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The existing philosophical views on what is the meaning of causality adequate to medicine are vastly divided. We approach this question and offer two arguments in favor of pluralism regarding concepts of causality. First, we analyze the three main types of research designs (randomized-controlled trials, observational epidemiology and laboratory research). We argue, using examples, that they allow for making causal conclusions that are best understood differently in each case (in agreement with a version of manipulationist, probabilistic and mechanistic definitions, respectively). (...) |
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This article responds to Yafeng Shan and Jon Williamson’s 2022 volume Evidential Pluralism in the Social Sciences, focusing on the applicability of Evidential Pluralism in the field of case study research through the use of examples from political science. The article argues that Shan and Williamson’s guidance on (a) what evidence one needs to establish causation in singular case studies and (b) what one may conclude at the population level once one has done so is lacking in some important respects. (...) |
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This paper aims to clarify the nature of understanding in medicine. The first part describes in more detail what it means to understand something and links a type of understanding (i.e., objectual understanding) to explanations. The second part proceeds to investigate what objectual understanding of a disease (i.e., biomedical understanding) requires by considering the case of scurvy from the history of medicine. The main hypothesis is that grasping a mechanistic explanation of a condition is necessary for a biomedical understanding of (...) |
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This paper aims to clarify the nature of understanding in medicine. The first part describes in more detail what it means to understand something and links a type of understanding (i.e., objectual understanding) to explanations. The second part proceeds to investigate what objectual understanding of a disease (i.e., biomedical understanding) requires by considering the case of scurvy from the history of medi- cine. The main hypothesis is that grasping a mechanistic explanation of a condi- tion is necessary for a biomedical (...) |
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Social scientists often draw on a variety of evidence for their causal inferences. There is also a call to use a greater variety of evidence in social science research. This topical collection examines the philosophical foundations and implications of evidential diversity in the social sciences. It assesses the application of Evidential Pluralism in the context of the social sciences, especially its application to economics and political science. It also discusses the concept of causation in cognitive science and the implications of (...) |
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Establishing the effectiveness of medical treatments is one of the most important aspects of medical practice. Bradford Hill's viewpoints play an important role in inferring causality in medicine,... |
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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. (...) |
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Evidential Pluralism maintains that in order to establish a causal claim one normally needs to establish the existence of an appropriate conditional correlation and the existence of an appropriate mechanism complex, so when assessing a causal claim one ought to consider both association studies and mechanistic studies. Hitherto, Evidential Pluralism has been applied to medicine, leading to the EBM+ programme, which recommends that evidence-based medicine should systematically evaluate mechanistic studies alongside clinical studies. This paper argues that Evidential Pluralism can also (...) |
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While the importance of mechanisms in determining causality in medicine is currently the subject of active debate, the role of mechanistic reasoning in clinical practice has received far less attention. In this paper we look at this question in the context of the treatment of a particular individual, and argue that evidence of mechanisms is indeed key to various aspects of clinical practice, including assessing population-level research reports, diagnostic as well as therapeutic decision making, and the assessment of treatment effects. (...) |
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The teratogenicity of the Zika virus was considered established in 2016, and is an interesting case because three different sets of causal criteria were used to assess teratogenicity. This paper appeals to the thesis of Russo and Williamson (2007) to devise an epistemological framework that can be used to compare and evaluate sets of causal criteria. The framework can also be used to decide when enough criteria are satisfied to establish causality. Arguably, the three sets of causal criteria considered here (...) |
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Evidence-Based Medicine has little consideration for mechanisms and philosophers of science and medicine have recently made pleas to increase the place of mechanisms in the medical evidence hierarchy. However, in this debate the notions of mechanisms seem to be limited to 'mechanistic processes' and 'complex-systems mechanisms,' understood as 'componential causal systems'. I believe that this will not do full justice to how mechanisms are used in biological, psychological and social sciences and, consequently, in a more biopsychosocial approach to medicine. Here, (...) |
