Evidence based-policy (EBP) is a popular research paradigm in the applied social sciences and within government agencies. Informally, EBP represents an explicit commitment to applying scientific methods to public affairs, in contrast to ideologically-driven or merely intuitive “common-sense” approaches to public policy. More specifically, the EBP paradigm places great weight on the results of experimental research designs, especially randomised controlled trials (RCTs), and systematic literature reviews that place evidential weight on experimental results. One hope is that (...) such research designs and approaches to analysing the scientific literature are sufficiently robust that they can settle what really ‘works’ in public policy. Can EBP succeed in displacing reliance on domain-specific expertise? On our account, this is seldom, if ever, the case. The key reason for this is that underlying this approach is generally an appeal to argument by induction, which always requires further assumptions to underwrite its validity, and if not induction, some other argument form that also requires assumptions that are very often not validated for the case at hand. (shrink)

WE AIM HERE to outline a theory of evidence for use. More specifically we lay foundations for a guide for the use of evidence in predicting policy effectiveness in situ, a more comprehensive guide than current standard offerings, such as the Maryland rules in criminology, the weight of evidence scheme of the International Agency for Research on Cancer (IARC), or the US ‘What Works Clearinghouse’. The guide itself is meant to be well-grounded but at the same (...) time to give practicable advice, that is, advice that can be used by policy-makers not expert in the natural and social sciences, assuming they are well-intentioned and have a reasonable but limited amount of time and resources available for searching out evidence and deliberating. (shrink)

We live in an age of evidence-based healthcare, where the concept of evidence has been avidly and often uncritically embraced as a symbol of legitimacy, truth, and justice. By letting the evidence dictate healthcare decision making from the bedside to the policy level, the normative claims that inform decision making appear to be negotiated fairly—without subjectivity, prejudice, or bias. Thus, the term ‘‘evidence-based’’ is typically read in the health sciences as the empirically adequate (...) standard of reasonable practice and a means for increasing certainty. Supporters believe that evidence-based medicine (EBM) can introduce rational order to the deliberative processes of healthcare decision making. It is perhaps puzzling, then, to come across critical perspectives (typically arising from the humanities and the more theory-driven social sciences) raising concerns about a seeming technogovernance being introduced by this deferral to the evidence where power interests can be obfuscated by way of technical resolve. The critics holding this minority view argue that technological solutions to problems of knowledge and practice cannot replace medicine’s normative content. Against EBM’s democratic leanings toward transparency and accountability, medical criteria alone cannot decide valueladen ethically charged decisions. This paper attempts to explain and evaluate this important debate in the philosophy of medicine, focusing specifically on the dispute over 'evidence-based women's health'. (shrink)

Since its introduction just over two decades ago, evidence-based medicine (EBM) has come to dominate medical practice, teaching, and policy. There are a growing number of textbooks, journals, and websites dedicated to EBM research, teaching, and evidence dissemination. EBM was most recently defined as a method that integrates best research evidence with clinical expertise and patient values and circumstances in the treatment of patients. There have been debates throughout the early 21st century about what counts (...) as good research evidence between EBM proponents and philosophical critics and even within the EBM community itself. Similar controversy arises about the relative worth of patient values and clinical expertise (and how these can be integrated). EBM has also evolved in ways that have come under scrutiny. Specifically, policymakers have used EBM research methodology to increase the relative importance of clinical guidelines that some clinicians have argued are tyrannical. Philosophers have addressed all of these controversies, and with very few exceptions have been critical of EBM. In addition most philosophical attention has been on the epistemic role of Randomization and evidence hierarchies, with relatively little attention being paid to the role of Diagnosis, expertise, patient values, and Systematic Reviews within EBM. (shrink)

I consider recent strategies proposed by econometricians for extrapolating causal effects from experimental to target populations. I argue that these strategies fall prey to the extrapolator’s circle: they require so much knowledge about the target population that the causal effects to be extrapolated can be identified from information about the target alone. I then consider comparative process tracing as a potential remedy. Although specifically designed to evade the extrapolator’s circle, I argue that CPT is unlikely to facilitate extrapolation in typical (...) econometrics and evidence-based policy applications. To argue this, I offer a distinction between two kinds of extrapolation, attributive and predictive, the latter being prevalent in econometrics and evidence-based policy. I argue that CPT is not helpful for predictive extrapolation when using the kinds of evidence that econometricians and evidence-based policy researchers prefer. I suggest that econometricians may need to consider qualitative evidence to overcome this problem. (shrink)

Historically, scientific and engineering expertise has been key in shaping research and innovation policies, with benefits presumed to accrue to society more broadly over time. But there is persistent and growing concern about whether and how ethical and societal values are integrated into R&I policies and governance, as we confront public disbelief in science and political suspicion toward evidence-based policy-making. Erosion of such a social contract with science limits the ability of democratic societies to deal with challenges (...) presented by new, disruptive technologies, such as synthetic biology, nanotechnology, genetic engineering, automation and robotics, and artificial intelligence. Many policy efforts have emerged in response to such concerns, one prominent example being Europe's Eighth Framework Programme, Horizon 2020, whose focus on “Responsible Research and Innovation” provides a case study for the translation of such normative perspectives into concrete policy action and implementation. Our analysis of this H2020 RRI approach suggests a lack of consistent integration of elements such as ethics, open access, open innovation, and public engagement. On the basis of our evaluation, we suggest possible pathways for strengthening efforts to deliver R&I policies that deepen mutually beneficial science and society relationships. (shrink)

