and provide an a priori justification of the proposed hypotheses. We hold that Brown's connection between thought experiments and laws of nature exhibits a problematic aspect of his philosophy: the unjustified commitment with an inflationary metaphysics. We show that it is possible to explain the mechanism through which these devices provide new knowledge and give an account of both their heuristic power and their evidential value from modest metaphysical commitments. (shrink)

Exploring the early development of an area of medical literature can inform contemporary medical debates. Different methods of inference include deduction, induction, abduction, and inference to the best explanation. I argue that early shaken baby research is best understood as using abduction to tentatively suggest that infants with unexplained intracranial and ocular bleeding have been assaulted. However, this tentative conclusion was quickly interpreted, by some at least, as a general rule that infants with these pathological signs were certainly cases of (...) abuse. Rather than focusing on inductive arguments, researchers today may be better off focusing on making a compelling inference to the best explanation. (shrink)

Most philosophers agree that abduction (in the sense of Inference to the Best Explanation) is a type of inference that is frequently employed, in some form or other, both in everyday and in scientific reasoning. However, the exact form as well as the normative status of abduction are still matters of controversy. This entry contrasts abduction with other types of inference; points at prominent uses of it, both in and outside philosophy; considers various more or less precise statements of it; (...) discusses its normative status; and highlights possible connections between abduction and Bayesian confirmation theory. (shrink)