This paper argues that there exists a collective epistemic state of ‘Broad Medical Uncertainty’ regarding the effectiveness of many medical interventions. We outline the features of BMU, and describe some of the main contributing factors. These include flaws in medical research methodologies, bias in publication practices, financial and other conflicts of interest, and features of how evidence is translated into practice. These result in a significant degree of uncertainty regarding the effectiveness of many medical treatments and unduly optimistic beliefs about (...) the benefit/harm profiles of such treatments. We argue for an ethical presumption in favour of openness regarding BMU as part of a ‘Corrective Response’. We then consider some objections to this position, including concerns that public honesty about flaws in medical research could undermine trust in healthcare institutions. We suggest that, as it stands, the Anti-Corrective Response is unconvincing. (shrink)

I argue that the appropriateness of an assertion is sensitive to context—or, really, the “common ground”—in a way that hasn’t previously been emphasized by philosophers. This kind of context-sensitivity explains why some scientific conclusions seem to be appropriately asserted even though they are not known, believed, or justified on the available evidence. I then consider other recent attempts to account for this phenomenon and argue that if they are to be successful, they need to recognize the kind of context-sensitivity that (...) I argue for. (shrink)

In the past few years, social epistemologists have developed several formal models of the social organisation of science. While their robustness and representational adequacy has been analysed at length, the function of these models has begun to be discussed in more general terms only recently. In this article, I will interpret many of the current formal models of the scientific community as representing the latest development of what I will call the ‘Kuhnian project’. These models share with Kuhn a number (...) of questions about the relation between individuals and communities. At the same time, they also inherit some of Kuhn’s problematic characterisations of the scientific community. In particular, current models of the social organisation of science represent the scientific community as essentially value-free. This may put into question both their representational adequacy and their normative ambitions. In the end, it will be shown that the discussion on the formal models of the scientific community may contribute in fruitful ways to the ongoing debates on value judgements in science. (shrink)

Sometimes retracted or refuted scientific information is used and propagated long after it is understood to be misleading. Likewise, retracted news items may spread and persist, despite being publi...

In recent years, industry-funded research has come under fire because of concerns that it can be biased in favor of the funders. This article suggests that efforts by philosophers of science to analyze the concept of objectivity can provide important lessons for those seeking to evaluate and improve industry-funded research. It identifies three particularly relevant criteria for objectivity: transparency, reproducibility, and effective criticism. On closer examination, the criteria of transparency and reproducibility turn out to have significant limitations in this context, (...) but the criterion of effective criticism suggests some important strategies for improving the objectivity of industry-funded science. (shrink)

What are the proper epistemic aims of social media sites? A great deal of social media critique is in the grips of an Epistemic Apocalypse narrative, which claims that the technologies associated with social media have catastrophically undermined our traditional knowledge-generating practices, and that the remedy is to recreate our pre-catastrophe practices as closely as possible. This narrative relies on a number of questionable assumptions, and problematically narrows the imaginative possibilities for redesigning social media. Our goal in this paper is (...) to shake off the epistemic apocalypse narrative and offer a better account of the epistemic aims of social media. I will pursue a critical approach to social epistemology that appreciates the non-ideal features of epistemic systems, and the ways in which knowledge production can be a site of domination, and apply this framework to thinking about the epistemic design of social media sites. I will argue that social systems ought to pursue three distinct epistemic goals: promoting good epistemic outcomes for users, realising epistemically good institutional features, and achieving structural epistemic justice. Although these goals are often mutually supportive, I will consider a number of cases in which these values lead to dilemmas about how to design epistemic institutions, which can only be resolved by appealing to ethical considerations. I will close by considering some ways in which social media might realise these aims. (shrink)

The democratization of science entails the public having greater influence over science and that influence being shared more equally among members of the public. This chapter will present a thumbnail sketch of the arguments for the democratization of science based on the importance of collectively shaping science’s impact on society, the instrumental benefits of public participation in science, and the need to ensure that the use of science in politics does not undermine collective self-government. It will then outline worries about (...) citizen competence, the abuse of democratic ideals and the limits posed by the nation-state. (shrink)

Modeling and computer simulations, we claim, should be considered core philosophical methods. More precisely, we will defend two theses. First, philosophers should use simulations for many of the same reasons we currently use thought experiments. In fact, simulations are superior to thought experiments in achieving some philosophical goals. Second, devising and coding computational models instill good philosophical habits of mind. Throughout the paper, we respond to the often implicit objection that computer modeling is “not philosophical.”.

