The Empirical school of medicine, which arose in the third century BCE, defined itself in opposition to rationalist tendencies in medical thought. Causal explanation, which typically appeals to hidden, theoretical entities, is most at home in rationalist physiology and pathology, and much of what the Empiricists had to say about causes belongs to their anti-rationalist polemics. Over the course of the school’s history, however, some members appropriated the language and idea of cause, though always in ways that was consistent (...) with its defining commitment to Empiricism. (shrink)

Empiricism has many different faces. As the contributions to this volume demonstrate, in the 17th and 18th century demonstrate medical and philosophical empiricism is less about an "essence" and more a series of specifically modern "acts" or "gestures.".

Vitalism, from its early modern to its Enlightenment forms (from Glisson and Willis to La Caze and Barthez), is notoriously opposed to intervention into the living sphere. Experiment, quantification, measurement are all ‘vivisectionist’, morally suspect and worse, they alter and warp the ‘life’ of the subject. They are good for studying corpses, not living individuals. This much is well known, and it has disqualified vitalist medicine from having a place in standard histories of medicine, until recent, post-Foucauldian maneuvers have sought (...) to change the situation (but for unrelated, contextualist reasons). What is perhaps more suprising is that if we consider the emergence of medical ‘theory’ as a whole, from Harvey through to Locke and Sydenham, is the presence of a sustained anti-experimentalist line of argument, and this from the ‘empiricist’ (not Cartesian or Boerhaavian rationalist) side. It would seem then that ‘empiricks’, medical empiricists and other protagonists of an ‘embodied empiricism’ are not Boylean experimentalists who seek to map out Nature in its transparency, but deliberately archaic, Hippocratic observers of living bodies. (shrink)

Kant introduces empiricism as a deficient position that is unsuitable for the generation of scientific knowledge. The reason for this is that, according to him, empiricism fails to connect with the world by remaining trapped within the realm of appearances. If we follow Galen’s account of the debate ensuing among Hellenistic doctors in the third century B.C., empiricism presents itself in an entirely different light. It emerges as a position that criticises medical practitioners who stray away (...) from the here and now by indulging in theory-driven a priori forms of reasoning. In so doing empiricism remains at all times committed to the world and its agents. In this paper Galen’s account of empiricism will serve me as a means to unravel the dynamics of a discussion that aims to reassess the standards of a dogmatic scientific practice. By looking at Bacon’s and Gassendi’s perception of the ancient medical tradition I will furthermore show that the understanding of what empiricism is crucially depends on the understanding of what scepticism is. (shrink)

Name der Zeitschrift: Apeiron Jahrgang: 47 Heft: 2 Seiten: 141-171.

Amending and Defending Critical Contextual Empiricism: Lessons from Medical Research In Science as Social Knowledge (1990) and The Fate of Knowledge (2002), Helen Longino develops a social epistemological theory known as Critical Contextual Empiricism (CCE). While Longino’s work has been generally well-received, there have been a number of criticisms of CCE raised in the philosophical literature in recent years. In this paper I outline the key elements of Longino’s theory and propose several modifications to the four norms (...) offered by the account. The revisions I propose are shaped by a number of developments in the medical context in recent years. The modified norms, which determined whether a particular community produces objective knowledge, are thus: 1. Avenues for Criticism – there must be recognized avenues for criticism, and these avenues must be publicly accessible and require transparent disclosure of all relevant information (including competing interests) from those who present their ideas. It must also be a community requirement that all members present their ideas for critical scrutiny if they wish them to be recognized as knowledge. 2. Responsiveness to Criticism – the community must be responsive to criticism. 3. Shared Public Standards – there must be some shared standards that determine community membership. Outsiders to a particular community are welcome to engage in critical debates as long as they share at least one of the community standards with the target community. 4. Cultivation of Diverse Perspectives – communities must cultivate diverse perspectives, that is, the perspectives of those who express strong dissent. The version of CCE I defend gives the principle of diversity a more central role than the original and provides greater specification of two of the other norms in light of challenges faced by medical researchers in recent years. The medical context provides us with a number of cautionary tales in which knowledge production that appears to meet the original four norms has been seriously compromised by particular social interests. The proposed modifications attempt to address these ‘loopholes’ in a way that is not ad hoc. I argue that the modifications I suggest are in line with the underlying assumptions and goals of CCE. The modified version of CCE also offers resources for defending CCE against the criticisms leveled against it by Miriam Solomon & Alan Richardson, Alvin Goldman and Philip Kitcher as well as one general concern arising out of a recent work by David Michaels. I provide responses to these criticisms in the final section of the paper. Throughout the paper I connect the theoretical work done in social epistemology to the real practice of knowledge-production as is occurs in the medical context. In light of the variety of social pressures influencing contemporary scientific research, and the role of science in shaping public policy, I argue that a rigorous social epistemology such as CCE is indispensable for understanding and assessing contemporary scientific practice. (shrink)

