In this paper I shall venture into an area with which I am not very familiar and in which I feel far from confident; namely into phenomenology. My main motive is not to get away from standard, boring, methodological questions like those of induction and demarcation; but the conviction that a phenomenological account of the empirical basis forms a necessary complement to Popper's falsificationism. According to the latter, a scientific theory is a synthetic and universal, hence unverifiable proposition. In fact, (...) in order to be technologically useful, a scientific hypothesis must refer to future states-of-affairs; it ought therefore to remain unverified. But in order to be empirical, a theory must bear some kind of relation to factual statements. According to Popper, such a relation can only be one of potential conflict. Thus a theory T will be termed scientific if and only if T is logically incompatible with a so-called basic statement b, where b is both empirically verifiable and empirically falsifiable. In other words: T is scientific if it entails ¬b; where b, hence also ¬b, is an empirically decidable proposition. (shrink)

It has been maintained, by both philosophers and modern scientists, that the two domains of discourse of science and of philosophy are disjoint Though admitting that many physicists subscribed to metaphysical principles, it was claimed - by Duhem and Reichenbach among others - that the scientist's philosophical convictions play, or should play, no role in his scientific work. The present paper attempts to refute this separatist view by showing that Einstein's metaphysical realism - coupled with his Platonistic panmathematicism - played (...) a crucial role in his construction of the Relativity Programme and in his criticism of Quantum Mechanics. The article also shows that although Einstein was neither a strict Humean nor a strict Machian, his phenomenalist interpretation of the empirical basis proved to be an antidote against both conventionalist scepticism and Neurath's coherence theory of truth. /// Tanto filósofos como cientistas têm defendido a ideia de que os domínios discursivos da Ciência e da Filosofia seguem caminhos separados. Mesmo admitindo que muitos cientistas subscreveram princípios metafísicos, a ideia tem sido defendida - por Duhem e Reichenbach, entre outros - de que as convicções filosóficas do cientista não desempenham, ou deveriam não desempenhar, qualquer papel no seu trabalho científico. O objectivo do presente artigo é refutar esta visão separatista das coisas mostrando de que modo o realismo metafísico de Einstein - associado ao seu panmatematicismo platónico - desempenhou um papel crucial na sua construção do Programa da Relatividade e nas suas críticas à Mecânica Quântica. O artigo mostra igualmente que embora Einstein não fosse nem um Humeano estrito nem um estrito Macheano, a sua interpretação fenomenalista da base empírica demonstrou ser um antídoto quer contra o cepticismo convencionalista quer contra a teoria da coerência da verdade de Neurath. (shrink)

The evolving Ebola epidemic in West Africa is unprecedented in its size and scope, requiring the rapid mobilization of resources. It is too early to determine all of the ethical challenges associated with the outbreak, but these should be monitored closely. Two issues that can be discussed are the decision to implement and evaluate unregistered agents to determine therapeutic or prophylactic safety and efficacy and the justification behind this decision. In this paper, I argue that it is not compassionate use (...) that justifies this decision and suggest three lines of reasoning to support the decision. (shrink)

This essay explores the role of informal logicand its application in the context of currentdebates regarding evidence-based medicine. This aim is achieved through a discussion ofthe goals and objectives of evidence-basedmedicine and a review of the criticisms raisedagainst evidence-based medicine. Thecontributions to informal logic by StephenToulmin and Douglas Walton are explicated andtheir relevance for evidence-based medicine isdiscussed in relation to a common clinicalscenario: hypertension management. This essayconcludes with a discussion on the relationshipbetween clinical reasoning, rationality, andevidence. It is argued that (...) informal logic hasthe virtue of bringing explicitness to the roleof evidence in clinical reasoning, and bringssensitivity to understanding the role ofdialogical context in the need for evidence inclinical decision making. (shrink)

The Alexandrian emphasis on smallness, elegance, and slightness at the expense of grand themes in major poetic genres was not preciosity for its own sake: although the poetry was written by and for scholars, it had much larger sources than the bibliothecal context in which it was composed. Since the time of the classical poets, much had changed. Earlier Greek poetry was an intimate part of the life of the city-state, written for its religious occasions and performed by its citizens. (...) But eh conquests of Alexander had altered the structure and the boundaries of the Greek world to an astonishing degree. Alexandria, the center of the poetic culture of the new age, was a city that had not even existed at the time of Euripides; it was in Egypt, not in Greece, and was a huge, polyglot community. As immigrants immersed in a new, impersonal, and bureaucratic society, the poets not unreasonably sought out what was small, intimate, and personal in their verses. The heroes of early Greek poetry are larger than life; those of Alexandrian poetry are life-size. They are human, like us; they have a childhood and an old age; they are afraid or in love or caught in a rainstorm. It was simply one way of reducing the world to more manageable dimensions. At the same time, the new world of Alexandria needed a new poetry. To continue writing epics about a mythology that seemed very far away was senseless; it was impossible to recapture either the style or the immediacy of Homer, lyric poetry, or Attic tragedy. The scholar-poets of Alexandria admired the literature of classical Greece; for them Homer was incomparable and inimitable, to be studied—but not to be copied. Far better, then, to find a new voice on a more manageable scale: instead of oral epic, erudite epyllion; instead of lyric, epigram; instead of tragedy, mime. The poets of an urban and unheroic world might long for but could never re-create the grandeur of the past. James E. G. Zetzel is associate professor of classics at Princeton University and editor of the Transactions of the American Philological Association. He is the author of Latin Textual Criticism in Antiquity and, with Anthony T. Grafton and Glenn W. Most, has translated Friedrich August Wolf’s Prolegomena ad Homerum. (shrink)