Scientists are generally subject to social pressures, including pressures to conform with others in their communities, that affect achievement of their epistemic goals. Here we analyze a network epistemology model in which agents, all else being equal, prefer to take actions that conform with those of their neighbors. This preference for conformity interacts with the agents’ beliefs about which of two possible actions yields the better result. We find a range of possible outcomes, including stable polarization in belief and action. (...) The model results are sensitive to network structure. In general, though, conformity has a negative effect on a community’s ability to reach accurate consensus about the world. (shrink)

There are some philosophical questions that can be answered without attention to the social context in which evidence is produced and distributed.ing away from social context is an excellent way to ignore messy details and lay bare the underlying structure of the limits of inference. Idealization is entirely appropriate when one is essentially asking: In the best of all possible worlds, what am I entitled to infer? Yet, philosophers’ concerns often go beyond this domain. As an example I examine the (...) debate on mechanistic evidence and then reevaluate a canonical case study in this debate. I show that for the assessment of actual evidence, produced in a world that is far from ideal, omission of the social aspects of medical epistemology leads philosophers to draw the wrong lessons from cases they take as paradigmatic cases for their views. I close by arguing that social epistemology provides an avenue to incorporate these complications and provides the necessary framework to understand medical evidence. (shrink)

The growing commercialization of scientific research has raised important concerns about industry bias. According to some evidence, so-called industry bias can affect the integrity of the science as well as the direction of the research agenda. I argue that conceptualizing industry’s influence in scientific research in terms of bias is unhelpful. Insofar as industry sponsorship negatively affects the integrity of the research, it does so through biasing mechanisms that can affect any research independently of the source of funding. Talk about (...) industry bias thus offers no insight into the particular epistemic shortcomings at stake. If the concern is with the negative effects that industry funding can have on the research agenda, conceptualizing this influence as bias obscures the ways in which such impact is problematic and limits our ability to offer solutions that can successfully address the concerns raised by the growing role of private funding in science. (shrink)

Arguments that medical decision making should rely on a variety of evidence often begin from the claim that meta-analysis has been shown to be problematic. In this paper, I first examine Stegenga’s argument that meta-analysis requires multiple decisions and thus fails to provide an objective ground for medical decision making. Next, I examine three arguments from social epistemologists that contend that meta-analyses are systematically biased in ways not appreciated by standard epistemology. In most cases I show that critiques of meta-analysis (...) fail to account for the full range of meta-analytic procedures. In the remainder of cases, I argue that the critiques identify problems that do not uniquely cut against meta-analysis. I close by suggesting one reason why it may be pragmatically rational to violate the principle of total evidence and by outlining the criteria for a successful argument against meta-analysis. A set of criteria I contend remain unmet. (shrink)

The trustworthiness of nutrition science has been questioned recently. According to the critics, the food industry has corrupted scientists in the field. I argue that the worries that commercialization threatens the epistemic trustworthiness of nutrition science are indeed well-founded. However, it is problematic that the discussion has revolved around how funding can threaten the integrity of researchers and the methodological quality of the studies. By extending Wilholt’s :233–253, 2013) account of epistemic trustworthiness, I argue that when assessing the epistemic trustworthiness (...) of research that forms the basis for different health policy measures, it is necessary to evaluate research at the macro-level and whether agenda setting advances the goals that are assigned to the field. The prevalence of commercial funding becomes problematic if it leads to a situation where the body of available evidence that is used for making health policy decisions does not reflect the shared sense of what epistemic and non-epistemic goals of the inquiry are important. (shrink)