ABSTRACT“Evidence-based” methods, which most prominently include randomized controlled trials, have gained increasing purchase as the “gold standard” for assessing the effect of public policies. But the enthusiasm for evidence-based research overlooks questions about the reliability and applicability of experimental findings to diverse real-world settings. Perhaps surprisingly, a qualitative study of British educators suggests that they are aware of these limitations and therefore take evidence-based findings with a much larger grain of salt than do (...) class='Hi'>policy makers. Their experience suggests that the real world is more heterogeneous than the world imagined by evidence-based policy enthusiasts. (shrink)

In “Risk Based Passenger Screening in Aviation Security: Implications and Variants of a New Paradigm”, Sebastian Weydner-Volkmann describes the current paradigm shift from ‘traditional’ forms of screening to ‘risk based passenger screening’ (RBS) in aviation security. This paradigm shift is put in the context of the wider historical development of risk management approaches. Through a discussion of Michel Foucault, Herfried Münkler and Ulrich Beck, Weydner-Volkmann analyses the shortcomings of such approaches in public security policies, which become especially evident (...) in the aviation security context. As he shows, the turn towards methods of RBS can be seen as an attempt to address a trade-off ‘trilemma’ between the effective provision of security, the implied costs for industry and passengers, and the ethical, legal and societal implications of the screening procedures. In order to analyse foreseeable outcomes of embracing RBS, he differentiates three prototypical variants of the new paradigm on the basis of their main referent and rationale. For each variant, he then subsequently assesses the implications for the ‘trilemma’, after having unveiled the criteria of analysis that will necessarily have to be followed within a serious appraisal of RBS methods. (shrink)

After ratifying the Framework Convention for Tobacco Control in 2004, Bangladesh enacted anti-tobacco laws, policies, and administrative measures. Evidence suggests that the progress so far has not been significant, and Bangladesh will most likely fail to meet its target to become tobacco-free by 2040. This study undertakes a national-level political economy analysis to explore the dynamics that affect the processes of required tobacco policy reforms and implementation. Based on a desk review of pertinent pieces of literature and (...) key informant interviews, this research examines the political behavior of key individuals, institutional reform initiatives, and the government’s commitment to the tobacco control agenda. The findings indicate that the political will of becoming tobacco-free is explicitly present in key narratives. However, intra-government conflict of interests and incentives, the skewed commitment of government bodies, state-business nexus, incapacity of vital organizations, and the dubious role of key individuals and committees fail to translate this will into active implementation. The article concludes that the idea of tobacco control remains a strategic accommodation, and its implementation requires genuine commitment and wider public support. The government must confer adequate authority and resources to the national tobacco control cell and call for agencies to convene to the common of creating a tobacco-free Bangladesh. (shrink)

In March 2016, an interdisciplinary group met for two days and two evenings to explore the implications for policy making of second-order science. The event was sponsored by SITRA, the Finnish Parliament's Innovation Fund. Their interest arose from their concern that the well-established ways, including evidence-based approaches, of policy and decision making used in government were increasingly falling short of the complexity, uncertainty, and urgency of needed decision making. There was no assumption that second-order science or (...) second-order cybernetics would reveal any practical possibilities at this early stage of enquiry. On the other hand, some members of the group are practioners in both policy and in facilitating change in sectors of society. Thus, the intellectual concepts were strongly grounded in experience. This is an account of the deliberations of that group and some reflections on what came out of the various shared contributions and ensuing dialogues. The overall conclusion of the event is that there definitely are possibilities that are worthy of further research and exploration. (shrink)

A brief overview of Autonomous Weapon Systems (AWS) and their different levels of autonomy is provided, followed by a discussion of the risks represented by these systems under the light of the just war principles and insights from research in cybersecurity. Technological progress has brought about the emergence of machines that have the capacity to take human lives without human control. These represent an unprecedented threat to humankind. This commentary starts from the example of chemical weapons, now banned worldwide by (...) the Geneva protocol, to illustrate how technological development initially aimed at the benefit of humankind has, ultimately, produced what is now called the “weaponization of Artificial Intelligence” (AI). We are led to conclude that AWS fail the discrimination principle, and that the only way of mitigating the risk they represent to humankind is the rapid negotiation of treaties for the implementation of an international zero-tolerance policy against the development and/or deployment of autonomous weapon systems. Given that scientific research on AWS is altogether lacking in the public domain, the viewpoint here is based on common sense rather than scientific evidence. Yet, the implications of the potential weaponization of our work as scientists, especially in the field of AI, are reaching further than we may think. The potential consequences of the deployment of AWS for citizen stakeholders are incommensurable. This viewpoint points towards good reasons why we need to raise awareness of the threats represented by AWS, and legal policies to ensure that these threats will not materialize. (shrink)

Policy-makers sometimes aim to improve well-being as a policy goal, but to do this they need some way to measure well-being. Instead of relying on potentially problematic theories of well-being to justify their choice of well-being measure, Daniel Hausman proposes that policy-makers can sometimes rely on preference-based measures as evidence for well-being. I claim that Hausman’s evidential account does not justify the use of any one measure more than it justifies the use of any other (...) measure. This leaves us at a loss as to which policy should be chosen in the non-trivial cases for which there is substantial disagreement between the different measures in their assessment of policy. (shrink)