Getting physical: Empiricism’s medical History Content Type Journal Article DOI 10.1007/s11016-010-9474-4 Authors John Gascoigne, School of History and Philosophy, University of New South Wales, Sydney, NSW 2056, Australia Journal Metascience Online ISSN 1467-9981 Print ISSN 0815-0796.

Thirty years after the rise of the evidence-based medicine (EBM) movement, formal training in philosophy remains poorly represented among medical students and their educators. In this paper, I argue that EBM’s reception in this context has resulted in a privileging of empiricism over rationalism in clinical reasoning with unintended consequences for medical practice. After a limited review of the history of medical epistemology, I argue that a solution to this problem can be found in the method (...) of the 2nd-century Roman physician Galen, who brought empiricism and rationalism together in a synthesis anticipating the scientific method. Next, I review several of the problems that have been identified as resulting from a staunch commitment to empiricism in medical practice. Finally, I conclude that greater epistemological awareness in the medical community would precipitate a Galenic shift toward a more epistemically balanced, scientific approach to clinical research. (shrink)

In this paper we suggest a revisionist perspective on two significant figures in early modern life science and philosophy: William Harvey and John Locke. Harvey, the discoverer of the circulation of the blood, is often named as one of the rare representatives of the ‘life sciences’ who was a major figure in the Scientific Revolution. While this status itself is problematic, we would like to call attention to a different kind of problem: Harvey dislikes abstraction and controlled experiments (aside from (...) the ligature experiment in De Motu Cordis), tends to dismiss the value of instruments such as the microscope, and emphasizes instead the privileged status of ‘observed experience’. To use a contemporary term, Harvey appears to rely on, and chiefly value, ‘tacit knowledge’. Secondly, Locke’s project is often explained with reference to the image he uses in the Epistle to the Reader of his Essay, that he was an “underlabourer” of the sciences. In fact, despite the significant medical phase of his career, Locke’s ‘empiricism’ turns out to be above all a practical (i.e. ‘moral’) project, which focuses on the delimitation of our powers in order to achieve happiness, and rejects the possibility of naturalizing knowledge. When combined, these two cases suggest a different view of some canonical moments in early modern natural philosophy. (shrink)

Research into the proper mission of business falls within the context of theoretical and applied ethics. And ethics is fast becoming a part of required business school curricula. However, while business ethics research occasionally appears in high‐profile venues, it does not yet enjoy a regular place within any top management journal. I offer a partial explanation of this paradox and suggestions for resolving it. I begin by discussing the standard conception of human nature given by neoclassical economics as disseminated in (...) business schools; showing it is a significant obstacle to an accurate conception of ethics and how this limits consideration of sustainability and corporate social responsibility. I then examine the scope of the top management journals, showing how their empirical and descriptive focus leaves little room for ethics, which is an essentially conceptual and prescriptive discipline. Finally, I suggest avenues for research into the ethical mission of business, generally—and sustainability and CSR, in particular—by appeal to the precepts of Harvard Business School’s Master’s in Business Administration ethics oath modeled on the medical and legal professions. (shrink)