Philosophers of science and medicine now aspire to provide useful, socially relevant accounts of mechanism. Existing accounts have forged the path by attending to mechanisms in historical context, scientific practice, the special sciences, and policy. Yet, their primary focus has been on more proximate issues related to therapeutic effectiveness. To take the next step toward social relevance, we must investigate the challenges facing researchers, clinicians, and policy makers involving values and social context. Accordingly, we learn valuable lessons about the connections (...) between mechanistic processes and more fundamental reasons for medical interventions, particularly moral, ethical, religious, and political concerns about health, agency, and power. This paper uses debates over the controversial morning-after pill to gain insight into the deeper reasons for the production and use of mechanistic knowledge throughout biomedical research, clinical practice, and governmental regulation. To practice socially relevant philosophy of science, I argue that we need to account for mechanistic knowledge beyond immediate effectiveness, such as how it can also provide moral guidance, aid ethical categorization in the clinic, and function as a political instrument. Such insights have implications for medical epistemology, including the value-laden dimensions of mechanistic reasoning and the “epistemic friction” of values. Furthermore, there are broader impacts for teaching research ethics and understanding the role of science advisors as political advocates. (shrink)

It is often argued that while biases routinely influence the generation of scientific theories, a subsequent rational evaluation of such theories will ensure that biases do not affect which theories are ultimately accepted. Against this line of thought, this paper shows that the existence of certain kinds of biases at the generation-stage implies the existence of biases at the evaluation-stage. The key argumentative move is to recognize that a scientist who comes up with a new theory about some phenomena has (...) thereby gained an unusual type of evidence, viz. information about the space of theories that could be true of the phenomena. It follows that if there is bias in the generation of scientific theories in a given domain, then the rational evaluation of theories with reference to the total evidence in that domain will also be biased. (shrink)

The US Food and Drug Administration (FDA) is fraught with controversies over the role of values and politics in regulatory science, especially with drugs in the realm of reproductive health. Philosophers and science studies scholars have investigated the ways in which social context shapes medical knowledge through value judgments, and feminist scholars and activists have criticized sexism and injustice in reproductive medicine. Nonetheless, there has been no systematic study of values and gender norms in FDA drug regulation. I focus on (...) three questions about values in regulatory science. First, how have societal values and gender norms shaped the way that the FDA regulates drugs in the realm of reproductive health, specifically with drug labels? Second, what are the ethical, epistemic, and social consequences of these influences on regulation for women and other marginalized groups? Third, which societal values and gender norms ought to influence drug regulation about reproductive health, and how ought this happen? Integrating philosophical analysis with historical archival research and in-depth interviews, I conduct three case studies of drug labeling about reproductive health: (1) the “drug fact” about the mechanism of the morning-after pill; (2) the package inserts for patients about the health risks of oral contraceptives; and (3) the special physician labels made for prescribing drugs to pregnant women. I identify three challenges for the FDA and suggest ways to reduce the influence of sexist values and facilitate feminist alternatives. First, across these cases, I have found that there are many ways in which other concerns in reproductive medicine (such as zygotic life, fetal health, and population control) have devalued women’s health. Second, both knowledge and ignorance xvi about their reproductive health have contributed to women’s oppression, especially poor women and women of color. Finally, by avoiding the epistemic dimensions of ethics, powerful, mostly male parties in medicine (such as doctors, pharmaceutical companies, and religious institutions) have misused “informed consent,” “religious freedom,” and “paternalism” for unethical purposes. For improvement, I suggest extracting sexist values and gender norms from regulatory science that cause epistemic injustices, and I point to success stories for reforming sexism with feminism at the FDA. (shrink)

Diversity of practice is widely recognized as crucial to scientific progress. If all scientists perform the same tests in their research, they might miss important insights that other tests would yield. If all scientists adhere to the same theories, they might fail to explore other options which, in turn, might be superior. But the mechanisms that lead to this sort of diversity can also generate epistemic harms when scientific communities fail to reach swift consensus on successful theories. In this paper, (...) we draw on extant literature using network models to investigate diversity in science. We evaluate different mechanisms from the modeling literature that can promote transient diversity of practice, keeping in mind ethical and practical constraints posed by real epistemic communities. We ask: what are the best ways to promote the right amount of diversity of practice in such communities? (shrink)