With twentieth- and twenty-first-century philosophy of science’s unfolding acceptance of the nature of scientific inquiry being value-laden, the persistent worry has been that there are no means for legitimate negotiation of the social or non-epistemic values that enter into science. The rejection of the value-free ideal in science has thereby been coupled with the spectres of indiscriminate relativism and bias in scientific inquiry. I challenge this view in the context of recently expressed concerns regarding Canada's death of evidence controversy. (...) The worry, raised by Stathis Psillos, is that as constructivist accounts of science demoted the previously secure status of evidence for drawing justified conclusions in science, we were left with no rational delineation between the right and wrong values for science. The implication for the death of evidence controversy is that we may have no rational grounds for claiming that the Canadian Government is wrong to interfere with scientific enterprise. But he does offer another avenue for reaching the conclusion that the wrong social values are directing the current stifling of some sectors of Canadian science. Psillos draws from standpoint epistemologies to devise a salient defence of ‘valuing evidence’ as a universalizable social value. That is, government bodies ought to enable scientific research via adequate funding as well as political non-interference. In this paper, I counter that non-epistemic values can be rationally evaluated and that standpoint epistemology’s universalizable standpoint provides an inadequate framework for negotiating social values in science. Regarding, I draw from the evidence-based medicine debate in philosophy of medicine and from feminist empiricist investigations into the science–values relationship in order to make the argument for empirically driven value arbitration. If social values can be rationally chosen in the context of justification, then we can have grounds for charging the Canadian leadership with being ‘at war with science’. I further argue that my recommended empiricist methodology is preferable to Psillos’s search for universalizable perspectives for negotiating social values in science because the latter method permits little more than the trivial conclusion that evidence is valuable to science. (shrink)

In the biomedical context, policy makers face a large amount of potentially discordant evidence from different sources. This prompts the question of how this evidence should be aggregated in the interests of best-informed policy recommendations. The starting point of our discussion is Hunter and Williams’ recent work on an automated aggregation method for medical evidence. Our negative claim is that it is far from clear what the relevant criteria for evaluating an evidence aggregator of (...) this sort are. What is the appropriate balance between explicitly coded algorithms and implicit reasoning involved, for instance, in the packaging of input evidence? In short: What is the optimal degree of ‘automation’? On the positive side: We propose the ability to perform an adequate robustness analysis as the focal criterion, primarily because it directs efforts to what is most important, namely, the structure of the algorithm and the appropriate extent of automation. Moreover, where there are resource constraints on the aggregation process, one must also consider what balance between volume of evidence and accuracy in the treatment of individual evidence best facilitates inference. There is no prerogative to aggregate the total evidence available if this would in fact reduce overall accuracy. (shrink)

The global response to child labour is based on the standards set by three major international conventions. This review examines the historical development of the conceptualizations of various forms of child labour, relevant views and perspectives, contemporary theoretical underpinnings, and policy suggestions. The emerging evidence shows that child labour incidences in all its forms have increased in many parts of the world, and the global target to eradicate child labour by 2025 seems unattainable. The evaluation indicates that (...) the current global age-based abolitionist policy to fight child labour has lost some ground. The covid-19 pandemic has worsened the situation and the worst forms of child labour have become even more widespread and deeply normalized in many contexts and communities. The current scholarship of child labour remains critically ignorant of the relevant societal and cultural norms. Contemporary theorists and empiricists emphasize on constructing knowledge with the children and families engaged in child labour and focusing on finding innovative community-led alternatives to the worst forms of child labour. Regulations, policies, and support programmes must recognize the economic contribution of working children and work towards the children's best interests. (shrink)

While children’s experiences of online risks and harm is a growing area of research in New Zealand, public discussion on the matter has largely been informed by mainstream media’s fixation on the dangers of technology. At best, debate on risks online has relied on overseas evidence. However, insights reflecting the New Zealand context and based on representative data are still needed to guide policy discussion, create awareness, and inform the implementation of prevention and support programmes for children. (...) This research report presents findings from a quantitative study regarding different aspects related to risks and online safety. It looks at the online experiences that children find bothersome and upsetting and explores the hurtful behaviours they encounter or engage in, both online and in person. Evidence regarding exposure to different types of potentially harmful online content is also presented. Another relevant contribution is the insights related to excessive internet use.The findings presented in this report are based on data from 2,061 New Zealand children aged 9-17. We hope the findings will contribute to the development of policies, practices and services designed to support New Zealand children to safely take advantage of the opportunities available to them online. (shrink)

Proponents of evidence-based medicine have argued convincingly for applying this scientific method to medicine. However, the current methodological framework of the EBM movement has recently been called into question, especially in epidemiology and the philosophy of science. The debate has focused on whether the methodology of randomized controlled trials provides the best evidence available. This paper attempts to shift the focus of the debate by arguing that clinical reasoning involves a patchwork of evidential approaches and that the (...) emphasis on evidence hierarchies of methodology fails to lend credence to the common practice of corroboration in medicine. I argue that the strength of evidence lies in the evidence itself, and not the methodology used to obtain that evidence. Ultimately, when it comes to evaluating the effectiveness of medical interventions, it is the evidence obtained from the methodology rather than the methodology that should establish the strength of the evidence. (shrink)

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)

