This contribution explores how Forrester’s work on cases has opened up an arena that might be called ‘the medical case as a travelling genre’. Although usually focused on the course of disease in an individual patient and authored mostly by one medical author, medical case histories have a social dimension: Once published, they often circulate in networks of scholars. Moreover, scholars of the history of literature have shown that numerous medical cases seem to travel easily beyond the context of medical (...) science into the realm of popular literature and journalism. After tracing the idea of cases travelling in Forrester’s Thinking in Cases, I discuss several contributions by authors who, in the wake of interdisciplinary research on cases in the past two decades, have dealt in different ways with this idea. In the third section, I present my own research on a case of self-crucifixion that was widely discussed in 19th-century Europe. I suggest that understanding the case as a ‘traveling genre’ – an expression borrowed from literary genre theory – highlights the role of readers and publication formats as constitutive for cases, and enables us to see more clearly what cases do for scientists and writers who work with them. (shrink)

Prior to the genomic sequencing era, the bible for those working in clinical genetics was McKusick’s Mendelian Inheritance in Man, which appeared in multiple editions between the 1960s and the late 1990s. This catalogue was organized according to general patterns of inheritance and focused on phenotypes. Beginning in the mid-1980s, it was replaced by Online Mendelian Inheritance in Man, a continuously updated catalogue documenting molecular relationships between genetic variation and phenotypic expression. This paper explores this resource’s evolution with attention to (...) how disease is distinguished from clinically irrelevant variation and how phenotypic similarities are captured in cases where there is no obvious genotypic association. It is argued that hybrid compromises are encoded into OMIM®; in addition to serving its key original purpose of being a diagnostic catalogue, it also began to record detectable variations in the genome even if they were not known to be associated with phenotypically visible disorders or even phenotypic variations. Although the impacts of geneticization have been well recognized, particularly in popular media, this example allows exploration of some of the historic, epistemic, and methodological causes that underlie tendencies toward disease geneticization in contemporary medicine, while highlighting that such gene-focused strategies may in fact be warranted in some contexts. (shrink)

This paper assesses the epistemic challenges of giving nutrition advice to elite athletes in light of recent philosophical discussion concerning evidence-based practice. Our trust in experts largely depends on the assumption that their advice is based on reliable evidence. In many fields, the evaluation of the reliability of evidence is made on the basis of standards that originate from evidence-based medicine. I show that at the Olympic or professional level, implementing nutritional plans in real-world competitions requires contextualization of knowledge in (...) a way that contravenes the tenets of evidence-based thinking. Nutrition experts need to be able to combine and apply evidence from multiple sources, including the previous successes and failures of particular athletes. I argue that in this sense, the practice of elite sport nutrition embodies casuistic reasoning. (shrink)

This groundbreaking, open access volume analyses and compares data practices across several fields through the analysis of specific cases of data journeys. It brings together leading scholars in the philosophy, history and social studies of science to achieve two goals: tracking the travel of data across different spaces, times and domains of research practice; and documenting how such journeys affect the use of data as evidence and the knowledge being produced. The volume captures the opportunities, challenges and concerns involved in (...) making data move from the sites in which they are originally produced to sites where they can be integrated with other data, analysed and re-used for a variety of purposes. The in-depth study of data journeys provides the necessary ground to examine disciplinary, geographical and historical differences and similarities in data management, processing and interpretation, thus identifying the key conditions of possibility for the widespread data sharing associated with Big and Open Data. The chapters are ordered in sections that broadly correspond to different stages of the journeys of data, from their generation to the legitimisation of their use for specific purposes. Additionally, the preface to the volume provides a variety of alternative “roadmaps” aimed to serve the different interests and entry points of readers; and the introduction provides a substantive overview of what data journeys can teach about the methods and epistemology of research. (shrink)

This paper aims to address some methodological issues related to case-based research in the philosophy of contemporary sciences. We focus on the selection processes by which philosophers pick or generate a particular set of papers to conduct their case-based research. We illustrate how to use various quantitative and qualitative methods to improve the epistemic features of the selection processes, and help generate some potential case-based hypotheses for further philosophical investigation.

