All univocal analyses of causation face counterexamples. An attractive response to this situation is to become a pluralist about causal relationships. "Causal pluralism" is itself, however, a pluralistic notion. In this article, I argue in favor of pluralism about concepts of cause in the social sciences. The article will show that evidence for, inference from, and the purpose of causal claims are very closely linked. Key Words: causation • pluralism • evidence • methodology.

Francesco Guala once wrote that ‘The problem of extrapolation is a minor scandal in the philosophy of science’. This paper agrees with the statement, but for reasons different from Guala’s. The scandal is not, or not any longer, that the problem has been ignored in the philosophy of science. The scandal is that framing the problem as one of external validity encourages poor evidential reasoning. The aim of this paper is to propose an alternative—an alternative which constitutes much better evidential (...) reasoning about target systems of interest, and which makes do without consideration of external validity. (shrink)

The history of the research on peptic ulcer disease is characterized by a premature abandonment of the bacterial hypothesis, which subsequently had its comeback, leading to the discovery of Helicobacter pylori—the major cause of the disease. In this paper we examine the received view on this case, according to which the primary reason for the abandonment of the bacterial hypothesis in the mid-twentieth century was a large-scale study by a prominent gastroenterologist Palmer, which suggested no bacteria could be found in (...) the human stomach. To this end, we employ the method of digital textual analysis and study the literature on the etiology of PUD published in the decade prior to Palmer’s article. Our findings suggest that the bacterial hypothesis had already been abandoned before the publication of Palmer’s paper, which challenges the widely held view that his study played a crucial role in the development of this episode. In view of this result, we argue that the PUD case does not illustrate harmful effects of a high degree of information flow, as it has frequently been claimed in the literature on network epistemology. Moreover, we argue that alternative examples of harmful effects of a high degree of information flow may be hard to find in the history of science. (shrink)

The aim of the paper is to present and analyze problems associated with the mechanisms of auditory perception (especially those responsible for speech perception), their specific disorders and functions. I discuss research on speech perception in the broader theoretical context of the mechanistic model of scientific explanation and the perspective of cognitive implantology that explores the possibilities for building hybrid auditory systems.

Although coherence has become one of the key concepts in contemporary legal theory, its meaning is taken almost universally to be elusive, complex and controversial. However, these difficulties are due just to the failure of commentators to distinguish the intension of the notion from other features of its (many) referents in extension. The oversight has caused qualities to be ascribed routinely to coherence that properly attach to various object(s) of which coherence is predicated, and which a theorist happens to have (...) in mind when bringing coherence into view. This conceptual error has significance for the substance of present claims made for the use of the notion in law. Freed from the entanglement, coherence emerges thinner and fitter, better able to be deployed with confidence in legal application. (shrink)

Philosophy of psychiatry has boomed in the last few years. We are now seeing a growing literature on the nature of psychiatric explanation, including work that makes contact with longstanding disputes in the philosophy of science as well as more specific work on mental disorders. This paper looks at some recent work on both representing and explaining mental illness. An emerging picture sees explanation of mental disorder as first constructing causal-statistical networks that represent disease pathways as they unfold in time, (...) and then choosing strategies for causal explanation. The epistemic problems in psychiatry are huge, and they arise from the extreme variety in the causes and trajectories of mental disorders across patients. Existing concepts of levels of explanation and mechanism may seem like an obvious epistemic armoury, but they may not fit psychiatry very well, and philosophical theories of psychiatric explanation stress different ways of trying to understand robust patterns amid the individual variation. (shrink)

In somatic medicine, diagnostic terms often refer to the disease processes that are the causes of patients' symptoms. The language used in some clinical textbooks and health information resources suggests that this is also sometimes assumed to be the case with diagnoses in psychiatry. However, this seems to be in tension with the ways in which psychiatric diagnoses are defined in diagnostic manuals, according to which they refer solely to clusters of symptoms. This paper explores how theories of reference in (...) the philosophy of language can help to resolve this tension. After the evaluation of descriptive and causal theories of reference, I put forward a conceptual framework based on two-dimensional semantics that allows the causal analysis of diagnostic terms in psychiatry, while taking seriously their descriptive definitions in diagnostic manuals. While the framework is presented as a solution to a problem regarding the semantics of psychiatric diagnoses, it can also accommodate the analysis of diagnostic terms in other medical disciplines. (shrink)