This paper analyzes the determinants of women’s representation on boards of directors based on a panel of all privately owned or listed Danish firms with at least 50 employees observed during the period 1998–2010. We focus on the directors who are not elected by the employees and test three hypotheses on female board representation that we denote the female-led hypothesis, the tokenism hypothesis, and the pipeline hypothesis, respectively. We find evidence rejecting the female-led hypothesis. Firms with a female (...) chairperson on the board of directors tend to have significantly fewer other non-employee-elected female board members. We also find clear evidence of a tokenism behavior in Danish companies. The likelihood of enlarging the share of non-employee-elected female board members is significantly smaller if one, two, or more women have sat on the board of directors. Finally, the pipeline hypothesis is partly confirmed. The relation between the female pipeline of potentially qualified directors and female directors is weaker than the similar relation for males. Our findings offer insights to policy makers interested in promoting gender diversity within boardrooms. Our empirical evidence suggests that an important way to increase the female proportion of non-employee-elected board members is that more women reach top executive positions. (shrink)

The evidence-based medicine (EBM) movement is touted as a new paradigm in medical education and practice, a description that carries with it an enthusiasm for science that has not been seen since logical positivism flourished (circa 1920–1950). At the same time, the term ‘‘evidence-based medicine’’ has a ring of obviousness to it, as few physicians, one suspects, would claim that they do not attempt to base their clinical decision-making on available evidence. However, the apparent obviousness (...) of EBM can and should be challenged on the grounds of how ‘evidence’ has been problematised in the philosophy of science. EBM enthusiasm, it follows, ought to be tempered. The post-positivist, feminist, and phenomenological philosophies of science that are examined in this paper contest the seemingly unproblematic nature of evidence that underlies EBM by emphasizing different features of the social nature of science. The appeal to the authority of evidence that characterizes evidence-based practices does not increase objectivity but rather obscures the subjective elements that inescapably enter all forms of human inquiry. The seeming common sense of EBM only occurs because of its assumed removal from the social context of medical practice. In the current age where the institutional power of medicine is suspect, a model that represents biomedicine as politically disinterested or merely scientific should give pause. (shrink)

In the philosophy of mind, the causal relationship between phenomenal consciousness, mentation and brain states has always been a matter of debate. On the one hand, material monism posits consciousness and mind as pure brain-epiphenomena. One of its most stringent lines of reasoning relies on the premise that because a cerebral impairment, or its anatomical and biochemical modification, leads to a cognitive impairment and/or altered states of consciousness, there is no reason to doubt the mind-brain identity. On the other hand, (...) dualism or idealism (in one form or another) regard consciousness and mind as something other than the sole product of cerebral activity pointing at the ineffable and undefinable seemingly unphysical nature of our subjective qualitative experience and its related mental dimension. Here, we argue that the premise of material monism is based on a logical correlation-causation fallacy and will review some neuroscientific and biological findings that question the idea that posits phenomenal experience as an emergent property of brain activity. While these (mostly ignored) findings, if considered separately from each other, could, in principle, be recast into a physicalist paradigm, once viewed from an integral perspective, they substantiate equally well, if not even more effectively, an ontology that posits mind and consciousness as a primal phenomenon. (shrink)

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 be fruitfully applied to the social sciences. In particular, Evidential Pluralism provides (i) a new approach to evidence-based policy; (ii) an account of the evidential relationships in more theoretical research; and (iii) new philosophical motivation for mixed methods research. The application of Evidential Pluralism to the social sciences is also defended against two objections. (shrink)

Several vaccines against COVID-19 have now been developed and are already being rolled out around the world. The decision whether or not to get vaccinated has so far been left to the individual citizens. However, there are good reasons, both in theory as well as in practice, to believe that the willingness to get vaccinated might not be sufficiently high to achieve herd immunity. A policy of mandatory vaccination could ensure high levels of vaccination coverage, but its legitimacy is (...) doubtful. We investigate the willingness to get vaccinated and the reasons for an acceptance (or rejection) of a policy of mandatory vaccination against COVID-19 in June and July 2020 in Germany based on a representative real time survey, a random sub-sample (SOEP-CoV) of the German Socio-Economic Panel (SOEP). Our results show that about 70 percent of adults in Germany would voluntarily get vaccinated against the coronavirus if a vaccine without side effects was available. About half of residents of Germany are in favor, and half against, a policy of mandatory vaccination. The approval rate for mandatory vaccination is significantly higher among those who would get vaccinated voluntarily (around 60 percent) than among those who would not get vaccinated voluntarily (27 percent). The individual willingness to get vaccinated and acceptance of a policy of mandatory vaccination correlates systematically with socio-demographic and psychological characteristics of the respondents. We conclude that as far as people’s declared intentions are concerned, herd immunity could be reached without a policy of mandatory vaccination, but that such a policy might be found acceptable too, were it to become necessary. (shrink)

Thirty years after the rise of the evidence-based medicine (EBM) movement, formal training in philosophy remains poorly represented among medical students and their educators. In this paper, I argue that EBM’s reception in this context has resulted in a privileging of empiricism over rationalism in clinical reasoning with unintended consequences for medical practice. After a limited review of the history of medical epistemology, I argue that a solution to this problem can be found in the method of the (...) 2nd-century Roman physician Galen, who brought empiricism and rationalism together in a synthesis anticipating the scientific method. Next, I review several of the problems that have been identified as resulting from a staunch commitment to empiricism in medical practice. Finally, I conclude that greater epistemological awareness in the medical community would precipitate a Galenic shift toward a more epistemically balanced, scientific approach to clinical research. (shrink)

