Evidence based medicine (EBM) is under critical debate, and person centered healthcare (PCH) has been proposed as an improvement. But is PCH offered as a supplement or as a replacement of EBM? Prima facie PCH only concerns the practice of medicine, while the contended features of EBM also include methods and medical model. I here argue that there are good philosophical reasons to see PCH as a radical alternative to the existing medical paradigm of EBM, since the two seem committed (...) to conflicting ontologies. This paper aims to make explicit some of the most fundamental assumptions that motivate EBM and PCH, respectively, in order to show that the choice between them ultimately comes down to ontological preference. While EBM has a solid foundation in positivism, or what I here call Humeanism, PCH is more consistent with causal dispositionalism. I conclude that if there is a paradigmatic revolution on the way in medicine, it is first of all one of ontology. (shrink)

A standard way of representing causation is with neuron diagrams. This has become popular since the influential work of David Lewis. But it should not be assumed that such representations are metaphysically neutral and amenable to any theory of causation. On the contrary, this way of representing causation already makes several Humean assumptions about what causation is, and which suit Lewis’s programme of Humean Supervenience. An alternative of a vector diagram is better suited for a powers ontology. Causation should be (...) understood as connecting property types and tokens where there are dispositions towards some properties rather than others. Such a model illustrates how an effect is typically polygenous: caused by many powers acting with each other, and sometimes against each other. It models causation as a tendency towards an effect which can be counteracted. The model can represent cases of causal complexity, interference, over-determination and causation of absence (equilibrium). (shrink)

In this paper I argue that a truth functional account of conditional statements ‘if A then B’ not only is inadequate, but that it eliminates the very conditionality expressed by ‘if’. Focusing only on the truth-values of the statements ‘A’ and ‘B’ and different combinations of these, one is bound to miss out on the conditional relation expressed between them. But this is not a flaw only of truth functionality and the material conditional. All approaches that try to treat conditionals (...) as mere functions of their antecedents and consequents will end up in some sort of logical atomism where causal matters simply are reduced to the joint occurrence of A and B. What we need is a non-extensional approach to conditionals that can account for hypotheticality, potentiality, and dependency, none of which can be understood by looking to the antecedent or consequent per se. (shrink)

What is the connection between dispositions and ethics? Some might think very little and those who are interested in dispositions tend to be metaphysicians whose interests are far from value. However, we argue in this paper that dispositions and dispositionality are central to ethics, indeed a precondition. Ethics rests on a number of notions that are either dispositional in nature or involve real dispositions or powers at work. We argue for a dispositional account of value that offers an alternative to (...) the traditional fact-value dichotomy. We explain the place of value within a structure that explains the possibility of ethics. Elsewhere in this structure, we argue that moral responsibility is a precondition for ethics and that it is a dispositional notion depending critically on what Mumford and Anjum have called the dispositional modality. Moral responsibility in turn depends on there being both agency and normativity. We argue that intentionality and agency are preconditions for agency and that value is a precondition of normativity. All these notions are dispositional and make best sense if there are real dispositions or causal powers of agents. (shrink)

In this paper a dispositional account of meaning is offered. Words might dispose towards a particular or ‘literal’ meaning, but whether this meaning is actually conveyed when expressed will depend on a number of factors, such as speaker’s intentions, the context of the utterance and the background knowledge of the hearer. It is thus argued that no meaning is guaranteed or necessitated by the words used.