Diagnoses in medicine are often taken to serve as explanations of patients’ symptoms and signs. This article examines how they do so. I begin by arguing that although some instances of diagnostic explanation can be formulated as covering law arguments, they are explanatory neither in virtue of their argumentative structures nor in virtue of general regularities between diagnoses and clinical presentations. I then consider the theory that medical diagnoses explain symptoms and signs by identifying their actual causes in particular cases. (...) While I take this to be largely correct, I argue that for a diagnosis to function as a satisfactory causal explanation of a patient’s symptoms and signs, it also needs to be supplemented by understanding the mechanisms by which the identified cause produces the symptoms and signs. This mechanistic understanding comes not from the diagnosis itself, but rather from the theoretical framework within which the physician operates. (shrink)

In clinical medicine, a diagnosis can offer an explanation of a patient's symptoms by specifying the pathology that is causing them. Diagnoses in psychiatry are also sometimes presented in clinical texts as if they pick out pathological processes that cause sets of symptoms. However, current evidence suggests the possibility that many diagnostic categories in psychiatry are highly causally heterogeneous. For example, major depressive disorder may not be associated with a single type of underlying pathological process, but with a range of (...) different causal pathways, each involving complex interactions of various biological, psychological, and social factors. This paper explores the implications of causal heterogeneity for whether psychiatric diagnoses can be said to serve causal explanatory roles in clinical practice. I argue that while they may fall short of picking out a specific cause of the patient's symptoms, they can nonetheless supply different sorts of clinically relevant causal information. In particular, I suggest that some psychiatric diagnoses provide negative information that rules out certain causes, some provide approximate or disjunctive information about the range of possible causal processes, and some provide causal information about the relations between the symptoms themselves. (shrink)

In 1958, Francis Crick distinguished the flow of information from the flow of matter and the flow of energy in the mechanism of protein synthesis. Crick’s claims about information flow and coding in molecular biology are viewed from the perspective of a new characterization of mechanisms and from the perspective of information as holding a key to distinguishing work in molecular biology from that of biochemistry in the 1950s–1970s . Flow of matter from beginning to end does not occur in (...) the protein synthesis mechanism; flow of information does. The flow of information and coding in molecular biological mechanisms are distinguished, on the one hand, from formal information theory, and, on the other, from information as used in cognitive neuroscience, where information and representation are often coupled. (shrink)

This paper primarily argues that Epidemiology is Ecosystem Science. It will not only explore this notion in detail but will also relate it to the argument that Classical Chinese Medicine was/is Ecosystem Science. Ecosystem Science and Ecosystem Science share these characteristics: they do not subscribe to the monogenic conception of disease; they involve multi variables; the model of causality presupposed is multi-factorial as well as non-linear.

Disease transmission is a fruitful domain in which to examine how scientific and folk theories interrelate, given laypeople’s access to multiple sources of information to explain events of personal significance. The current paper reports an in-depth survey of U.S. adults’ causal reasoning about two viral illnesses: a novel, deadly disease that has massively disrupted everyone’s lives, and a familiar, innocuous disease that has essentially no serious consequences. Participants received a series of closed-ended and open-ended questions probing their reasoning about disease (...) transmission, with a focus on causal mechanisms underlying disease contraction, transmission, treatment, and prevention; non-visible biological processes; and ontological frameworks regarding what kinds of entities viruses are. We also assessed participants’ attitudes, such as their trust in scientific experts and willingness to be vaccinated. Results indicated complexity in people’s reasoning, consistent with the co-existence of multiple explanatory frameworks. An understanding of viral transmission and viral replication existed alongside folk theories, placeholder beliefs, and lack of differentiation between viral and non-viral disease. For example, roughly 40% of participants who explained illness in terms of the transmission of viruses also endorsed a non-viral folk theory, such as exposure to cold weather or special foods as curative. Additionally, participants made use of competing modes of construal when explaining how viruses operate, such as framing the immune system response as cells trying to fight off the virus. Indeed, participants who displayed greater knowledge about viral transmission were significantly more likely to anthropomorphize bodily processes. Although comparisons of COVID-19 and the common cold revealed relatively few differences, the latter, more familiar disease elicited consistently lower levels of accuracy and greater reliance on folk theories. Moreover, for COVID-19 in particular, accuracy positively correlated with attitudes, self-protective behaviors, and willingness to be vaccinated. For both diseases, self-assessed knowledge about the disease negatively predicted accuracy. The results are discussed in relation to challenges for formal models of explanatory reasoning. (shrink)