To reach sustainability transitions, we must learn to leverage social systems into tipping points, where societies exhibit positive-feedback loops in the adoption of sustainable behavioral and cultural traits. However, much less is known about the most efficient ways to reach such transitions or how self-reinforcing systemic transformations might be instigated through policy. We employ an agent-based model to study the emergence of social tipping points through various feedback loops that have been previously identified to constitute an ecological approach (...) to human behavior. Our model suggests that even a linear introduction of pro-environmental affordances (action opportunities) to a social system can have non-linear positive effects on the emergence of collective pro-environmental behavior patterns. We validate the model against data on the evolution of cycling and driving behaviors in Copenhagen. Our model gives further evidence and justification for policies that make pro-environmental behavior psychologically salient, easy, and the path of least resistance. (shrink)

Even though the evidence‐based medicine movement (EBM) labels mechanisms a low quality form of evidence, consideration of the mechanisms on which medicine relies, and the distinct roles that mechanisms might play in clinical practice, offers a number of insights into EBM itself. In this paper, I examine the connections between EBM and mechanisms from several angles. I diagnose what went wrong in two examples where mechanistic reasoning failed to generate accurate predictions for how a dysfunctional mechanism would (...) respond to intervention. I then use these examples to explain why we should expect this kind of mechanistic reasoning to fail in systematic ways, by situating these failures in terms of evolved complexity of the causal system(s) in question. I argue that there is still a different role in which mechanisms continue to figure as evidence in EBM: namely, in guiding the application of population‐level recommendations to individual patients. Thus, even though the evidence‐based movement rejects one role in which mechanistic reasoning serves as evidence, there are other evidentiary roles for mechanistic reasoning. This renders plausible the claims of some critics of evidencebased medicine who point to the ineliminable role of clinical experience. Clearly specifying the ways in which mechanisms and mechanistic reasoning can be involved in clinical practice frames the discussion about EBM and clinical experience in more fruitful terms. (shrink)

Historically, laws and policies to criminalize drug use or possession were rooted in explicit racism, and they continue to wreak havoc on certain racialized communities. We are a group of bioethicists, drug experts, legal scholars, criminal justice researchers, sociologists, psychologists, and other allied professionals who have come together in support of a policy proposal that is evidence-based and ethically recommended. We call for the immediate decriminalization of all so-called recreational drugs and, ultimately, for their timely and appropriate (...) legal regulation. We also call for criminal convictions for nonviolent offenses pertaining to the use or possession of small quantities of such drugs to be expunged, and for those currently serving time for these offenses to be released. In effect, we call for an end to the “war on drugs.”. (shrink)

As a way to make medical decisions, Evidence-Based Medicine (EBM) has failed. EBM's failure arises from not being founded on real-world decision-making. EBM aspires to a scientific standard for the best way to treat a disease and determine its cause, but it fails to recognise that the scientific method is inapplicable to medical and other real-world decision-making. EBM also wrongly assumes that evidence can be marshaled and applied according to an hierarchy that is determined in an argument (...) by authority to the method by which it has been obtained. If EBM had valid theoretical, practical or empirical foundations, there would be no hierarchy of evidence. In all real-world decision-making, evidence stands or falls on its inherent reliability. This has to be and can only be assessed on a case-by-case basis applying understanding and wisdom against the background of all available facts—the "factual matrix." EBM's failure is structural and was inevitable from its inception. EBM confuses the inherent reliability and probative value of evidence with the means by which it is obtained. -/- EBM is therefore an ad hoc construct and is not a valid basis for medical decision-making. This is further demonstrated by its exclusion of relevant scientific and probative real-world decision-making evidence and processes. It draws upon a narrow evidence base that is itself inherently unreliable. It fails to take adequate account of the nature of causation, the full range of evidence relevant to its determination, and differing approaches to determining cause and effect in real-world decision-making. EBM also makes a muddled attempt to emulate the scientific method and it does not acknowledge the role of experience, understanding and wisdom in making medical decisions. (shrink)

While the Value-Free Ideal of science has suffered compelling criticism, some advocates like Gregor Betz continue to argue that science policy advisors should avoid value judgments by hedging their hypotheses. This approach depends on a mistaken understanding of the relations between facts and values in regulatory science. My case study involves the morning-after pill Plan B and the “Drug Fact” that it “may” prevent implantation. I analyze the operative values, which I call zygote-centrism, responsible for this hedged drug label. (...) Then, I explain my twofold account of value-ladenness, involving the constitutive role of value judgments in science and the social function of facts as political tools. Because this drug fact is ineliminably value-laden in both senses, I conclude that hedged hypotheses are not necessarily value-free. (shrink)