Språket vårt utgjør en stor del av vår identitet. Det er et redskap for kommunikasjon med andre mennesker, men også med oss selv. Vi uttrykker oss gjennom språket, og vi tenker ved hjelp av språket. Men hva er egentlig språk? Gjennom å ta for meg to vesensforskjellige tilnærminger til dette spørsmålet ønsker jeg å vise at det synet vi har på språk, har stor filosofiske betydning. Dette er fordi et språksyn nødvendigvis vil få konsekvenser for hvordan vi tenker om beslektede (...) filosofiske spørsmål, som blant annet: -/- – Hva er forholdet mellom språk og verden? -/- – Hva er sannhet? -/- – Hvordan får vi kunnskap om verden? -/- – Hva gjør vi når vi bruker språk? -/- – Hva er vår rolle som språkbrukere? -/- – Hvordan lærer vi språk? -/- Det er to ting som er viktig å avklare om vinklingen av denne artikkelen: Det første er at når jeg her velger å skissere to ulike filosofiske syn på språk, er det for å belyse de spørsmålene jeg har satt opp ovenfor, snarere enn å angripe eller fremme konkrete filosofiske teorier. Det andre er at når jeg her skriver om forholdet mellom språk og verden, og vår rolle som språkbrukere, vil jeg ta for gitt at dette omfatter alle naturlige språksystemer. Poengene mine er derfor ment å ha overføringsverdi til tegnspråk i sin alminnelighet, og selvfølgelig også til norsk tegnspråk. Dette innebærer at det jeg sier om ord, like gjerne kan sies om tegn. Målet med artikkelen er først og fremst å vise at språket må forstås som et gjennomgripende erkjennelsesmiddel i vårt møte med verden. (shrink)

Omissions are sometimes linked to responsibility. A harm can counterfactually depend on an omission to prevent it. If someone had the ability to prevent a harm but didn’t, this could suffice to ground their responsibility for the harm. Michael S. Moore’s claim is illustrated by the tragic case of Peter Parker, shortly after he became Spider-Man. Sick of being pushed around as a weakling kid, Peter became drunk on the power he acquired from the freak bite of a radioactive spider. (...) When a police officer called to Spider-Man to stop an escaping burglar, which he could have done easily, he failed to act. He was through taking orders. The omission was followed by a crime. That very same burglar later robbed Peter’s own house and when challenged he shot dead Peter’s Uncle Ben. Later, Spider-Man tracked down the killer and, when seeing his face close up, the possibility of prevention dawned on him. He could have stopped this crook and had he done so Uncle Ben would still be alive. Stan Lee’s tale of power finished with a Shakespearean twist. Young Peter realised the truth of the WGPCGR-thesis: With Great Power Comes Great Responsibility. We too will endorse the WGPCGR-thesis. There is a close connection between our notions of moral and legal responsibility and the powers we have as causal agents. This will be particularly important when it comes to the case of omissions: where we had the power to act but failed to do so. We hope to show the connections between the notions of power, cause, act, omission and responsibility but also some of the nuances. We will do so with particular reference to Moore’s account in Causation and Responsibility. (shrink)

This textbook is a comprehensive, engaging, and user-friendly introduction to philosophy of science written by a philosopher and a scientist. By exploring traditional debates within philosophy of science, as well as analysing contemporary scientific controversies for philosophical bias, the reader is invited to reflect upon how philosophical assumptions influence scientific theory, methods, and practice. -/- Key features: -/- - Is an accessible introduction to philosophy of science written by a philosopher and a scientist. - Includes some of the many important (...) contributions from women philosophers and scientists. - Demonstrates the philosophical influences on scientific thinking, practice, and expert disagreement. - Applies philosophy of science to analyse some specific real-life cases of scientific controversy. -/- This book is an essential resource for students and teachers in philosophy of science. It is also ideal for anyone interested in the philosophical influences on contemporary science. (shrink)

Hume thought that if you believed in powers, you believed in necessary connections in nature. He was then able to argue that there were none such because anything could follow anything else. But Hume wrong-footed his opponents. A power does not necessitate its manifestations: rather, it disposes towards them in a way that is less than necessary but more than purely contingent. -/- In this paper a dispositional theory of causation is offered. Causes dispose towards their effects and often produce (...) them. But a set of causes, even though they may succeed in producing an effect, cannot necessitate it since the effect could have been counteracted by some additional power. This would require a separation of our concepts of causal production and causal necessitation. The most conspicuous cases of causation are those where powers accumulate and pass a requisite threshold for an effect to occur. -/- We develop a model for representing powers as constituent vectors within an n-dimensional quality space, where composition of causes appears as vector addition. Even our resultant vector, however, has to be understood as having dispositional force only. This model throws new light on causal modality and cases of prevention, causation by absence and probabilistic causation. (shrink)

This is the trial lecture for Anjum's doctoral defence in 2005 at University of Tromsø.