What clinicians, biomedical scientists, and other health care professionals know as individuals or as groups and how they come to know and use knowledge are central concerns of medical epistemology. Activities associated with knowledge production and use are called epistemic practices. Such practices are considered in biomedical and clinical literatures, social sciences of medicine, philosophy of science and philosophy of medicine, and also in other nonmedical literatures. A host of different kinds of knowledge claims have been identified, each with different (...) uses and logics of justification. A general framework is needed to situate these diverse contributions in medical epistemology, so we can see how they fit together. But developing such a framework turns out to be quite tricky. In this survey, three possible frameworks are considered along with the difficulties associated with each of them. The essay concludes with a fourth framework, which considers any epistemology as part of a practice that is oriented toward overcoming errors that emerge in antecedently given practices where knowledge is developed and used. As medicine indirectly advances health by directly mitigating disease, so epistemology indirectly advances knowledge by directly mitigating error. (shrink)

In this essay, I provide normative guidelines for developing a philosophically interesting and plausible version of social constructivism as a philosophy of science, wherein science aims for social-epistemic values rather than for truth or empirical adequacy. This view is more plausible than the more radical constructivist claim that scientific facts are constructed. It is also more interesting than the modest constructivist claim that representations of such facts emerge in social contexts, as it provides a genuine rival to the scientific axiologies (...) of scientific realists and constructive empiricists. I further contrast my view with positions holding that the aims of science are context dependent, that the unit of normative analysis is the scientific community, and that the aims of science are non-epistemic social values. (shrink)

Proponents of evidence-based medicine and some philosophers of science seem to agree that knowledge of mechanisms can help solve the problem of applying results of controlled studies to target populations (‘the problem of extrapolation’). We describe the problem of extrapolation, characterize mechanisms, and outline how mechanistic knowledge might be used to solve the problem. Our main thesis is that there are four often overlooked problems with using mechanistic knowledge to solve the problem of extrapolation. First, our understanding of mechanisms is (...) often (and arguably, likely to remain) incomplete. Secondly, knowledge of mechanisms is not always applicable outside the tightly controlled laboratory conditions in which it is gained. Thirdly, mechanisms can behave paradoxically. Fourthly, as Daniel Steel points out, using mechanistic knowledge faces the problem of the ‘extrapolator’s circle’. At the same time, when the problems with mechanistic knowledge have been addressed, such knowledge can and should be used to mitigate (nothing can entirely solve) the problem of extrapolation. (shrink)

Sober and Lewontin's critique of genic selectionism is based upon the principle that a unit of selection should make a context‐independent contribution to fitness. Critics have effectively shown that this principle is flawed. In this paper I show that the context independence principle is an instance of a more general principle for characterizing causes,called the contextual unanimity principle. I argue that this latter principle, while widely accepted, is erroneous. What is needed is to replace the approach to causality characterized by (...) the contextual unanimity criterion with an approach based on the concept of causal mechanism. After sketching such an approach, I show how it can be used to shed light on the units of selection problem. (shrink)

The nosological diagnosis is a particular type of nontheoretical diagnosis consisting of identifying the disease that afflicts the patient without explaining the underlying etiopathological mechanisms. Its origins are within the essentialist point of view on the nature of diseases, which dates back at least to 18th-century taxonomy studies. In this article, we propose a model of nosological diagnosis as a two-phase process composed of the categorization of inductive inferences and argumentations by analogy. In the inductive phase, disease entities are identified (...) by means of typicality-based categorization processes, and meaningful clinical samples are learned ; in the subsequent phase, those samples are used as the bases of argumentations by analogy to obtain a diagnosis for a given patient. This model extends the prototype resemblance theory of disease including also the exemplar theory proposed in cognitive science and, moreover, it frames the clinical activity of nosological diagnosis and how it can be explained within the theory of argumentation. According to it, diagnosis based on the recognition of a typical syndrome is explained in terms of the prototype theory of categorization and the antisymmetrical argumentation by analogy, while diagnosis based on a comparison with a previous clinical case is explained by the exemplar theory of categorization and by the symmetrical argumentation by analogy. (shrink)

In this paper, I utilise the tools of analytic philosophy to amalgamate mono-causal and multi-causal theories of disease. My aim is to better integrate viral and socio-economic explanations of AIDS in particular, and to consider how the perceived divide between mono-causal and multi-causal theories played a role in the tragedy of AIDS denialism in South Africa in the early 2000s. Currently, there is conceptual ambiguity surrounding the relationship between mono-causal and multi-causal theories in biomedicine and epidemiology. Mono-causal theories focus on (...) single, typically microbial, sources of illness and are most concerned with infectious diseases. By contrast, multi-causal theories allow for multiple factors to underpin a disease’s aetiology, including socio-economic and behavioural factors, and they usually focus on chronic non-communicable diseases. However, if these theories are taken to be strictly distinct, this prevents the inclusion of both microbial and socio-economic factors in a single explanation of any particular disease. This strict distinction became a problem when trying to explain the disproportionate prevalence of AIDS in southern Africa and ultimately contributed to the tragedy of AIDS denialism in South Africa. In tandem with viewing how the perceived divide between multi-causal and mono-causal theories underpinned AIDS denialism, I examine Thabo Mbeki’s specific role, while acknowledging that AIDS is being deprioritised on a broader international level. Overall, I will demonstrate that any long-term plan to eliminate AIDS will require viral and socio-economic factors to be considered simultaneously and that such a theoretical approach requires a clearer understanding of the underlying concepts of disease aetiology. (shrink)