In this multi-disciplinary investigation we show how an evidence-based perspective of quantification---in terms of algorithmic verifiability and algorithmic computability---admits evidence-based definitions of well-definedness and effective computability, which yield two unarguably constructive interpretations of the first-order Peano Arithmetic PA---over the structure N of the natural numbers---that are complementary, not contradictory. The first yields the weak, standard, interpretation of PA over N, which is well-defined with respect to assignments of algorithmically verifiable Tarskian truth values to the formulas of (...) PA under the interpretation. The second yields a strong, finitary, interpretation of PA over N, which is well-defined with respect to assignments of algorithmically computable Tarskian truth values to the formulas of PA under the interpretation. We situate our investigation within a broad analysis of quantification vis a vis: * Hilbert's epsilon-calculus * Goedel's omega-consistency * The Law of the Excluded Middle * Hilbert's omega-Rule * An Algorithmic omega-Rule * Gentzen's Rule of Infinite Induction * Rosser's Rule C * Markov's Principle * The Church-Turing Thesis * Aristotle's particularisation * Wittgenstein's perspective of constructive mathematics * An evidence-based perspective of quantification. By showing how these are formally inter-related, we highlight the fragility of both the persisting, theistic, classical/Platonic interpretation of quantification grounded in Hilbert's epsilon-calculus; and the persisting, atheistic, constructive/Intuitionistic interpretation of quantification rooted in Brouwer's belief that the Law of the Excluded Middle is non-finitary. We then consider some consequences for mathematics, mathematics education, philosophy, and the natural sciences, of an agnostic, evidence-based, finitary interpretation of quantification that challenges classical paradigms in all these disciplines. (shrink)

This thesis examines philosophical controversies surrounding the evaluation of medical treatments, with a focus on the evidential roles of randomised trials and mechanisms in Evidence-Based Medicine. Current 'best practice' usually involves excluding non-randomised trial evidence from systematic reviews in cases where randomised trials are available for inclusion in the reviews. The first paper challenges this practice and evaluates whether adding of evidence from non-randomised trials might improve the quality and precision of some systematic reviews. The second (...) paper compares the alleged methodological benefits of randomised trials over observational studies for investigating treatment benefits. It suggests that claims about the superiority of well-conducted randomised controlled trials over well-conducted observational studies are justified, especially when results from the two methods are contradictory. The third paper argues that postulating the unpredictability paradox in systematic reviews when no detectable empirical differences can be found requires further justification. The fourth paper examines the problem of absence causation in the context of explaining causal mechanisms and argues that a recent solution is incomplete and requires further justification. Solving the problem by describing absences as causes of 'mechanism failure' fails to take into account the effects of absences that lead to vacillating levels of mechanism functionality. The fifth paper criticises literature that has emphasised functioning versus 'broken' or 'non-functioning' mechanisms emphasising that many diseases result from increased or decreased mechanism function, rather than complete loss of function. Mechanistic explanations must account for differences in the effectiveness of performed functions, yet current philosophical mechanistic explanations do not achieve this. The last paper argues that the standard of evidence embodied in the ICE theory of technological function is too permissive for evaluating whether the proposed functions of medical technologies have been adequately assessed and correctly ascribed. It argues that high-quality evidence from clinical studies is necessary to justify functional ascriptions to health care technologies. (shrink)

The central thesis of this essay is that basic income experiments are justified if their expected benefits in terms of justice exceed their expected costs in terms of justice. The benefits are a function of basic income’s effect on the level of justice attained in the context in which it is implemented, and the experiment’s impact on future policy-making. The costs comprise the sacrifices made as a result of the experiment’s interventional character, as well as the study’s opportunity costs. (...) In light of the proposed standard of justification for basic income experiments, the factors that play a role in it, and the way these interact with one another, this essay provides some practical recommendations for researchers hoping to conduct such an experiment. (shrink)

The transferability problem—whether the results of an experiment will transfer to a treatment population—affects not only Randomized Controlled Trials but any type of study. The problem for any given type of study can also, potentially, be addressed to some degree through many different types of study. The transferability problem for a given RCT can be investigated further through another RCT, but the variables to use in the further experiment must be discovered. This suggests we could do better on the epistemological (...) problem of transferability by promoting, in the repeated process of formulating public health guidelines, feedback loops of information from the implementation setting back to researchers who are defining new studies. (shrink)

We consider the argument that Tarski's classic definitions permit an intelligence---whether human or mechanistic---to admit finitary evidence-based definitions of the satisfaction and truth of the atomic formulas of the first-order Peano Arithmetic PA over the domain N of the natural numbers in two, hitherto unsuspected and essentially different, ways: (1) in terms of classical algorithmic verifiabilty; and (2) in terms of finitary algorithmic computability. We then show that the two definitions correspond to two distinctly different assignments of satisfaction (...) and truth to the compound formulas of PA over N---I_PA(N; SV ) and I_PA(N; SC). We further show that the PA axioms are true over N, and that the PA rules of inference preserve truth over N, under both I_PA(N; SV ) and I_PA(N; SC). We then show: (a) that if we assume the satisfaction and truth of the compound formulas of PA are always non-finitarily decidable under I_PA(N; SV ), then this assignment corresponds to the classical non-finitary putative standard interpretation I_PA(N; S) of PA over the domain N; and (b) that the satisfaction and truth of the compound formulas of PA are always finitarily decidable under the assignment I_PA(N; SC), from which we may finitarily conclude that PA is consistent. We further conclude that the appropriate inference to be drawn from Goedel's 1931 paper on undecidable arithmetical propositions is that we can define PA formulas which---under interpretation---are algorithmically verifiable as always true over N, but not algorithmically computable as always true over N. We conclude from this that Lucas' Goedelian argument is validated if the assignment I_PA(N; SV ) can be treated as circumscribing the ambit of human reasoning about `true' arithmetical propositions, and the assignment I_PA(N; SC) as circumscribing the ambit of mechanistic reasoning about `true' arithmetical propositions. (shrink)

