There are two competing views regarding the role of mechanistic knowledge in inferences about the effectiveness of interventions. One view holds that inferences about the effectiveness of interventions should be based only on data from population-level studies (often statistical evidence from randomised trials). The other view holds that such inferences must be based in part on mechanistic evidence. The competing views are local principles of inference, the plausibility of which can be assessed by a more general normative principle of inference. (...) Bayesianism tells us to base inferences on both the ‘likelihood’ and the ‘prior’. The likelihood represents statistical evidence. One influence on the prior probability of a hypothesis like ‘d causes x’ is mechanistic knowledge of how d causes x. Thus, reasoning about such inferences by appealing to both statistical and mechanistic evidence is vindicated by our best general theory of inference. The primary contribution of this paper is to assess the merits and weaknesses of the arguments on both sides of the debate, using the Bayesian framework. This analysis lends support to those who argue that we should base our causal inferences about interventions in part on mechanistic evidence. (shrink)

Philosophers use historical case studies to support wide-ranging claims about science. This practice is often criticized as problematic. In this paper we suggest that the function of case studies can be understood and justified by analogy to a well-established practice in biology: the investigation of model organisms. We argue that inferences based on case studies are no more problematic than inferences from model organisms to larger classes of organisms in biology. We demonstrate our view in detail by reference to a (...) case study with a long history: Semmelweis’s discovery of the cause of childbed fever. (shrink)

This paper challenges the appeal to theory virtues in theory choice as well as the appeal to the intellectual and moral virtues of an agent as determining unique choices between empirically equivalent theories. After arguing that theoretical virtues do not determine the choice of one theory at the expense of another theory, I argue that nor does the appeal to intellectual and moral virtues single out one agent, who defends a particular theory, and exclude another agent defending an alternative theory. (...) I analyse Duhem’s concept of good sense and its recent interpretation in terms of virtue epistemology. I argue that the virtue epistemological interpretation does not show how good sense leads to conclusive choices and scientific progress. (shrink)

Systematicity theory—developed and articulated by Paul Hoyningen-Huene—and scientific realism constitute separate encompassing and empirical accounts of the nature of science. Standard scientific realism asserts the axiological thesis that science seeks truth and the epistemological thesis that we can justifiably believe our successful theories at least approximate that aim. By contrast, questions pertaining to truth are left “outside” systematicity theory’s “intended scope” ; the scientific realism debate is “simply not” its “focus”. However, given the continued centrality of that debate in the (...) general philosophy of science literature, and given that scientific realists also endeavor to provide an encompassing empirical account of science, I suggest that these two contemporary accounts have much to offer one another. Overlap for launching a discussion of their relations can be found in Nicholas Rescher’s work. Following through on a hint from Rescher, I embrace a non-epistemic, purely axiological scientific realism—what I have called, Socratic scientific realism. And, bracketing the realist’s epistemological thesis, I put forward the axiological tenet of scientific realism as a needed supplement to systematicity theory. There are two broad components to doing this. First, I seek to make clear that axiological realism and systematicity theory accord with one another. Toward that end, after addressing Hoyningen-Huene’s concerns about axiological analysis, I articulate a refined axiological realist meta-hypothesis: it is, in short, that the end toward which scientific inquiry is directed is an increase in a specific subclass of true claims. I then identify a key feature of scientific inquiry, not generally flagged explicitly, that I take to stand as shared terrain for the two empirical meta-hypotheses. And I argue that this feature can be informatively accounted for by my axiological meta-hypothesis. The second broad component goes beyond mere compatibility between the two positions: I argue that, in want of a systematic account of science, we are prompted to find an end toward which scientific inquiry is directed that is deeper than what systematicity theory offers. Specifically, I argue that my refined axiological realist meta-hypothesis is required to both explain and justify key dimensions of systematicity in science. To the quick question, what is it that the scientific enterprise is systematically doing? My quick answer is that it is systematically seeking to increase a particular subclass of true claims. (shrink)

This chapter relocates the debate about the theoretical virtues to the empirical level and argues that the question of whether the virtues (and what virtues, if any) have epistemic import is best answered empirically, through an examination of actual scientific theories and hypotheses in the history of science. As a concrete example of this approach, the chapter discusses a case study from the mid-nineteenth-century debate about the transmissibility of puerperal fever. It argues that this case shows that the virtues are (...) at least sometimes epistemic, but also that neither scientific realists nor anti-realists get it quite right: the virtues, even if epistemic, are not necessarily truth-conducive, but neither are they merely pragmatic. It also argues that the discussion of puerperal fever shows that the virtue question, as it is currently featured in the scientific realism debate, ought to be reformulated. We should examine not just whether a given scientific theory has virtues or not, but rather how debates among competing theories, all of which have some virtues, get resolved. (shrink)

This paper adapts Kuhn’s conceptual framework to developmental episodes in the theory and practice of medicine. Previous attempts to understand the reception of Ignaz Semmelweis’s work on puerperal fever in Kuhnian terms are used as a starting point. The author identifies some limitations of these attempts and proposes a new way of understanding the core Kuhnian notions of “paradigm,” “progress,” and “revolution” in the context of a socially embedded technoscience such as medicine.