Supported by Ian Hacking’s concept of “intervention,” and Charles Taylor’s concept of “intentionality,” this article argues that doubting is acting, and that doubting is therefore subject to the same demands of responsibility as any other action. The argument is developed by using medical practice as a test-case. The central suggestion is that the demand of acting responsibly limits doubt in medicine. The article focuses on two such limitations to doubt. Firstly, the article argues that it is irresponsible to doubt that (...) our actions can harm other people. Secondly, the article argues that it is irresponsible not to strive for coherence between our utterances of doubt and our other actions. Incoherence here can cause “cultural impoverishment.” In a larger context this article also argues that medicine can enrich our epistemology, because medical knowledge displays important traits of knowledge that are downplayed in traditional epistemology derived from mathematics and physics. In particular, medicine makes it possible to get the relation between ethics and epistemology into sharper focus. The endpoint in medical epistemology is “responsible action,” and not certainty in and of itself. (shrink)

According to the Russo-Williamson Thesis, causal claims in the health sciences need to be supported by both difference-making and mechanistic evidence. In this article, we attempt to determine whether Evidence-based Medicine can be improved through the consideration of mechanistic evidence. We discuss the practical composition and function of each RWT evidence type and propose that exposure-outcome evidence provides associations that can be explained through a hypothesis of causation, while mechanistic evidence provides finer-grained associations and knowledge of entities that ultimately explains (...) a causal hypothesis. We suggest that mechanistic evidence holds untapped potential to add value to the assessment of evidence quality in EBM and propose initial recommendations for the integration of mechanistic and exposure-outcome evidence to improve EBM by robustly leveraging available evidence in support of good medical decisions. (shrink)

Researchers, clinicians, and patients have good reasons for wanting answers to causal questions of disease and therapeutic intervention. This paper uses microbiologist Robert Koch’s pioneering work and famous postulates to extrapolate a logical sequence of evidence for confirming the causes of disease: association between individuals with and without a disease; isolation of causal agents; and the creation of a counterfactual. This paper formally introduces counter-counterfactuals, which appear to have been used, perhaps intuitively, since the time of Koch and possibly earlier. (...) An argument is presented that counter-counterfactuals are a useful tool for identifying necessary causes of disease, and sometimes must be used in place of isolation which is not always possible. In addition, a logical sequence of causal evidence for a therapeutic intervention is presented: creating a counterfactual, comparisons between subjects in receipt of treatment versus those who are not, and counter-counterfactuals. (shrink)

Throughout the first half of the twentieth century the research on peptic ulcer disease focused on two rivaling hypothesis: the “acidity” and the “bacterial” one. According to the received view, the latter was dismissed during the 1950s only to be revived with Warren’s and Marshall’s discovery of Helicobacter pylori in the 1980s. In this paper we investigate why the bacterial hypothesis was largely abandoned in the 1950s, and whether there were good epistemic reasons for its dismissal. Of special interest for (...) our research question is Palmer’s 1954 large-scale study, which challenged the bacterial hypothesis with serious counter-evidence, and which by many scholars is considered as the shifting point in the research on PUD. However, we show that: The perceived refutatory impact of Palmer’s study was disproportionate to its methodological rigor. This undermines its perceived status as a crucial experiment against the bacterial hypothesis. In view of this and other considerations we argue that the bacterial hypothesis was worthy of pursuit in the 1950s. (shrink)

There has been a probabilistic turn in contemporary cognitive science. Far and away, most of the work in this vein is Bayesian, at least in name. Coinciding with this development, philosophers have increasingly promoted Bayesianism as the best normative account of how humans ought to reason. In this paper, we make a push for exploring the probabilistic terrain outside of Bayesianism. Non-Bayesian, but still probabilistic, theories provide plausible competitors both to descriptive and normative Bayesian accounts. We argue for this general (...) idea via recent work on explanationist models of updating, which are fundamentally probabilistic but assign a substantial, non-Bayesian role to explanatory considerations. (shrink)