Prepublication peer review should be abolished. We consider the effects that such a change will have on the social structure of science, paying particular attention to the changed incentive structure and the likely effects on the behaviour of individual scientists. We evaluate these changes from the perspective of epistemic consequentialism. We find that where the effects of abolishing prepublication peer review can be evaluated with a reasonable level of confidence based on presently available evidence, they are either positive or neutral. (...) We conclude that on present evidence abolishing peer review weakly dominates the status quo. (shrink)

In their recent book, Oreskes and Conway describe the ‘tobacco strategy’, which was used by the tobacco industry to influence policymakers regarding the health risks of tobacco products. The strategy involved two parts, consisting of promoting and sharing independent research supporting the industry’s preferred position and funding additional research, but selectively publishing the results. We introduce a model of the tobacco strategy, and use it to argue that both prongs of the strategy can be extremely effective—even when policymakers rationally update (...) on all evidence available to them. As we elaborate, this model helps illustrate the conditions under which the tobacco strategy is particularly successful. In addition, we show how journalists engaged in ‘fair’ reporting can inadvertently mimic the effects of industry on public belief. 1Introduction2Epistemic Network Models3Selective Sharing4Biased Production5Journalists as Unwitting Propagandists6ConclusionAppendix. (shrink)

Why do people who disagree about one subject tend to disagree about other subjects as well? In this paper, we introduce a model to explore this phenomenon of ‘epistemic factionization’. Agents attempt to discover the truth about multiple propositions by testing the world and sharing evidence gathered. But agents tend to mistrust evidence shared by those who do not hold similar beliefs. This mistrust leads to the endogenous emergence of factions of agents with multiple, highly correlated, polarized beliefs.

There has been much discussion of the moral, legal and prudential implications of geoengineering, and of governance structures for both the research and deployment of such technologies. However, insufficient attention has been paid to how such measures might affect geoengineering in terms of the incentive structures which underwrite scientific progress. There is a tension between the features that make science productive, and the need to govern geoengineering research, which has thus far gone underappreciated. I emphasize how geoengineering research requires governance (...) which reaches beyond science’s traditional boundaries, and moreover requires knowledge which itself reaches beyond what we traditionally expect scientists to know about. How we govern emerging technologies should be sensitive to the incentive structures which drive science. (shrink)

Scientists are generally subject to social pressures, including pressures to conform with others in their communities, that affect achievement of their epistemic goals. Here we analyze a network epistemology model in which agents, all else being equal, prefer to take actions that conform with those of their neighbors. This preference for conformity interacts with the agents’ beliefs about which of two possible actions yields the better result. We find a range of possible outcomes, including stable polarization in belief and action. (...) The model results are sensitive to network structure. In general, though, conformity has a negative effect on a community’s ability to reach accurate consensus about the world. (shrink)

Although the impact of so-called “sponsorship bias” has been the subject of increased attention in the philosophy of science, what exactly constitutes its epistemic wrongness is still debated. In this paper, I will argue that neither evidential accounts nor social–epistemological accounts can fully account for the epistemic wrongness of sponsorship bias, but there are good reasons to prefer social–epistemological to evidential accounts. I will defend this claim by examining how both accounts deal with a paradigm case from medical epistemology, recently (...) discussed in a paper by Bennett Holman. I will argue that evidential accounts cannot adequately capture cases of sponsorship bias that involve the manufacturing of certainty because of their neutrality with respect to the role of non-epistemic values in scientific practice. If my argument holds, it further highlights the importance of integrating social and ethical concerns into epistemological analysis, especially in applied contexts. One can only properly grasp sponsorship bias as an epistemological problem if one resists the methodological tendency to analyze social, ethical, and epistemological issues in isolation from each other. (shrink)

Amalgamating evidence from heterogeneous sources and across levels of inquiry is becoming increasingly important in many pure and applied sciences. This special issue provides a forum for researchers from diverse scientific and philosophical perspectives to discuss evidence amalgamation, its methodologies, its history, its pitfalls, and its potential. We situate the contributions therein within six themes from the broad literature on this subject: the variety-of-evidence thesis, the philosophy of meta-analysis, the role of robustness/sensitivity analysis for evidence amalgamation, its bearing on questions (...) of extrapolation and external validity of experiments, its connection with theory development, and its interface with causal inference, especially regarding causal theories of cancer. (shrink)