This article explores the question of how scientific uncertainty can be managed in medical decision making using the Advisory Committee on Immunization Practices as a case study. It concludes that where a high degree of technical consensus exists about the evidence and data, decision makers act according to a clear decision rule. If a high degree of technical consensus does not exist and uncertainty abounds, the decision will be based on a variety of criteria, including readily available resources, decision-process constraints, (...) and the available knowledge base, among other things. Decision makers employ a variety of heuristic devices and techniques, thereby employing a pragmatic approach to uncertainty in medical decision making. The article concludes with recommendations for managing scientific uncertainty in medical decision making. (shrink)

With an innovative perspective on the social character of ignorance production, agnotology has been a fruitful approach for understanding the social and epistemological consequences of the interaction between industry and scientific research. In this paper, I argue that agnotology, or the study of ignorance, contributes to a better understanding of commercially driven research and its societal impact, showing the ways in which industrial interests have reshaped the epistemic aims of traditional scientific practices, turning them into mechanisms of ignorance production. To (...) do so, I examine some of the main contributions to agnotology and provide a taxonomy of practices of ignorance construction common in commercially driven research today. In particular, I present the tobacco industry’s campaign against the health hazards of smoking as a paradigmatic case of ignorance production, identifying five central strategies. I then argue that the same strategies have been used in three other cases—global warming, pharmaceuticals, and the 2008 financial crisis. (shrink)