In Science as Social Knowledge in 1990 and The Fate of Knowledge in 2002, Helen Longino develops an epistemological theory known as Critical Contextual Empiricism (CCE). Knowledge production, she argues, is an active, value-laden practice, evidence is context dependent and relies on background assumptions, and science is a social inquiry that, under certain conditions, produces social knowledge with contextual objectivity. While Longino’s work has been generally well-received, there have been a number of criticisms of CCE raised in the philosophical (...) literature in recent years. In this paper I outline the key elements of Longino’s theory and propose modifications to the four norms offered by the account. The version of CCE I defend, which draws on lessons learned by medical researchers in recent years, gives principles of epistemic diversity a central role and also provides greater specification of three of the four norms. Further, it offers additional resources for defending CCE against Alvin Goldman’s suggestion that there is a need for a “healthy dogmatism” in science, as well as a concern about “manufactured uncertainty” arising out of recent work by David Michaels. Finally, the modified version proposed here is also well positioned to respond (negatively) to a suggestion from Kristen Intemann that CCE needs to be adapted to incorporate a central insight from feminist standpoint theory. In light of the variety of social pressures influencing contemporary scientific research, and the role of science in shaping public policy, I argue that a rigorous social epistemology such as CCE is indispensable for understanding and assessing contemporary scientific practice. (shrink)

My topic is the materialist appropriation of empiricism – as conveyed in the ‘minimal credo’ nihil est in intellectu quod non fuerit in sensu (which interestingly is not just a phrase repeated from Hobbes and Locke to Diderot, but is also a medical phrase, used by Harvey, Mandeville and others). That is, canonical empiricists like Locke go out of their way to state that their project to investigate and articulate the ‘logic of ideas’ is not a scientific project: (...) “I shall not at present meddle with the Physical consideration of the Mind” (Essay, I.i.2, in Locke 1975; which Kant gets exactly wrong in his reading of Locke, in the Preface to the A edition of the first Critique). Indeed, I have suggested elsewhere, contrary to a prevalent reading of Locke, that the Essay is not the extension to the study of the mind of the methods of natural philosophy; that he is actually not the “underlabourer” of Newton and Boyle he claims politely to be in the Epistle to the Reader (Wolfe and Salter 2009, Wolfe 2010). Rather, Locke says quite directly if we pay heed to such passages, “Our Business here is not to know all things, but those which concern our Conduct” (Essay, I.i.6). There would be more to say here about what this implies for our understanding of empiricism (see Norton 1981 and Gaukroger 2005), but instead I shall focus on a different aspect of this episode: how a non-naturalistic claim which falls under what we now call epistemology (a claim about the senses as the source of knowledge) becomes an ontology – materialism. That is, how an empiricist claim could shift from being about the sources of knowledge to being about the nature of reality (and/or the mind, in which case it needs, as David Hartley saw and Denis Diderot proclaimed more overtly, an account of the relation between mental processes and the brain). (David Armstrong, for one, denied that there could be an identification between empiricism and materialism on this point: eighteenth-century history of science seems to prove him wrong: see Armstrong 1968 and 1978.) Put differently, I want to examine the shift from the logic of ideas in the seventeenth century (Locke) to an eighteenth-century focus on what kind of ‘world’ the senses give us (Condillac), to an assertion that there is only one substance in the universe (Diderot, giving a materialist cast to Spinozism), and that we need an account of the material substrate of mental life. This is neither a ‘scientific empiricism’ nor a linear developmental process from philosophical empiricism to natural science, but something else again: the unpredictable emergence of an ontology on empiricist grounds. (shrink)

This article explores Galen's analysis of and response to the Rationalist and Empiricist medical sects. It argues that his interest in their debate concerning the epistemology of medicine and anatomy was key to his advancement of an experimental methodology.

This paper examines the status of medical experiments using the Leibnizian conception of knowledge. The aim is to consider whether experimentation is a “perceptive foretaste” or a real condition for the advancement of knowledge. To this end I argue, first, that acting on bodies could be a way to understand them and, second, I establish a place for medical experiments in the field of learning. In these ways, I identify a “provisional empiricism” in Leibniz’ medical texts.

