Traditionally, mechanistic reasoning has been assigned a negligible role in standard EBM literature, although some recent authors have argued for an upgrade. Even so, the mechanistic reasoning that has received attention has almost exclusively been positive—both in an epistemic sense of claiming that there is a mechanistic chain and in a health-related sense of there being claimed benefits for the patient. Negative mechanistic reasoning has been neglected, both in the epistemic and in the health-related sense. I distinguish three main types (...) of negative mechanistic reasoning and subsume them under a new definition of mechanistic reasoning in the context of assessing medical interventions. This definition is wider than a previous suggestion in the literature. Each negative type corresponds to a range of evidential strengths, and it is argued that there are differences with respect to typical evidential strengths. The variety of negative mechanistic reasoning should be acknowledged in EBM, and it presents a serious challenge to proponents of so-called medical hierarchies of evidence. (shrink)

The validity of clinical trials for certain alternative treatments has been called into question by supporters of unconventional and pseudoscientific practices, who criticize the way their beliefs are investigated scientifically or the verdicts reached by science. This chapter focuses on the following basic question: what treatments can be scientifically investigated at all? It aims to provide a better understanding of what conditions medical treatments must fulfill to be eligible for scientific investigation. In particular, the discussion is a rejoinder to the (...) claims put forward by adherents of alternative medicine that their treatments are inaccessible to scientific scrutiny. (shrink)

QC 20120521. Review of 'Science in the Age of Computer Simulation' by Eric Winsberg.