In this article we analyse the role that artificial intelligence (AI) could play, and is playing, to combat global climate change. We identify two crucial opportunities that AI offers in this domain: it can help improve and expand current understanding of climate change and it contribute to combating the climate crisis effectively. However, the development of AI also raises two sets of problems when considering climate change: the possible exacerbation of social and ethical challenges already associated with AI, and the (...) contribution to climate change of the greenhouse gases emitted by training data and computation-intensive AI systems. We assess the carbon footprint of AI research, and the factors that influence AI’s greenhouse gas (GHG) emissions in this domain. We find that the carbon footprint of AI research may be significant and highlight the need for more evidence concerning the trade-off between the GHG emissions generated by AI research and the energy and resource efficiency gains that AI can offer. In light of our analysis, we argue that leveraging the opportunities offered by AI for global climate change whilst limiting its risks is a gambit which requires responsive, evidence-based and effective governance to become a winning strategy. We conclude by identifying the European Union as being especially well-placed to play a leading role in this policy response and provide 13 recommendations that are designed to identify and harness the opportunities of AI for combating climate change, while reducing its impact on the environment. (shrink)

This paper addresses global bioethical challenges entailed in emerging viral diseases, focussing on their socio-cultural dimension and seeing them as symptomatic of the current era of globalisation. Emerging viral threats exemplify the extent to which humans evolved into a global species, with a pervasive and irreversible impact on the planetary ecosystem. To effectively address these disruptive threats, an attitude of preparedness seems called for, not only on the viroscientific, but also on bioethical, regulatory and governance levels. This paper analyses the (...) global bioethical challenges of emerging viral threats from a dialectical materialist perspective, focussing on three collisions: the collision of expanding networks of globalisation with local husbandry practices; the collision of global networks of mobility with disrupted ecosystems; and the collision of viroscience as a globalised research field with existing regulatory frameworks. These collisions emerge in a force field defined by the simultaneity of the non-simultaneous. Evidence-based health policies invoke discontent as they reflect the normative logic of a globalised knowledge regime. The development of a global bioethics or macro-ethics requires us to envision these collisions not primarily as issues of benefits and risks, but first and foremost as normative tensions closely entangled with broader socio-economic and socio-cultural developments. (shrink)

We show how removing faith-based beliefs in current philosophies of classical and constructive mathematics admits formal, evidence-based, definitions of constructive mathematics; of a constructively well-defined logic of a formal mathematical language; and of a constructively well-defined model of such a language. -/- We argue that, from an evidence-based perspective, classical approaches which follow Hilbert's formal definitions of quantification can be labelled `theistic'; whilst constructive approaches based on Brouwer's philosophy of Intuitionism can be labelled `atheistic'. (...) -/- We then adopt what may be labelled a finitary, evidence-based, `agnostic' perspective and argue that Brouwerian atheism is merely a restricted perspective within the finitary agnostic perspective, whilst Hilbertian theism contradicts the finitary agnostic perspective. -/- We then consider the argument that Tarski's classic definitions permit an intelligence---whether human or mechanistic---to admit finitary, evidence-based, definitions of the satisfaction and truth of the atomic formulas of the first-order Peano Arithmetic PA over the domain N of the natural numbers in two, hitherto unsuspected and essentially different, ways. -/- We show that the two definitions correspond to two distinctly different---not necessarily evidence-based but complementary---assignments of satisfaction and truth to the compound formulas of PA over N. -/- We further show that the PA axioms are true over N, and that the PA rules of inference preserve truth over N, under both the complementary interpretations; and conclude some unsuspected constructive consequences of such complementarity for the foundations of mathematics, logic, philosophy, and the physical sciences. -/- . (shrink)

The thesis that agents should calibrate their beliefs in the face of higher-order evidence—i.e., should adjust their first-order beliefs in response to evidence suggesting that the reasoning underlying those beliefs is faulty—is sometimes thought to be in tension with Bayesian approaches to belief update: in order to obey Bayesian norms, it's claimed, agents must remain steadfast in the face of higher-order evidence. But I argue that this claim is incorrect. In particular, I motivate a minimal constraint on (...) a reasonable treatment of the evolution of self-locating beliefs over time and show that calibrationism is compatible with any generalized Bayesian approach that respects this constraint. I then use this result to argue that remaining steadfast isn't the response to higher-order evidence that maximizes expected accuracy. (shrink)

Methadone maintenance therapy is a cost-effective, evidence-based treatment for heroin dependence. In the USA, a majority of heroin-dependent offenders are forced to detox from methadone when incarcerated. Recent research published in The Lancet has demonstrated the negative health and economic outcomes associated with such policies. Methadone Continuation Versus Forced Withdrawal on Incarceration in a Combined US Prison and Jail: A Randomised, Open Label Trial. The Lancet, 386, 350–359). This novel evidence raises questions as to the justification for (...) current policies of forced detox in American prisons. Opponents of methadone provision in prisons might offer arguments from retributivism, resource allocation and curative effectiveness to justify their position. This article contends that these arguments do not stand up to ethical scrutiny. In light of this, we hold that American policymakers should reform criminal justice policies to allow the initiation and continuation of methadone treatment in correctional settings. This would be consistent with both international recommendations and the example set by a number of other Western countries. (shrink)

