Causality in medicine with particular reference to the viral causation of cancers

Dissertation, University College London (2011)
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Abstract
In this thesis, I give a metascientific account of causality in medicine. I begin with two historical cases of causal discovery. These are the discovery of the causation of Burkitt’s lymphoma by the Epstein-Barr virus, and of the various viral causes suggested for cervical cancer. These historical cases then support a philosophical discussion of causality in medicine. This begins with an introduction to the Russo- Williamson thesis (RWT), and discussion of a range of counter-arguments against it. Despite these, I argue that the RWT is historically workable, given a small number of modifications. I then expand Russo and Williamson’s account. I first develop their suggestion that causal relationships in medicine require some kind of evidence of mechanism. I begin with a number of accounts of mechanisms and produce a range of consensus features of them. I then develop this consensus position by reference to the two historical case studies with an eye to their operational competence. In particular, I suggest that it is mechanistic models and their representations which we are concerned with in medicine, rather than the mechanism as it exists in the world. I then employ these mechanistic models to give an account of the sorts of evidence used in formulating and evaluating causal claims. Again, I use the two human viral oncogenesis cases to give this account. I characterise and distinguish evidence of mechanism from evidence of difference-making, and relate this to mechanistic models. I then suggest the relationship between types of evidence presents us with a means of tackling the reference-class problem. This sets the scene for the final chapter. Here, I suggest the manner in which these two different classes of evidence become integrated is also reflected in the way that developing research programmes change as their associated causal claims develop.
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Archival date: 2012-10-09
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References found in this work BETA
Thinking About Mechanisms.Machamer, Peter K.; Darden, Lindley & Craver, Carl F.
Causation, Prediction, and Search.Spirtes, Peter; Glymour, Clark & Scheines, Richard

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Citations of this work BETA
Mechanisms and the Evidence Hierarchy.Clarke, Brendan; Gillies, Donald; Illari, Phyllis; Russo, Federica & Williamson, Jon

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2012-10-09

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