A physician and spokesman for the French Ideologues, Pierre-JeanGeorges Cabanis (1757-1808) stands at the crossroads of several influential developments in modern culture--Enlightenment optimism about human perfectibility, the clinical method in medicine, and the formation and adaptation of liberal social ideals in the French Revolution. This first major study of Cabanis in English traces the influences of these developments on his thought and career. Originally published in 1980. The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously (...) out-of-print books from the distinguished backlist of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905. (shrink)

How are we to connect the mechanist methodology used by Baglivi in his physiological treatises with the apparently strict empiricism that he promotes in his therapeutic work entitled Practice of Physick, reduc’d to the Ancient Way of Observations? In order to answer this question, we examine the methodological implications of the “history of diseases” that Baglivi promotes by using Bacon’s recommendations in the Novum organum. Then, we compare this result with the place that historians generally gave to Baglivi in (...) the medical context of that time: the place of a dogmatic and “iatromechanist” physician who was far from practical and therapeutic concerns. This confrontation allows us first to apprehend the polemical origin of the so-called “iatromechanism” as a historiographical label, and second, to question the preeminence of the role of observations in the shaping of the classical distinction between “rational” physicians and “empirical” ones. When Early Modern physicians use the dichotomy between “empirical” and “rationalist” in order to discredit what they perceive as oversimplification or dogmatism, there is most often a third group at stake: a group which is depicted as the providential and intelligent solution to sectarianism. For Baglivi, this third group would be an “Empirick rational sect.” The distinction between a medicina prima and a medicina secunda allows us to understand such an apparently paradoxical category. (shrink)

The clinical empiricism of Thomas Sydenham (1624–1689) and his definition of especie morbosae represented a substantial turn in the medicine of his time. This turn supposed the shift towards an ontological conception of diseases, from a qualitative to quantitative interpretation. Sydenham’s clinical proposal had a great influence on empiricism philosophical thinking, particularly in John Locke and his delimitation of knowledge. The dialogue between medicine and philosophy, set out by Sydenham-Locke, reactivates the problem of the clinical and theoretical foundations (...) of medical thought, as well as the limits of scientific knowledge. Similar to problem exposed in the Hippocratic treatise On ancient medicine, seventeenth-century medicine seeks its epistemological foundations and the solution to its difficulties in clinical experience, probability and analogy. The aim of this work is to show the Sydenham’s contribution to one of the great controversies between medicine and philosophy. (shrink)

This book provides a post-positivist theory of deterministic and probabilistic causality that supports both quantitative and qualitative explanations. Features of particular interest include the ability to provide true explanations in contexts where our knowledge is incomplete, a systematic interpretation of causal modeling techniques in the social sciences, and a direct realist view of causal relations that is compatible with a liberal empiricism. The book should be of wide interest to both philosophers and scientists. Originally published in 1989. The Princeton (...) Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905. (shrink)

We write in response to the original article by Rennie and Rudland published in the April 2003 edition of this journal.1 Current and former Dundee Medical School students are concerned at the media misinterpretation of the study and the consequences that this branding of “dishonesty” will have on Dundee Medical School’s reputation and also on individuals embarking on their ….

This code of practice for health professionals was prepared by a multi-professional group and reflects good clinical practice in encouraging dialogue about individuals' wishes concerning their future treatment. It has a broad practical approach, considers a range of advance statements, advises of dangers and benefits of making treatment decisions in advance and combines annotated code of practice with a quick pull out guide for easy reference.

Summary Principles Timely support for patients and people close to them, and effective, sensitive communication are essential. Decisions must be based on the individual patient's circumstances and reviewed regularly. Sensitive advance discussion should always be encouraged, but not forced. Information about CPR and the chances of a successful outcome needs to be realistic. Practical matters Information about CPR policies should be displayed for patients and staff. Leaflets should be available for patients and people close to them explaining about CPR, how (...) decisions are made and their involvement in decisions. Decisions about attempting CPR must be communicated effectively to relevant health professionals. In emergencies If no advance decision has been made or is known, CPR should be attempted unless: the patient has refused CPR; the patient is clearly in the terminal phase of illness; or the burdens of the treatment outweigh the benefits. Advance decision making Competent patients should be involved in discussions about attempting CPR unless they indicate that they do not want to be. Where patients lack competence to participate, people close to them can be helpful in reflecting their views. Legal issues Patients' rights under the Human Rights Act must be taken into account in decision making. Neither patients nor relatives can demand treatment which the health care team judges to be inappropriate, but all efforts will be made to accommodate wishes and preferences. In England, Wales and Northern Ireland relatives and people close to the patient are not entitled in law to take health care decisions for the patient. In Scotland, adults may appoint a health care proxy to give consent to medical treatment. Health professionals need to be aware of the law in relation to decision making for children and young people.IntroductionWhy policies are neededCardiopulmonary resuscitation can be attempted on any person whose cardiac or respiratory functions cease. Failure of these functions is part of dying and thus …. (shrink)