Does A cause B simply if A prevents what would have prevented B? Such a case is known as double prevention: where we have the prevention of a prevention. One theory of causation is that A causes B when B counterfactually depends on A and, as there is such a dependence, proponents of the view must rule that double prevention is causation.<br><br>However, if double prevention is causation, it means that causation can be an extrinsic matter, that the cause and effect (...) need not be connected by a continuous chain of events, that there can be causation by absence, and that there can be causation at a distance. All of these implications jar with strong intuitions we have about the nature of causation. There is, on the other hand, a theory of causation based on an ontology of real dispositions, where causation involves the passing around of powers. This theory in contrast entails that double prevention is not causation and, on this issue, it can claim a victory over the counterfactual dependence account. (shrink)

Grice argues that indicative conditionals ‘if p then q’ have conventional, truth conditional meaning according to the material conditional ‘p  q’. In order to explain away the known paradoxes with this interpretation, he distinguishes between truth conditions and assertion conditions, attempting to demonstrate that the assumed connection between ‘p’ and ‘q’ (the Indirectness Condition) is a conversational implicature; hence a matter only relevant for the assertion conditions of a conditional. This paper argues that Grice fails to demonstrate i) that (...) the Indirectness Condition is cancellable, hence a conversational implicature, ii) that the Indirectness Condition is not part of the conventional, truth-relevant meaning of ‘if’, and accordingly, iii) semantic or logical equivalence between indicative and material conditionals. (shrink)

The material interpretation of conditionals is commonly recognized as involving some paradoxical results. I here argue that the truth functional approach to natural language is the reason for the inadequacy of this material interpretation, since the truth or falsity of some pair of statements ‘p’ and ‘q’ cannot per se be decisive for the truth or falsity of a conditional relation ‘if p then q’. This inadequacy also affects the ability of the overall formal system to establish whether or not (...) arguments involving conditionals are valid. I also demonstrate that the Paradox of Indicative Conditionals does not actually involve a paradox, but instead contains some paralogistic elements that make it appear to be a paradox. The discussion of the paradox in this paper further reveals that the material interpretation of conditionals adversely affects the treatment of disjunctions. -/- Much has been said about these matters in the literature that point in the same direction. However, there seems to be some reluctance against fully complying with the arguments against the truth functional account of conditionals, since many of the alternative accounts rely on the material conditional, or at least on an understanding of the conditional as a function of antecedent and consequent in a similar sense as the material conditional. My argument against truth functionality indicates that it may in general involve similar problems to treat conditionals as such functions, whether one deals with theories of truth, assertability or probability. (shrink)

The conditional interpretation of general categorical statements like ‘All men are animals’ as universally quantified material conditionals ‘For all x, if x is F, then x is G’ suggests that the logical structure of law statements is conditional rather than categorical. Disregarding the problem that the universally quantified material conditional is trivially true whenever there are no xs that are F, there are some reasons to be sceptical of Frege’s equivalence between categorical and conditional expressions. -/- Now many philosophers will (...) claim that the material conditional interpretation of laws statements, dispositions ascriptions, or any causal claim is generally accepted as wrong and outdated. Still, there seem to be some basic logical assumptions that are shared by most of the participants in the debate on causal matters which at least stems from the traditional truth functional interpretation of conditionals. This is indicated by the vocabulary in the philosophical debate on causation, where one often speaks of ‘counterfactuals’, ‘possible worlds’ and ‘necessity’ without being explicit on whether or to what extent one accepts the logical-technical definition of these notions. To guarantee a non-Humean and non-extensional approach to causal relations, it is therefore important to be aware of the logical and metaphysical implications of the technical vocabulary. -/- In this paper we want to show why extensional logic cannot deal with causal relations. Via a logical analysis of law-like statements ‘All Fs are Gs’ we hope to throw some new light on interrelated notions like causation, laws, induction, hypotheticality and modality. If successful, our analysis should be of relevance for a deeper understanding of any type of causal relations, whether we understand them to be laws, dispositions, singulars or categoricals. (shrink)

