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)

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)

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)

Starting with the results of Li et al. in 1992 there is valuable interest in finding long range correlations in DNA sequences since it raises questions about the role of introns and intron-containing genes. In the present paper we studied two sequences that are the human T-cell receptor alpha/delta locus, Gen-Bank name HUMTCRADCV, a noncoding chromosomal fragment of M = 97630 bases (composed of less than 10% of coding regions), and the Escherichia Coli K12, Gen-Bank name ECO110K, a genomic fragment (...) with M = 111401 bases consisting of mostly coding regions and containing more that 80% of coding regions. We attributed the value (+1) to the purines and the value (-1) to the pirimidines and to such reconstructed random walk we applied the method of the Recurrence Quantification Analysis(RQA) that was introduced by Zbilut and Webber in 1994. By using dimension D=1 and Embedded Dimensions D=3 and D=5, we obtain some indicative results. Also by a simple eye examination of the reconstructed maps, the differences between coding and non coding regions are evident and impressive and consist in the presence in noncoding regions of long patches of the same colour that are absent in the coding sequence. At first sight this suggests a simple explanation to the concept of „long-range‟ correlation. On the quantitative plane, we used the %Rec., the %Det., the Ratio, the Entropy, the %Lam., and the Lmax that, as explained in detail in the text, represent the basic variables of RQA. The significant result that we have here is that both Lmax and Laminarity exhibit very large values in HUMTCRADCV and actually different in values respect to ECO110K where such variables assume more modest values. Therefore we suggest that there is the observed difference between HUMTCRADCV and ECO110K. The claimed higher long-range correlations of introns respect to exons from many authors may be explained here in reasonof such found higher values of Lmax and of Laminarity in HUMTCRADCV respect to ECO110K. (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)

This study examines social media's quantitative effect on juvenile criminality. The researcher intends to quantify how social media usage affects juvenile delinquency. The research will examine mediating elements, including peer influence, self-esteem, and antisocial content. This study may educate parents, educators, politicians, and mental health experts on adolescent social media usage hazards. This study aims to establish evidence-based social media mitigation and youth development solutions. This research employed quantitative methodologies. The target population for this study will be two (...) hundred (200) criminology students of Headstart College of Cotabato. Participants will be selected using a time-efficient random selection strategy. The findings of a power analysis will be used to calculate the sample size needed to achieve the desired level of statistical significance. The researcher will administer the survey questionnaire face-to-face after proper coordination with the College head. Respondents had enough time to complete the survey questions. The researcher and respondents will complete the questionnaire in their own time to gather and retrieve data: data quantification, categorization, and statistical description. Weighted mean and correlation were utilized to assess the association between social media use and teenage delinquency and behavior. The researcher carried out all methods using SPSS Application Guide as statistical software. The study revealed that excessive social media use is associated with negative outcomes such as mental health issues, decreased social interactions, and potential impacts on academic performance. Additionally, the level of parental monitoring and communication regarding social media usage was varied, and family conflict related to social media use was evident to some extent. There needs to be more research done to determine the mechanisms that link adolescent social media usage and behavior. Longitudinal studies may help explain what happens and why, as well as suggest any necessary countermeasures. (shrink)

Public policymakers and institutional decision-makers routinely face questions about whether interventions “work”: does universal basic income improve people’s welfare and stimulate entrepreneurial activity? Do gated alleyways reduce burglaries or merely shift the crime burden to neighbouring communities? What is the most cost-effective way to improve students’ reading abilities? These are empirical questions that seem best answered by looking at the world, rather than trusting speculations about what will be effective. Evidence-based policy (EBP) is a movement that concretizes this (...) intuition. It maintains that policy should be based on evidence of “what works.” Not any evidence will do, however. Following on the heels of its intellectual progenitor, evidence-based medicine (EBM), EBP insists on the use of high-quality evidence produced in accordance with rigorous methodological standards. Though intuitively compelling, EBP has attracted significant criticism from methodologists, political scientists, and philosophers. This chapter provides a critical overview of EBP through a philosophical lens, reviewing and discussing some of the most pressing challenges that EBP faces and outlining some proposals for improving it. I first provide a brief overview of EBP and distinguish a broader and narrower understanding of it. I then review existing lines of criticism of EBP, two of which are considered in detail. The first elaborates how EBP struggles with extrapolation, that is, the use of evidence from study populations to make inferences about the effects of policies on novel target populations. The second maintains that EBP’s methodological tenets are deeply entwined with moral and political values, which can threaten EBP’s promise to promote objectivity in policymaking. Finally, I make some proposals for how EBP could be improved going forward. (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)