In 1747, James Lind carried out an experiment which proved the usefulness of citrus fruit as a cure for scurvy. Nonetheless, he rejected the earlier hypothesis of Bachstrom that the absence of fresh fruit and vegetables was the only cause of the disease. I explain why it was rational for James Lind not to accept Bachstrom’s explanation. I argue that it was the urge for scientific understanding that guided Lind in his rejection and in the development of his alternative theory (...) that humidity was the primary cause of the disease. Central in this process was the search for causal mechanisms which could provide understanding of how the disease developed and which fitted in with the knowledge of the time. Given that the relevant background knowledge and statistical methods were not yet available to Lind, he was right to prefer his own explanation to that of Bachstrom. Although his explanation turned out to be wrong, and Bachstrom’s right, from a historical point of view it offered deeper causal understanding of both the development of the disease and the preventive and curative effects of fresh vegetable food. This case study illustrates how the search for causal mechanisms can not only be enlightening, but also very misleading. (shrink)

This thesis is a philosophical examination of the explanatory roles of diagnoses in psychiatry. In medicine, diagnoses normally serve as causal explanations of patients’ symptoms. Given that psychiatry is a discipline whose practice is shaped by medical traditions, it is often implied that its diagnoses also serve such explanatory functions. This is evident in clinical texts that portray psychiatric diagnoses as referring to diseases that cause symptoms. However, there are problems which cast doubt on whether such portrayals are justified. I (...) address these problems and examine whether psychiatric diagnoses provide explanations of symptoms. The first problem is conceptual. In diagnostic manuals, psychiatric diagnoses are defined by their symptoms. This suggests that invoking them as explanations of the symptoms amounts to circularity. I argue that this can be resolved with an appropriate conceptual framework that captures the complex semantic values of diagnostic terms and their different uses in clinical discourse. I put forward such a framework based on two-dimensional semantics. The second problem is ontological. Empirical research suggests that diagnostic categories in psychiatry do not correspond to invariant causal types, but are associated with variable combinations of diverse causes that interact across biological, psychological, and social levels. Given this heterogeneity, I argue that psychiatric diagnoses fall short of paradigmatic cases of causal explanation, but that some can still provide other sorts of useful causal explanatory information. The original contribution of this thesis is the illumination of the conceptual relations between diagnoses and symptoms. This philosophical work is important, because it can be brought to valuable application in modifying psychiatric practice. (shrink)

The history of the research on peptic ulcer disease is characterized by a premature abandonment of the bacterial hypothesis, which subsequently had its comeback, leading to the discovery of Helicobacter pylori – the major cause of the disease. In this paper we examine the received view on this case, according to which the primary reason for the abandonment of the bacterial hypothesis in the mid-twentieth century was a large-scale study by a prominent gastroenterologist Palmer, which suggested no bacteria could be (...) found in the human stomach. To this end, we employ the methodof digital textual analysis and study the literature on the etiology of PUD published in the decade prior to Palmer’s article. Our findings suggest that the bacterial hypothesis had already been abandoned before the publication of Palmer’s paper, which challenges the widely held view that his study played a crucial role in the development of this episode. In view of this result, we argue that the PUD case does not illustrate harmful effects of a high degree of information flow, as it has frequently been claimed in the literature on network epistemology. Moreover, we argue that alternative examples of harmful effects of a high degree of information flow may be hard to find in the history of science. (shrink)

Cognitive science is the interdisciplinary investigation of mind and intelligence, embracing psychology, neuroscience, anthropology, artificial intelligence, and philosophy. There are many important philosophical questions related to this investigation, but this short chapter will focus on the following three. What is the nature of the explanations and theories developed in cognitive science? What are the relations among the five disciplines that comprise cognitive science? What are the implications of cognitive science research for general issues in the philosophy of science? I will (...) argue that cognitive theories and explanations depend on representations of mechanisms and that the relations among the five disciplines, especially psychology and neuroscience, depend on relations between kinds of mechanisms. These conclusions have implications for central problems in general philosophy of science such as the nature of theories, explanations, and reduction between theories at different levels. (shrink)

Debates about evolution and creation inevitably raise philosophical issues about the nature of scientific knowledge. What is a theory? What is an explanation? How is science different from non- science? How should theories be evaluated? Does science achieve truth? The aim of this chapter is to give a concise and accessible introduction to the philosophy of science, focusing on questions relevant to understanding evolution by natural selection, creation, and intelligent design. For the questions just listed, I state what I think (...) is the best available answer and show how it applies to debates about evolution and creationism. I also indicate alternative answers that are preferred by other philosophers. I hope that the result will be useful for science educators and anyone else involved in controversies about evolution and creation. (shrink)