The provocative paper by John Forrester ‘If p, Then What? Thinking in Cases’ opened up the question of case thinking as a separate mode of reasoning in the sciences. Case-based reasoning is certainly endemic across a number of sciences, but it has looked different according to where it has been found. This article investigates this mode of science – namely thinking in cases – by questioning the different interpretations of ‘If p?’ and exploring the different interpretative responses of what follows (...) in ‘Then What?’. The aim is to characterize how ‘reasoning in, within, with, and from cases’ forms a mode of scientific investigation for single cases, for runs of cases, and for comparative cases, drawing on materials from a range of different fields in which case-based reasoning appears. (shrink)

In the biomedical, behavioural and social sciences, the leading method used to estimate causal effects is commonly randomised controlled trials (RCTs) that are generally viewed as both the source and justification of the most valid evidence. In studying the foundation and theory behind RCTs, the existing literature analyses important single issues and biases in isolation that influence causal outcomes in trials (such as randomisation, statistical probabilities and placebos). The common account of biased causal inference is described in a general way (...) in terms of probabilistic imbalances between trial groups. This paper expands the common account of causal bias by distinguishing between the range of biases arising between trial groups but also within one of the groups or across the entire sample during trial design, implementation and analysis. This is done by providing concrete examples from highly influential RCT studies. In going beyond the existing RCT literature, the paper provides a broader, practice-based account of causal bias that specifies the between-group, within-group and across-group biases that affect the estimated causal results of trials – impacting both the effect size and statistical significance. Within this expanded framework, we can better identify the range of different types of biases we face in practice and address the central question about the overall validity of the RCT method and its causal claims. A study can face several smaller biases (related simultaneously to a smaller sample, smaller estimated effect, greater unblinding etc.) that generally add up to greater aggregate bias. Though difficult to measure precisely, it is important to assess and provide information in studies on how much different sources of bias, combined, can explain the estimated causal effect. The RCT method is thereby often the best we have to inform our policy decisions – and the evidence is strengthened when combined with multiple studies and other methods. Yet there is room for continually improving trials and identifying ways to reduce biases they face and to increase their overall validity. Implications are discussed. (shrink)

Hospital acquired infections (HAIs) are a major threat to patient safety. This paper addresses the following question: given what is known about the causes of and possible interventions on HAIs, to whom or what should the moral responsibility for preventing these infections be attributed? First, we show how generating robust evidence on the effectiveness of preventive hygiene measures is a complex endeavour and review the existing evidence on the causes of HAIs. Second, we demonstrate that the existing literature on the (...) ethical aspects of infection control has focused on responsibility at the individual-level. Thirdly, we argue that these accounts do not accommodate systemic factors relevant for HAI prevention. We show that the notion of collective responsibility is useful for making understandable how systemic factors, such as employment conditions in hospitals, are both causally and ethically relevant in infection control. (shrink)

When radiocarbon dating techniques were applied to archaeological material in the 1950s they were hailed as a revolution. At last archaeologists could construct absolute chronologies anchored in temporal data backed by immutable laws of physics. This would make it possible to mobilize archaeological data across regions and time-periods on a global scale, rendering obsolete the local and relative chronologies on which archaeologists had long relied. As profound as the impact of 14C dating has been, it has had a long and (...) tortuous history now described as proceeding through three revolutions, each of which addresses distinct challenges of capturing, processing and packaging radiogenic data for use in resolving chronological puzzles with which archaeologists has long wrestled. In practice, mobilizing radiogenic data for archaeological use is a hard-won achievement; it involves multiple transformations that, at each step of the way, depend upon a diverse array of technical expertise and background knowledge. I focus on strategies of triangulation and traceability that establish the integrity of these data and their relevance as anchors for evidential reasoning in archaeology. (shrink)