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Causation appears to present us with an interpretative difficulty. While arguably a redundant relation given fundamental physics, it is nevertheless apparently pragmatically indispensable. This chapter revisits certain arguments made previously by the author for these claims with the benefit of hindsight, starting with the role of causal models in the human sciences, and attempting to explain why it is not possible to straightforwardly ground such models in fundamental physics. This suggests that further constraints, going beyond physics, are needed to legitimate (...) |
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Causal pluralism can be defended not only in respect to causal concepts and methodological guidelines, but also at the finer-grained level of causal inference from a particular source of evidence for causation. An argument for this last variety of pluralism is made based on an analysis of causal inference from randomized experiments (RCTs). Here, the causal interpretation of a statistically significant association can be established via multiple paths of reasoning, each relying on different assumptions and providing distinct elements of information (...) |
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The Russo Williamson thesis (RWT) states that a causal claim can be established only if it can be established that there is a difference-making relationship between the cause and the effect, and that there is a mechanism linking the cause and the effect that is responsible for such a difference-making relationship (Russo & Williamson, 2007). The applicability of Russo and Williamson’s idea was hugely debated in relation to biomedical research, and recently it has been applied to the social sciences (Shan (...) |
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This thesis analyses the use of 'Evidence-Based' methodologies of evidence assessment and intervention and policy design from medicine, and their use in sport and exercise science. It argues that problems exist with the application of Evidence-Based methodologies in sports science, meaning that the quality of evidence used to inform decision-making is lower than is often assumed. This thesis also offers realistic solutions to these problems, broadly arguing for the importance of taking evidence from mechanistic studies seriously, in addition to evidence (...) |
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The results of econometric modeling are fragile in the sense that minor changes in estimation techniques or sample can lead to statistical models that support inconsistent causal hypotheses. The fragility of econometric results undermines making conclusive inferences from the empirical literature. I argue that the program of evidential pluralism, which originated in the context of medicine and encapsulates to the normative reading of the Russo-Williamson Thesis that causal claims need the support of both difference-making and mechanistic evidence, offers a ground (...) |
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The EBM+ programme is an attempt to improve the way in which present-day evidence-based medicine (EBM) assesses causal claims: according to EBM+, mechanistic studies should be scrutinised alongside association studies. This paper addresses two worries about EBM+: (i) that it is not feasible in practice, and (ii) that it is too malleable, i.e., its results depend on subjective choices that need to be made in order to implement the procedure. Several responses to these two worries are considered and evaluated. The (...) |
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Evidential pluralists, like Federica Russo and Jon Williamson, argue that causal claims should be corroborated by establishing both the existence of a suitable correlation and a suitable mechanism complex. At first glance, this fits well with mixed method research in the social sciences, which often involves a pluralist combination of statistical and mechanistic evidence. However, statistical evidence concerns a population of cases, while mechanistic evidence is found in individual case studies. How should researchers combine such general statistical evidence and specific (...) |
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In this paper we identify six theses that constitute core results of philosophical investigation into the nature of mechanisms, and of the role that the search for and identification of mechanisms play in the sciences. These theses represent the fruits of the body of research that is now often called New Mechanism. We concisely present the main arguments for these theses. In the literature, these arguments are scattered and often implicit. Our analysis can guide future research in many ways: it (...) |
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The current strategy of searching for an effective treatment for COVID-19 relies mainly on repurposing existing therapies developed to target other diseases. Conflicting results have emerged in regard to the efficacy of several tested compounds but later results were negative. The number of conducted and ongoing trials and the urgent need for a treatment pose the risk that false-positive results will be incorrectly interpreted as evidence for treatments’ efficacy and a ground for drug approval. Our purpose is twofold. First, we (...) |
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In contemporary philosophy of science, the consensus view seems to be that scientific explanations describe mechanisms responsible for the phenomena to be explained. Two kinds of explanatory relevance figure in mechanistic accounts of explanation: causal and constitutive. Following prominent accounts, it seems natural to analyze both these relations in terms of systematic interventions into some factor X with respect to another factor Y. However, such interventions are tailored to uncover causal relations only. Construing the constitutive relationship between parts and wholes (...) |
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