Computer science only became established as a field in the 1950s, growing out of theoretical and practical research begun in the previous two decades. The field has exhibited immense creativity, ranging from innovative hardware such as the early mainframes to software breakthroughs such as programming languages and the Internet. Martin Gardner worried that "it would be a sad day if human beings, adjusting to the Computer Revolution, became so intellectually lazy that they lost their power of creative thinking" (Gardner, 1978, (...) p. vi-viii). On the contrary, computers and the theory of computation have provided great opportunities for creative work. This chapter examines several key aspects of creativity in computer science, beginning with the question of how problems arise in computer science. We then discuss the use of analogies in solving key problems in the history of computer science. Our discussion in these sections is based on historical examples, but the following sections discuss the nature of creativity using information from a contemporary source, a set of interviews with practicing computer scientists collected by the Association of Computing Machinery’s on-line student magazine, Crossroads. We then provide a general comparison of creativity in computer science and in the natural sciences. (shrink)

By the early part of the twentieth century, academia in the English-speaking world had stabilized (or ossified!) into a set of scientific and humanistic disciplines that still survives at the century’s end. The natural sciences have such disciplines as physics, chemistry, and biology, and the social sciences include economics, psychology, and sociology. These disciplines provide a convenient organizing principle for university departments and professional organizations, but they often bear little relation to cuttingedge research, which can concern topics that cut across (...) or occur at the boundaries of two or more of the established disciplines. When this happens, productive research and teaching must be interdisciplinary. Cognitive science is the interdisciplinary study of mind, embracing psychology, artificial intelligence, philosophy, neuroscience, linguistics, and anthropology. It is undoubtedly one of the major interdisciplinary successes of the twentieth century, with its own society, journal, and textbooks, and with more than sixty cognitive science programs established at universities in North American and Europe. This paper is an attempt to answer the question: What are the factors contributing to the success of the interdisciplinary field of cognitive science? My discussion is organized around the metaphor of the trading zone, a novel and fertile analogy that Gallison (1997) developed for his rich and detailed discussion of the practices of twentieth-century physics. To understand the diverse groups of December 1, 2006 experimenters and theoreticians, Gallison presents their interactions in terms of the trading zones described by anthropologists: Subcultures trade. Anthropologists have extensively studied how different groups, with radically different ways of dividing up the world and symbolically organizing its parts, can not only exchange goods but also depend essentially on those trades.. (shrink)

Biology is the study of life, psychology is the study of mind, and medicine is the investigation of the causes and treatments of disease. This chapter describes how the central concepts of life, mind, and disease have undergone fundamental changes in the past 150 years or so. There has been a progression from theological, to qualitative, to mechanistic explanations of the nature of life, mind and disease. This progression has involved both theoretical change, as new theories with greater explanatory power (...) replaced older ones, and emotional change as the new theories brought reorientation of attitudes toward the nature of life, mind, and disease. After a brief comparison of theological, qualitative, and mechanistic explanations, I will describe how shifts from one kind of explanation to another have carried with them dramatic kinds of conceptual change in the key concepts in the life sciences. Three generalizations follow about the nature of conceptual change in the history of science: there has been a shift from conceptualizations in terms of simple properties to ones in terms of complex relations; conceptual change is theory change; and conceptual change is often emotional as well as cognitive. The contention that historical development proceeds in three stages originated with the nineteenth-century French philosophers, Auguste Comte, who claimed that November 9, 2006 human intellectual development progresses from a theological to a “metaphysical” stage to a “positive” (scientific) stage (Comte, 1988). The stages I have in mind are different from Comte’s, so let me say what they involve. By the theological stage I mean systems of thought in which the primary explanatory entities are supernatural ones beyond the reach of science, such as gods, devils, angels, spirits, and souls. For example, the concept of fire was initially theological, as in the Greek myth of Prometheus receiving fire from the gods.. (shrink)

Modern medicine has produced many successful theories concerning the causes of diseases. For example, we know that tuberculosis is caused by the bacterium Mycobacterium tuberculosis, and that scurvy is caused by a deficiency of vitamin C. This chapter discusses the nature of medical theories from the perspective of the philosophy, history, and psychology of science. I will review prominent philosophical accounts of what constitutes a scientific theory, and develop a new account of medical theories as representations of mechanisms that explain (...) disease. An account of the nature of medical theories should illuminate many aspects of the development and application of medical knowledge. Most importantly, it should contribute to understanding of medical explanation, both at the general level of causes of diseases and at the individual level of diagnosis of particular cases of a disease. Medical researchers seek to explain the causes of diseases such as tuberculosis, while physicians seek to identify diseases that explain symptoms such as fever. A medical theory such as the bacterial theory of tuberculosis provides good explanations at both the general and individual levels. The primary aim of this chapter is to show how these explanations work. A secondary aim is to show how an account of medical theories can shed light on other aspects of medical research and practice, including the nature of medical discovery, the process of evaluation of competing medical theories, and the ways in which effective treatments of disease depend on the development of good mechanistic theories about diseases. (shrink)

��This article reviews a theory of explanatory coherence that provides a psychologically plausible account of how people evaluate competing explanations. The theory is implemented in a computational model that uses simple artificial neural networks to simulate many important cases of scientific and legal reasoning. Current research directions include extensions to emotional thinking and implementation in more biologically realistic neural networks.