Nhiều nаm hơn nữ đượс đăng ký tên trên GCNQSDĐ. Phụ nữ sở hữu ít mảnh đất hơn nаm giới. Điều này đượс giải thíсh là dо phụ nữ tiếp сận đất đаi hạn сhế, vì ít mảnh đất hơn сhỉ dо phụ nữ sở hữu hоặс đồng sở hữu. Một số yếu tố giải thíсh sự kháс biệt. Để bắt đầu, đánh giá định tính và khảо sát сủа сhúng tôi сhо thấy rằng сáс khíа сạnh văn hóа ưu (...) tiên nаm giới như ưu tiên соn trаi trоng thựс hành thừа kế vẫn сòn phù hợp ở Việt Nаm. Những kết quả này сhо thấy сần сó những người hành nghề xã hội và pháp luật và сhính quyền làm việс ở сấp xã để hỗ trợ nhu сầu сủа người dân về thông tin về luật, quyền сủа họ và сáс quy trình để сó đượс đất. Tiếp сận сáс xã này để сảm hóа và thúс đẩy bình đẳng giới trоng quá trình сấp giấy сhứng nhận quyền sử dụng đất sẽ là một bướс đi đúng hướng quаn trọng. Cáс сơ quаn сhứс năng сấp tỉnh сấp GCNQSDĐ сần сảnh giáс và yêu сầu làm rõ khi người dân muốn đăng ký tài sản mà không ghi tên vợ hоặс сhồng. (shrink)

This chapter presents a typology of the different kinds of inductive inferences we can draw from our evidence, based on the explanatory relationship between evidence and conclusion. Drawing on the literature on graphical models of explanation, I divide inductive inferences into (a) downwards inferences, which proceed from cause to effect, (b) upwards inferences, which proceed from effect to cause, and (c) sideways inferences, which proceed first from effect to cause and then from that cause to an additional (...) effect. I further distinguish between direct and indirect forms of downwards and upwards inferences. I then show how we can subsume canonical forms of inductive inference mentioned in the literature, such as inference to the best explanation, enumerative induction, and analogical inference, under this typology. Along the way, I explore connections with probability and confirmation, epistemic defeat, the relation between abduction and enumerative induction, the compatibility of IBE and Bayesianism, and theories of epistemic justification. (shrink)

We report the results of an exploratory study that examines the judgments of climate scientists, climate policy experts, astrophysicists, and non-experts (N = 3367) about the factors that contribute to the creation and persistence of disagreement within climate science and astrophysics and about how one should respond to expert disagreement. We found that, as compared to non-experts, climate experts believe that within climate science (i) there is less disagreement about climate change, (ii) methodological factors play less of a role (...) in generating disagreements, (iii) fewer personal or institutional biases influence climate research, and (iv) there is more agreement about which methods should be used to examine relevant phenomena we also observed that the uniquely American political context predicted experts’ judgments about some of these factors. We also found that, in regard to disagreements concerning cosmic ray physics, and commensurate with the greater inherent uncertainty and data lacunae in their field, astrophysicists working on cosmic rays were generally more willing to acknowledge expert disagreement, more open to the idea that a set of data can have multiple valid interpretations, and generally less quick to dismiss someone articulating a non-standard view as non-expert, than climate scientists were in regard to climate science. (shrink)

The law views with suspicion statistical evidence, even evidence that is probabilistically on a par with direct, individual evidence that the law is in no way suspicious of. But it has proved remarkably hard to either justify this suspicion, or to debunk it. In this paper, we connect the discussion of statistical evidence to broader epistemological discussions of similar phenomena. We highlight Sensitivity – the requirement that a belief be counterfactually sensitive to the truth in a (...) specific way – as a way of epistemically explaining the legal suspicion towards statistical evidence. Still, we do not think of this as a satisfactory vindication of the reluctance to rely on statistical evidence. Knowledge – and Sensitivity, and indeed epistemology in general – are of little, if any, legal value. Instead, we tell an incentive-based story vindicating the suspicion towards statistical evidence. We conclude by showing that the epistemological story and the incentive-based story are closely and interestingly related, and by offering initial thoughts about the role of statistical evidence in morality. (shrink)

Cáс tài liệu trướс đây сhо rằng sứс khỏе thời thơ ấu kém làm giảm kết quả sứс khỏе, giảm trình độ họс vấn và thu nhập tiềm năng khi trưởng thành. Hơn nữа, hậu quả tíсh lũy сủа tình trạng sứс khỏе kém trоng giаi đоạn đầu đời сó thể gây bất lợi và lâu dài hơn сhо trẻ еm ở сáс nướс đаng phát triển sо với сáс nướс phát triển. Dо đó, phát hiện сủа сhúng tôi nhấn (...) mạnh tầm quаn trọng сủа giáо dụс bà mẹ trоng việс nâng сао điều kiện kinh tế và xã hội ở сáс nướс đаng phát triển. (shrink)

I accomplish two things in this paper. I explain the motivation for including experimental research in philosophical projects on epistemic reasons and the basing relation. And I present the first experimental contributions to these projects. The results from two experiments advance our understanding of the ordinary concepts of reasons and basing and set the stage for further research on the topics. More specifically, the results support a causal theory of the basing relation, according to which reasons are causes, and a (...) dualist theory of epistemic reasons, according to which reasons include both psychological and non-psychological items. (shrink)