Evidence-based medicine has beendefined as the conscientious and judicious useof current best evidence in making clinicaldecisions. This paper will attempt to explicatethe terms ``conscientious'''' and ``judicious''''within the evidence-based medicine definition.It will be argued that ``conscientious'''' and``judicious'''' represent virtue terms derived fromvirtue ethics and virtue epistemology. Theidentification of explicit virtue components inthe definition and therefore conception ofevidence-based medicine presents an importantstarting point in the connection between virtuetheories and medicine itself. In addition, aunification of virtue theories andevidence-based medicine will illustrate theneed for (...) future research in order to combinethe fields of virtue-based approaches andclinical practice. (shrink)

This paper explores the relationship between concepts of probability and hermeneutics. It seeks to examine the relationship between subjective (Bayesian) views of probability and hermeneutic descriptions of understanding. It is argued that Gadamer'saccount of the prejudicial nature of understanding, derived from Heidegger'sanalysis of foreunderstanding, offers a provocative model of clinical reasoning. The implications of this model for evidence-based medicine are discussed in conclusion.

ObjectivesTo describe reporting of informed consent in pragmatic trials, justifications for waivers of consent and reporting of alternative approaches to standard written consent. To identify factors associated with (1) not reporting and (2) not obtaining consent.MethodsSurvey of primary trial reports, published 2014–2019, identified using an electronic search filter for pragmatic trials implemented in MEDLINE, and registered in ClinicalTrials.gov.ResultsAmong 1988 trials, 132 (6.6%) did not include a statement about participant consent, 1691 (85.0%) reported consent had been obtained, 139 (7.0%) reported a (...) waiver and 26 (1.3%) reported consent for one aspect (eg, data collection) but a waiver for another (eg, intervention). Of the 165 trials reporting a waiver, 76 (46.1%) provided a justification. Few (53, 2.9%) explicitly reported use of alternative approaches to consent. In multivariable logistic regression analyses, lower journal impact factor (p=0.001) and cluster randomisation (p<0.0001) were significantly associated with not reporting on consent, while trial recency, cluster randomisation, higher-income country settings, health services research and explicit labelling as pragmatic were significantly associated with not obtaining consent (all p<0.0001).DiscussionNot obtaining consent seems to be increasing and is associated with the use of cluster randomisation and pragmatic aims, but neither cluster randomisation nor pragmatism are currently accepted justifications for waivers of consent. Rather than considering either standard written informed consent or waivers of consent, researchers and research ethics committees could consider alternative consent approaches that may facilitate the conduct of pragmatic trials while preserving patient autonomy and the public’s trust in research. (shrink)

As health care embraces the tenets of evidence-based medicine it is important to ask questions about how evidence is produced and interpreted. This essay explores normative dimensions of evidence production, particularly around issues of setting the tolerable level of uncertainty of results. Four specific aspects are explored: what health care providers know about statistics, why alpha levels have been set at 0.05, the role of randomization in the generation of sufficient grounds of belief, and the role of observational studies. The (...) essay concludes with recommendations to acknowledge the value permeation of outcome measures and suggests that attention to reasoning and argument analysis can augment traditional evidence-based approaches in providing a robust critical approach to medical knowledge. (shrink)

The Term ‘liberty’ invokes such universal respect that most modern political economists and moralists endeavour to find a conspicuous place for it somewhere in their systems or prescriptions. But in view of the innumerable senses of this term an insistence on some kind of definition prior to any discussion seems to be justified. For our present purposes attention to two particularly conflicting interpretations will be sufficient. These are sometimes called the ‘negative’ and the ‘positive’ notions of Liberty. According to the (...) ‘negative’ notion, my own liberty implies the reduction to a minimum of the deliberate interference of other human beings within the area in which I wish to act. Conversely the absence of liberty, or coercion, is regarded as undesirable because it amounts to the prevention by other persons of my doing what I want. On the other hand, the ‘positive’ sense of the word ‘liberty’ consists in the attainment of self-mastery, or, in other words, the release from the domination of ‘adverse’ influences. This ‘slavery’ from which men ‘liberate’ themselves is variously described to include slavery to ‘nature’, to ‘unbridled passions’, to ‘irrational impulses’, or simply slavery to one's ‘lower nature’. ‘Positive’ liberty is then identified with ‘self-realisation’ or an awakening into a conscious state of rationality. The fact that it is contended that such a state can often be attained only by the interference of other ‘rational’ persons who ‘liberate’ their fellow beings from their ‘irrationality’, brings this interpretation of liberty into open and striking conflict with liberty in the ‘negative’ sense. (shrink)

Despite the periodic table having been discovered by chemists half a century before the discovery of electronic structure, modern designs are invariably based on physicists’ definition of periods. This table is a chemists’ table, reverting to the phenomenal periods that led to the table’s discovery. In doing so, the position of hydrogen is clarified.

The subject is in both cases the voyage of the Argo, and therefore the use of the same words is not likely to be coincidental, even though the words themselves are scarcely uncommon. One would hesitate to deny, however, that such reminiscence might be unconscious; that Lucan had famous tags in his head is suggested by another allusion to famous opening lines.