Part I Introduction The specific problem adressed in this thesis is: what is the rational use of theory and experiment in the process of scientific discovery, in theory and in the practice of drug research for Parkinson’s disease? The thesis aims to answer the following specific questions: what is: 1) the structure of a theory?; 2) the process of scientific reasoning?; 3) the route between theory and experiment? In the first part I further discuss issues about rationality in science as (...) introduction to part II, and I present an overview of my case-study of neuropharmacology, for which I interviewed researchers from the Groningen Pharmacy Department, as an introduction to part III. Part II Discovery In this part I discuss three theoretical models of scientific discovery according to studies in the fields of Logic, Cognition, and Computation. In those fields the structure of a theory is respectively explicated as: a set of sentences; a set of associated memory chunks; and as a computer program that can generate the observed data. Rationality in discovery is characterized by: finding axioms that imply observation sentences; heuristic search for a hypothesis, as part of problem solving, by applying memory chunks and production rules that represent skill; and finding the shortest program that generates the data, respectively. I further argue that reasoning in discovery includes logical fallacies, which are neccesary to introduce new hypotheses. I also argue that, while human subjects often make errors in hypothesis evaluation tasks from a logical perspective, these evaluations are rational given a probabilistic interpretation. Part III Neuropharmacology In this last part I discusses my case-study and a model of discovery in a practice of drug research for Parkinson’s disease. I discuss the dopamine theory of Parkinson’s disease and model its structure as a qualitative differential equation. Then I discuss the use and reasons for particular experiments to both test a drug and explore the function of the brain. I describe different kinds of problems in drug research leading to a discovery. Based on that description I distinguish three kinds of reasoning tasks in discovery, inference to: the best explanation, the best prediction and the best intervention. I further demonstrate how a part of reasoning in neuropharmacology can be computationally modeled as qualitative reasoning, and aided by a computer supported discovery system. (shrink)

This work consists of two parts. Part I will be a contribution to a philo- sophical discussion of the nature of causal explanation. It will present my contrastive counterfactual theory of causal explanation and show how it can be used to deal with a number of problems facing theories of causal explanation. Part II is a contribution to a discussion of the na- ture of interest explanation in social studies of science. The aim is to help to resolve some controversies (...) concerning interest explanation by explicating the concept of interest and its explanatory uses by using the account of explanation developed in Part I. (shrink)

The vagueness or imprecision of ‘the normal’ allows it to be exploited for various purposes and political ends. It is conspicuous in both medicine and athletics; I am going to try to say something about the normal in each of these areas. In medicine the idea of the normal is often deployed in understanding what constitutes disease and hence, as some see it, in determining the role of physicians, in determining what is or ought to be covered by insurance, and (...) in underwriting certain views on social justice. In athletics the use of performance enhancing substances raises different sorts of questions about the normal, especially when it comes to deciding what constitutes an enhancement and which enhancements, if any, are acceptable. (shrink)

The US Food and Drug Administration (FDA) is fraught with controversies over the role of values and politics in regulatory science, especially with drugs in the realm of reproductive health. Philosophers and science studies scholars have investigated the ways in which social context shapes medical knowledge through value judgments, and feminist scholars and activists have criticized sexism and injustice in reproductive medicine. Nonetheless, there has been no systematic study of values and gender norms in FDA drug regulation. I focus on (...) three questions about values in regulatory science. First, how have societal values and gender norms shaped the way that the FDA regulates drugs in the realm of reproductive health, specifically with drug labels? Second, what are the ethical, epistemic, and social consequences of these influences on regulation for women and other marginalized groups? Third, which societal values and gender norms ought to influence drug regulation about reproductive health, and how ought this happen? Integrating philosophical analysis with historical archival research and in-depth interviews, I conduct three case studies of drug labeling about reproductive health: (1) the “drug fact” about the mechanism of the morning-after pill; (2) the package inserts for patients about the health risks of oral contraceptives; and (3) the special physician labels made for prescribing drugs to pregnant women. I identify three challenges for the FDA and suggest ways to reduce the influence of sexist values and facilitate feminist alternatives. First, across these cases, I have found that there are many ways in which other concerns in reproductive medicine (such as zygotic life, fetal health, and population control) have devalued women’s health. Second, both knowledge and ignorance xvi about their reproductive health have contributed to women’s oppression, especially poor women and women of color. Finally, by avoiding the epistemic dimensions of ethics, powerful, mostly male parties in medicine (such as doctors, pharmaceutical companies, and religious institutions) have misused “informed consent,” “religious freedom,” and “paternalism” for unethical purposes. For improvement, I suggest extracting sexist values and gender norms from regulatory science that cause epistemic injustices, and I point to success stories for reforming sexism with feminism at the FDA. (shrink)