Many philosophers have claimed that Bayesianism can provide a simple justification for hypothetico-deductive inference, long regarded as a cornerstone of the scientific method. Following up a remark of van Fraassen, we analyze a problem for the putative Bayesian justification of H-D inference in the case where what we learn from observation is logically stronger than what our theory implies. Firstly, we demonstrate that in such cases the simple Bayesian justification does not necessarily apply. Secondly, we identify a set of sufficient (...) conditions for the mismatch in logical strength to be justifiably ignored as a "harmless idealization''. Thirdly, we argue, based upon scientific examples, that the pattern of H-D inference of which there is a ready Bayesian justification is only rarely the pattern that one actually finds at work in science. Whatever the other virtues of Bayesianism, the idea that it yields a simple justification of a pervasive pattern of scientific inference appears to have been oversold. (shrink)

Science advances by means of argument and debate. Based on a formal model of complex argumentation, this article assesses the interplay between evidential and inferential drivers in scientific controversy, and explains, in particular, why both evidence accumulation and argumentation are veritistically valuable. By improving the conditions for applying veritistic indicators , novel evidence and arguments allow us to distinguish true from false hypotheses more reliably. Because such veritistic indicators also underpin inductive reasoning, evidence accumulation and argumentation enhance the reliability of (...) inductive inference, for example, inference to the best explanation. 1 Introduction2 Theory of Dialectical Structures3 Debate Simulations4 From Evidence and Arguments to Truth: The First Route5 From Evidence to Truth: The Second Route6 Conclusion. (shrink)

Semmelweis’ discovery of the etiology of childbed fever has long attracted the attention of historians of medicine and biographers. In recent years it has also become of increasing interest to philosophers. In this paper I discuss the interpretation of Semmelweis’ methodology from the viewpoint of the inference to the best explanation and argue that Popperian methodology is better at capturing the dynamics of the growth of knowledge. Furthermore, I criticize the attempts to explain the failure of Semmelweis to have his (...) discovery accepted on the basis of the Kuhnian concept of paradigms, and warn that this view may endorse dogmatism as the norm The Kuhnian position also raises the problem of the authoritarian nature of scientific institutions which defend a paradigm against unorthodox, rebellious views, such as in the case of Semmelweis. Popperian philosophy is seen as a challenge to promote a link between an open society and open science with its main aim being to cherish a free critical spirit. (shrink)

We present English translations of two French documents to show that the main reason for the rejection of Semmelweis's theory of the cause of childbed fever was because his proof relied on the post hoc ergo propter hoc fallacy, and not because Joseph Skoda referred only to cadaveric particles as the cause in his lecture to the Academy of Science on Semmelweis's discovery. Friedrich Wieger, an obstetrician from Strasbourg, published an accurate account of Semmelweis's theory six months before Skoda's lecture, (...) and reported a case in which the causative agent originated from a source other than cadavers. Wieger also presented data showing that chlorine hand disinfection reduced the annual maternal mortality rate from childbed fever from more than 7 per cent for the years 1840–1846 to 1.27 per cent in 1848, the first full year in which chlorine hand disinfection was practised. But an editorial in the Gazette médicale de Paris rejected the data as proof of the effectiveness of chlorine hand disinfection, stating that the fact that the MMR fell after chlorine hand disinfection was implemented did not mean that this innovation had caused the MMR to fall. This previously unrecognized objection to Semmelweis's proof was also the reason why Semmelweis's chief rejected Semmelweis's evidence. (shrink)

My doctoral project is a study of epistemological and ethical issues in Evidence-Based Medicine, a movement in medicine which emphasizes the use of randomized controlled trials. Much of the research on EBM suggests that, for a large part of the movement's history, EBM considered expertise, mechanisms, and values to be forces contrary to its goals and has sought to remove them, both from medical research and from the clinical encounter. I argue, however, that expertise, mechanisms and values have important epistemological (...) and ethical roles to play and can be incorporated into the current EBM movement. (shrink)

The public discussion on artificial intelligence for public health often revolves around future applications like drug discovery or personalized medicine. But already deployed artificial intelligence for content recommendation, especially on social networks, arguably plays a far greater role. After all, such algorithms are used on a daily basis by billions of users worldwide. In this paper, we argue that, left unchecked, this enormous influence of recommendation algorithms poses serious risks for public health, e.g., in terms of misinformation and mental health. (...) But more importantly, we argue that this enormous influence also yields a fabulous opportunity to provide quality information and to encourage healthier habits at scale. We also discuss the philosophical, technical and socio-economical challenges to seize this immense opportunity, and sketch the outlines of potential solutions. In particular, we argue that it would be extremely helpful if public and private institutions could publicly take a stand, as this may then generate the necessary social, economical and political pressure to massively invest in the research, development and deployment of the potential solutions. (shrink)