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Should doctors care about their patients? Understanding this as a question about the proper role of emotion in medical practice—that is, should doctors feel empathy and sympathy for their patients?—a clear answer is hard to find. |
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How could the initial, drastic decisions to implement “lockdowns” to control the spread of COVID-19 infections be justifiable, when they were made on the basis of such uncertain evidence? We defend the imposition of lockdowns in some countries by first, and focusing on the UK, looking at the evidence that undergirded the decision, second, arguing that this provided us with sufficient grounds to restrict liberty given the circumstances, and third, defending the use of poorly-empirically-constrained epidemiological models as tools that can (...) |
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Two challenges have faced policymakers during the Covid-19 pandemic: First, they must determine the reliability of expert testimony in the face of uncertainty; second, they must determine the relevance of different kinds of expertise with regard to particular decisions. I argue that both these problems can be fruitfully analyzed through the lens of trust by introducing an in-depth case study of Iceland’s handling of the first wave of the Covid-19 pandemic. I contend that the problem of relevance highlights the limited (...) |
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The concept of a “validator” as a unit of evidence for the validity of a psychiatric category has been important for more than fifty years. Validator evidence is aggregated by expert committees (for the Diagnostic and Statistical Manual of Mental Disorders (DSM), these are referred to as “workgroups”), which use the results to make nosological decisions. Through an examination of the recent history of psychiatric research, this paper argues that it is time to reassess this traditional practice. It concludes with (...) |
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Ockham’s razor is the idea that simpler hypotheses are to be preferred over more complex ones. In the context of medical diagnosis, this is taken to mean that when a patient has multiple symptoms, a single diagnosis should be sought that accounts for all the clinical features, rather than attributing a different diagnosis to each. This paper examines whether diagnostic parsimony can be justified by reference to probability theory. I argue that while attempts to offer universal justifications of diagnostic parsimony (...) |
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Most of the epidemiological models of the Covid-19 pandemic contain the reproduction number as a parameter. In this article we focus on some shortcomings regarding its role in driving health policies and political decisions. First, we summarize what R is and what it is used for. Second, we introduce a three-question matrix for the evaluation of any construct or parameter within a model. We then review the main literature about R to highlight some of its shortcomings and apply to them (...) |
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There are many analogies between medical and judicial practice. This article explores one such analogy, between “medicalization” and “criminalization.” Specifically, drawing on an analogy between a judge’s speech act of delivering a verdict and a physician’s speech act of giving a diagnosis, it suggests a novel account of the phenomenon of “overdiagnosis.” Using this approach, we can make some headway in understanding debates over the early detection of cancer. The final section outlines the relationship between this approach and familiar debates (...) |
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What kind of epidemiological modeling works well? This is determined by the nature of the target: the relevant causal relations are unstable across contexts. I look at two influential examples of modeling from the Covid pandemic. The first is the paper from Imperial College London, which, in March 2020, was influential in persuading the UK government to impose a lockdown. Because it assumes stability, this first example of modeling fails. A different modeling strategy is required, one less ambitious but more (...) |
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Review of Vital Norms: Canguilhem’s The Normal and the Pathological in the Twenty-First Century, edited by Pierre-Olivier Méthot. |
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