This paper argues that the technical notion of conditional probability, as given by the ratio analysis, is unsuitable for dealing with our pretheoretical and intuitive understanding of both conditionality and probability. This is an ontological account of conditionals that include an irreducible dispositional connection between the antecedent and consequent conditions and where the conditional has to be treated as an indivisible whole rather than compositional. The relevant type of conditionality is found in some well-defined group of conditional statements. As an (...) alternative, therefore, we briefly offer grounds for what we would call an ontological reading: for both conditionality and conditional probability in general. It is not offered as a fully developed theory of conditionality but can be used, we claim, to explain why calculations according to the RATIO scheme does not coincide with our intuitive notion of conditional probability. What it shows us is that for an understanding of the whole range of conditionals we will need what John Heil (2003), in response to Quine (1953), calls an ontological point of view. (shrink)

The truth functional account of conditional statements ‘if A then B’ is not only inadequate; it eliminates the very conditionality expressed by ‘if’. Focusing only on the truth-values of the statements ‘A’ and ‘B’ and different combinations of these, one is bound to miss out on the conditional relation expressed between them. All approaches that treat conditionals as functions of their antecedents and consequents will end up in some sort of logical atomism where causal matters simply are reduced to the (...) joint occurrence of A and B. (shrink)

In an explanation ‘y because x’, because can be used to express an explanatory relation between an explanandum ‘y’ and an explanans ‘x’. But because can also be used to express the speaker’s reason for uttering ‘y’. This difference will be elucidated by connecting it with the distinction between the at-issue dimension and the speaker dimension of meaning. There are also internal relations between if and because that can help us find and analyse different uses of because, and thus also (...) different types of explanatory relations. (shrink)

There has been much discussion of powers or real dispositions in the past decade, but there remains an issue that has been inadequately treated. This concerns the precise modal value that comes with dispositionality. We contend in this paper that dispositionality involves a non-alethic, sui generis, irreducible modality. Dispositions only tend towards their manifestations; they do not necessitate them. Tendency is, of course, a dispositional term itself, so this last statement offers little by way of illumination. But given our thesis (...) on the irreducible nature of dispositionality, we maintain that it cannot be explicated correctly in non-dispositional terms. Nevertheless, we all have experience of dispositionality at work, through the exercise or our own powers and the action of other powers upon us. The notion of dispositionality that we acquire is one that involves a modality stronger than pure contingency but weaker than necessity. The recognition of this distinct modal value for dispositionality is one of the biggest oversights in the growing literature in the area. Yet it is there for all to see in even the most mundane example. (shrink)

The transition of C. albicans from unicellular yeast form to filamentous form i.e., pseudohyphae and hyphae is referred to as morphogenesis. C. albicans has the ability to respond to environmental conditions and accordingly changing its cell morphology. Three main morphological forms of C. albicans are unicellular yeast, pseudohyphae and hyphae. The effect of different growth media (Horse serum medium, RPMI-1640, MSGB), incubation temperatures (34˚C, 37˚C, 40˚C) and pH values (5.4, 6.4, 7.4) on germ tube production by C. albicans was evaluated. (...) Horse serum medium noticeably promotes filamentation while RPMI-1640 medium shows moderate filamentation and MSGB media shows moderately low filamentation. The germ tube of C. albicans developed early in 1.5 hr at high temperature i.e., 40˚C. Incubation temperature of 37˚C was associated with highest germ tube formation while 34˚C shows low filamentation. A pH of 5.4 also induces low filamentation, pH 6.4 gives moderately lower than pH 7.4. A pH of 7.4 was best suited for germ tube induction. The peak of mycelium production appears between 1.5 and 6 hr after inoculation of C. albicans culture. These results suggested that environmental factors are important in selectively favoring yeast or hyphal form, most important being the growth medium, incubation temperature and external pH value. (shrink)

There seems to be widespread agreement that there are two modal values: necessity and possibility. X is necessary if it is not possible that not-X; and Y is possible if it is not necessary that not-Y. In their path-breaking book, Rani Lill Anjum and Stephen Mumford defend the radical idea that there is a third modal value, weaker than necessity and stronger than possibility. This third value is dubbed 'dispositional modality' (DM) or 'tendency' and is taken to be an (...) irreducible and sui generis worldly modality: "the modality that's everywhere" (5). The source of DM is the causal powers of particulars; hence, DM is constitutively involved in causation: "a cause tends or disposes towards its effect, and can sometimes succeed in producing it" (9). Accordingly, DM is involved in all causal processes, from fundamental physics to the social and moral realm. This "deeply tendential view" (11) of the metaphysics of nature is advanced as distinct from both extant neo-Aristotelian and Humean views. Its key feature is that there is neither pure contingency nor necessitation in nature. (shrink)

In this book, Mumford and Anjum advance a theory of causation based on a metaphysics of powers. The book is for the most part lucidly written, and contains some interesting contributions: in particular on the necessary connection between cause and effect and on the perceivability of the causal relation. I do, however, have reservations about some of the book’s central theses: in particular, that cause and effect are simultaneous, and that causes can fruitfully be represented as vectors.