This article presents an analysis of contractual relations in sport from the standpoint of the Croatian legislative system. Due to the complexity of the subject matter, the author considers only a small fragment of it - the significance and the role of sport in Croatian society and the law of contracts „as a cornerstone on which „sports law“ has been built and which is of primary importance in most areas where there is an interface between sport and the law, irrespective (...) of whether the sport is being played at an elite level or at a more humble one“. Bearing in mind the limited extent of this article, the autor tries to provide some clarifications and some guidance on how to deal with the designation and the determination of the applicable law for contracts in the sporting context. Considering that there are different legal regimes which may come into play with regard to the designation of the law applicable to contracts in the sporting context, the author first presents the determination of the applicable law according to the Rome I Regulation and then according to the Croatian Arbitration Act, Swiss Private International Law Act and the CAS Code of Sports-related Arbitration, as the most common in sports practice. Then, the author deals with contracts concluded with minor athletes and the determination of the law applicable to some preliminary questions. Finally, the author presents her perception of the problems encountered and some suggestions for the improvement of the existing legal framework. (shrink)

1. Aim of the guidelines2. Principles of good practice3. Circumcision for medical purposes4. Non-therapeutic circumcision 4.1. The law 4.1.1. Summary: the law 4.2. Consent and refusal 4.2.1. Children’s own consent 4.2.2. Parents’ consent 4.2.3. Summary: consent and refusal 4.3. Best interests 4.3.1. Summary: best interests 4.4. Health issues 4.5. Standards 4.6. Facilities 4.7. Charging patients 4.8. Conscientious objection5. Useful addresses.

*The views expressed are the author's own. This article should not be construed as representing policies of the American Medical Association.

Dubin S, Lane M, Morrison S, et al. Medically assisted gender affirmation: when children and parents disagree. ….

*Disclaimer: The views expressed are the author's and should not be ascribed to the American Medical Association.

In this sweeping volume of comparative philosophy and intellectual history, Barry Allen reassesses the values of experience and experiment in European and world traditions. His work traces the history of empirical philosophy from its birth in Greek medicine to its emergence as a philosophy of modern science. He surveys medical empiricism, Aristotlean and Epicurean empiricism, the empiricism of Gassendi and Locke, logical empiricism, radical empiricism, transcendental empiricism, and varieties of anti-empiricism from Parmenides (...) to Wilfrid Sellars. Throughout this extensive intellectual history, Allen builds an argument in three parts. A richly detailed account of history's empiricisms in Part One establishes a context in Part Two for reconsidering the work of the radical empiricists--William James, Henri Bergson, John Dewey, and Gilles Deleuze, each treated in a dedicated chapter. What is "radical" about them is their effort to return empiricism from epistemology to the ontology and natural philosophy where it began. In Part Three, Allen sets empirical philosophy in conversation with Chinese tradition, considering technological, scientific, medical, and alchemical sources, as well as selected Confucian, Daoist, and Mohist classics. The work shows how philosophical reflection on experience and a profound experimental practice coexist in traditional China with no interaction or even awareness of each other, slipping over each other instead of intertwining as they did in European history, a difference Allen attributes to a different understanding of the value of knowledge. Allen's book recovers empiricism's neglected, multi-textured contexts, and elucidates the enduring value of experience, to arrive at an idea of what is living and dead in philosophical empiricism. (shrink)

Zemyarska MS. Is it ethical to provide IVF add-ons when there is no evidence of a benefit if the patient requests it? J Med Ethics 2019;45:346–50. doi: 10.1136/medethics-2018-104983. The Acknowledgements section of ….