We claim that if a complete philosophy of evidence-based practice is intended, then attention to the nature of causation in health science is necessary. We identify how health science currently conceptualises causation by the way it prioritises some research methods over others. We then show how the current understanding of what causation is serves to constrain scientific progress. An alternative account of causation is offered. This is one of dispositionalism. We claim that by understanding causation from a dispositionalist stance, many (...) of the processes within an evidence-based practice framework are better accounted for. Further, some of the problems associated with the health research, e.g. external validity of causal findings, dissolve. (shrink)

After a decade of intense debate about mechanisms, there is still no consensus characterization. In this paper we argue for a characterization that applies widely to mechanisms across the sciences. We examine and defend our disagreements with the major current contenders for characterizations of mechanisms. Ultimately, we indicate that the major contenders can all sign up to our characterization.

Heuristics are efficient cognitive processes that ignore information. In contrast to the widely held view that less processing reduces accuracy, the study of heuristics shows that less information, computation, and time can in fact improve accuracy. We review the major progress made so far: the discovery of less-is-more effects; the study of the ecological rationality of heuristics, which examines in which environments a given strategy succeeds or fails, and why; an advancement from vague labels to computational models of heuristics; the (...) development of a systematic theory of heuristics that identifies their building blocks and the evolved capacities they exploit, and views the cognitive system as relying on an “adaptive toolbox;” and the development of an empirical methodology that accounts for individual differences, conducts competitive tests, and has provided evidence for people’s adaptive use of heuristics. Homo heuristicus has a biased mind and ignores part of the available information, yet a biased mind can handle uncertainty more efficiently and robustly than an unbiased mind relying on more resource-intensive and general-purpose processing strategies. (shrink)

The evidence-based practice and evidence-based medicine movements have promoted standardization through guideline development methodologies based on systematic reviews and meta-analyses of best available research. EBM has challenged clinicians to question their reliance on practical reasoning and clinical judgement. In this paper, we argue that the protagonists of EBM position their mission as reducing uncertainty through the use of standardized methods for knowledge evaluation and use. With this drive towards uniformity, standardization and control comes a suspicion towards intuition, creativity and uncertainty (...) as integral parts of medical practice. We question the appropriateness of attempts to standardize professional practice through a discussion of the importance of uncertainty. Greenhalgh’s taxonomy of uncertainty is used to inform an analysis of the clinical reasoning occurring in a potentially life threatening emergency situation with a young patient. The case analysis is further developed by the use of the Canadian philosopher Bernard Lonergan’s theory about understanding and objective knowing. According to Lonergan it is not by getting rid of or even by reducing uncertainty, but by attending systematically to it and by relating to it in a self-conscious way, that objective knowledge can be obtained. The paper concludes that uncertainty is not a regrettable and unavoidable aspect of decision making but a productive component of clinical reasoning. (shrink)

I argue that difference-making should be a crucial element for evaluating the quality of evidence for mechanisms, especially with respect to the robustness of mechanisms, and that it should take central stage when it comes to the general role played by mechanisms in establishing causal claims in medicine. The difference- making of mechanisms should provide additional compelling reasons to accept the gist of Russo-Williamson thesis and include mechanisms in the protocols for Evidence- Based Medicine, as the EBM+ research group has (...) been advocating. (shrink)

Vice epistemology is the philosophical study of the nature, identity, and epistemological significance of intellectual vices. Such vices include gullibility, dogmatism, prejudice, closed-mindedness, and negligence. These are intellectual character vices, that is, intellectual vices that are also character traits. I ask how the notion of an intellectual character vice should be understood, whether such vices exist, and how they might be epistemologically significant. The proposal is that intellectual character vices are intellectual character traits that impede effective and responsible inquiry. I (...) argue that situationist critiques of virtue epistemology pose no significant threat to this proposal. Studies by social psychologists of belief in conspiracy theories suggest that it is sometimes appropriate to explain questionable beliefs by reference to intellectual character vices. Neither ‘regulative’ nor ‘analytic’ epistemology has any good reason to question the epistemological significance of such vices. (shrink)

This is a concise, advanced introduction to current philosophical debates about truth. A blend of philosophical and technical material, the book is organized around, but not limited to, the tendency known as deflationism, according to which there is not much to say about the nature of truth. In clear language, Burgess and Burgess cover a wide range of issues, including the nature of truth, the status of truth-value gaps, the relationship between truth and meaning, relativism and pluralism about truth, and (...) semantic paradoxes from Alfred Tarski to Saul Kripke and beyond. Following a brief introduction that reviews the most influential traditional and contemporary theories of truth, short chapters cover Tarski, deflationism, indeterminacy, realism, antirealism, Kripke, and the possible insolubility of semantic paradoxes. The book provides a rich picture of contemporary philosophical theorizing about truth, one that will be essential reading for philosophy students as well as philosophers specializing in other areas. (shrink)

In "Upheavals of Thought", Martha Nussbaum offers a theory of the emotions. She argues that emotions are best conceived as thoughts, and she argues that emotion-thoughts can make valuable contributions to the moral life. She develops extensive accounts of compassion and erotic love as thoughts that are of great moral import. This paper seeks to elucidate what it means, for Nussbaum, to say that emotions are forms of thought. It raises critical questions about her conception of the structure of emotion, (...) and about her conception of compassion, in particular. Finally, the paper seeks to show how analyzing the structure, as well as the moral value, of the emotions ultimately requires entering the realm of religious ethics. (shrink)

Evidence based medicine (EBM) is under critical debate, and person centered healthcare (PCH) has been proposed as an improvement. But is PCH offered as a supplement or as a replacement of EBM? Prima facie PCH only concerns the practice of medicine, while the contended features of EBM also include methods and medical model. I here argue that there are good philosophical reasons to see PCH as a radical alternative to the existing medical paradigm of EBM, since the two seem committed (...) to conflicting ontologies. This paper aims to make explicit some of the most fundamental assumptions that motivate EBM and PCH, respectively, in order to show that the choice between them ultimately comes down to ontological preference. While EBM has a solid foundation in positivism, or what I here call Humeanism, PCH is more consistent with causal dispositionalism. I conclude that if there is a paradigmatic revolution on the way in medicine, it is first of all one of ontology. (shrink)