Neuron diagrams are heavily employed in academic discussions of causation. Stephen Mumford and Rani Lill Anjum, however, offer an alternative approach employing vector diagrams, which this paper attempts to develop further. I identify three ways in which dispositionalists have taken the activities of powers to be related: stimulation, mutual manifestation, and contribution combination. While Mumford and Anjum do provide resources for representing contribution combination, which might be sufficient for their particular brand of dispositionalism, I argue that those resources (...) are not flexible enough to further accommodate either stimulation or mutual manifestation. Representational tools are provided to address these limitations, improving the general value of the vector model for dispositionalist approaches to causation. (shrink)

In this paper I argue that even the most radical metaphysics of powers (such as that adopted by Mumford & Anjum, Cartwright, or Groff) are compatible with eternalism. I first offer a taxonomy of powers ontologies, and attempt to characterise the difference between moderate and radical powers ontologies – the latter are characterised by an emphasis on production and dynamicity. I consider an argument by C. Friebe to the effect that the productive character of powers is inconsistent with Eternalism (...) and find it wanting. I then elucidate the notion of dynamicity that radical powers theorists employ by making apparent their link with an ontology of irreducible processes. Finally, I respond to an argument by Donatella Donati to the effect that eternalism entails a reductive account of change which is inconsistent with process ontologies, and show that the the two are compatible. I conclude that we have no reason to think that radical powers metaphysics (and, a fortiori, every powers ontology) are not compatible with eternalism. (shrink)

In this paper, I argue in favor of necessitarianism, the view that dispositions, when stimulated, necessitate their manifestations. After introducing and clarifying what necessitarianism does and does not amount to, I provide reasons to support the view that dispositions once stimulated necessitate their manifestations according to the stimulating conditions and the relevant properties at stake. In this framework, I will propose a principle of causal relevance and some conditions for the possibility of interference that allow us to avoid the use (...) of ceteris paribus clauses. I then defend necessitarianism from recent attacks raised by, among others, Mumford and Anjum, noting that the antecedent strengthening test is a test for causal relevance that raises no difficulties for necessitarianism. (shrink)

Bird argues that Armstrong’s necessitarian conception of physical modality and laws of nature generates a vicious regress with respect to necessitation. We show that precisely the same regress afflicts Bird’s dispositional-monist theory, and indeed, related views, such as that of Mumford & Anjum. We argue that dispositional monism is basically Armstrongian necessitarianism modified to allow for a thesis about property identity.

Identifying the necessary and sufficient conditions for individuating and classifying diseases is a matter of great importance in the fields of law, ethics, epidemiology, and of course, medicine. In this paper, I first propose a means of achieving this goal, ensuring that no two distinct disease-types could correctly be ascribed to the same disease-token. I then posit a metaphysical ontology of diseases—that is, I give an account of what a disease is. This is essential to providing the most effective means (...) of interfering with disease processes. Following existing work in the philosophy of medicine and epidemiology (primarily Christopher Boorse; Caroline Whitbeck; Alexander Broadbent), philosophy of biology (Joseph LaPorte; D.L. Hull), conditional analyses of causation (J.L. Mackie; David Lewis), and recent literature on dispositional essentialism (Stephen Mumford and Rani Anjum; Alexander Bird), I endorse a dispositional conception of disease. Following discussion of various conceptions of disease-identity, their relations to the clinical and pathological effects of the diseases in question, and how diseases are treated, I conclude (i) that diseases should be individuated by their causes, and (ii) that diseases are causal processes best seen as simultaneously acting sequences of mutually manifesting dispositions. (shrink)