According to one large family of views, scientific explanations explain a phenomenon (such as an event or a regularity) by subsuming it under a general representation, model, prototype, or schema (see Bechtel, W., & Abrahamsen, A. (2005). Explanation: A mechanist alternative. Studies in History and Philosophy of Biological and Biomedical Sciences, 36(2), 421–441; Churchland, P. M. (1989). A neurocomputational perspective: The nature of mind and the structure of science. Cambridge: MIT Press; Darden (2006); Hempel, C. G. (1965). Aspects of scientific (...) explanation. In C. G. Hempel (Ed.), Aspects of scientific explanation (pp. 331–496). New York: Free Press; Kitcher (1989); Machamer, P., Darden, L., & Craver, C. F. (2000). Thinking about mechanisms. Philosophy of Science, 67(1), 1–25). My concern is with the minimal suggestion that an adequate philosophical theory of scientific explanation can limit its attention to the format or structure with which theories are represented. The representational subsumption view is a plausible hypothesis about the psychology of understanding. It is also a plausible claim about how scientists present their knowledge to the world. However, one cannot address the central questions for a philosophical theory of scientific explanation without turning one’s attention from the structure of representations to the basic commitments about the worldly structures that plausibly count as explanatory. A philosophical theory of scientific explanation should achieve two goals. The first is explanatory demarcation. It should show how explanation relates with other scientific achievements, such as control, description, measurement, prediction, and taxonomy. The second is explanatory normativity. It should say when putative explanations succeed and fail. One cannot achieve these goals without undertaking commitments about the kinds of ontic structures that plausibly count as explanatory. Representations convey explanatory information about a phenomenon when and only when they describe the ontic explanations for those phenomena. (shrink)

Tradition compels me to write dissertation acknowledgements that are long, effusive, and unprofessional. Fortunately for me, I heartily endorse that tradition.

Here are some of the most important discoveries in the history of medicine: blood circulation (1620s), vaccination, (1790s), anesthesia (1840s), germ theory (1860s), X- rays (1895), vitamins (early 1900s), antibiotics (1920s-1930s), insulin (1920s), and oncogenes (1970s). This list is highly varied, as it includes basic medical knowledge such has Harvey’s account of how the heart pumps blood, hypotheses about the causes of disease such as the germ theory, ideas about the treatments of diseases such as antibiotics, and medical instruments such (...) as X-ray machines. The philosophy of medicine should be able to contribute to understanding of the nature of discoveries such as these. The great originators of the field of philosophy of science were all concerned with the nature of scientific discovery, including Francis Bacon (1960), William Whewell (1967), John Stuart Mill (1974), and Charles Peirce (1931-1958). The rise of logical positivism in the 1930s pushed discovery off the philosophical agenda, but the topic was revived through the work of philosophers such as Norwood Russell Hanson (1958), Thomas Nickles (1980), Lindley Darden (1991, 2006), and Nancy Nersessian (1984). Scientific discovery has also become an object of investigations for researchers in the fields of cognitive psychology and artificial intelligence, as seen in the work of Herbert Simon, Pat Langley, and others (Langley et al., 1987; Klahr, 2000). Today, scientific September 14, 2009 discovery is an interdisciplinary topic at the intersection of the philosophy, history, and psychology of science. The aim of this chapter is to identify patterns of discovery that illuminate some of the most important developments in the history of medicine. I have used a variety of sources to identify forty great medical discoveries (Adler, 2004; Friedman and Friedland, 1998; Science Channel, 2006; Strauss and Strauss, 2006).. (shrink)

This paper discusses the representation and explanation of relationships between phenomena that are important in psychiatric contexts. After a general discussion of complexity in the philosophy of science, I distinguish zooming-out approaches from zooming-in approaches. Zooming-out has to do with seeing complex mental illnesses as abstract models for the purposes of both explanation and reduction. Zooming-in involves breaking complex mental illnesses into simple components and trying to explain those components independently in terms of specific causes. Connections between existing practice and (...) zooming-out are drawn, and zooming-in is criticised. (shrink)