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)

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)

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 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)

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)

In the philosophy of mind, neuroscience, and psychology, 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 a ‘loss-of-function lesion premise,’ according to which, since brain lesions and neurochemical modifications lead to 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, undefinable, and seemingly unphysical nature of our subjective qualitative experiences and its related mental dimension. Here, several neuroscientific findings are reviewed that question the idea that posits phenomenal experience as an emergent property of brain activity, and argue that the premise of material monism is based on a logical correlation-causation fallacy. 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 an ontology that posits mind and consciousness as a primal phenomenon. (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)

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)

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)

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)

Given the unprecedented novel nature and scale of coronavirus and the global nature of this public health crisis, which upended many public/environmental research norms almost overnight. However, with further waves of the virus expected and more pandemics anticipated. The COVID-19 pandemic of 2020 opened our eyes to the ever-changing conditions and uncertainty that exists in our world today, particularly with regards to environmental and public health practices disruption. This paper explores environmental and public health evidence-based practices toward responding (...) to Covid-19. A literature review tried to do a deep dive through the use of various search engines such as Mendeley, Research Gate, CAB Abstract, Google Scholar, Summon, PubMed, Scopus, Hinari, Dimension, OARE Abstract, SSRN, Academia search strategy toward retrieving research publications, “gray literature” as well as reports from expert working groups. To achieve enhanced population health, it is recommended to adopt widespread evidence-based strategies, particularly in this uncertain time. As only together can evidence-informed decision-making (EIDM) can become a reality which include effective policies and practices, transparency and accountability of decisions, and equity outcomes; these are all more relevant in resource-constrained contexts, such as Nigeria. Effective and ethical EIDM though requires the production as well as use of high-quality evidence that are timely, appropriate and structured. One way to do so is through co-production. Co-production (or co-creation or co-design) of environmental/public health evidence considered as a key tool for addressing complex global crises such as the high risk of severe COVID-19 in different nations. A significant evidence-based component of environmental/public health (EBEPH) consist of decisions making based on best accessible, evidence that is peer-reviewed; using data as well as systematic information systems; community engagement in policy-making; conducting sound evaluation; do a thorough program-planning frameworks; as well as disseminating what is being learned. As researchers, scientists, statisticians, journal editors, practitioners, as well as decision makers strive to improve population health, having a natural tendency toward scrutinizing the scientific literature aimed at novel research findings serving as the foundation for intervention as well as prevention programs. The main inspiration behind conducting research ought to be toward stimulating and collaborating appropriately on public/environmental health action. Hence, there is need for a “Plan B” of effective behavioral, environmental, social as well as systems interventions (BESSI) toward reducing transmission. (shrink)

Evidence-based medicine is a clinical decision-making framework which makes claims about what physicians ought to do. Though heralded as the cutting edge of medical science, evidence-based medicine is a value-laden normative theory which implicitly depends on substantive views regarding what is morally good or right. In this paper, I provide an ethical analysis of evidence-based medicine. I consider its normative underpinnings in three ethical theories: utilitarianism, Kantian deontology, and virtue ethics. In the face of (...) uncertainty, evidence-based medicine endorses expected utility theory using the best available evidence in order to avoid doing more harm than good. In accordance with the Kantian respect for individuals as ends in themselves, evidence-based medicine calls for integrating the values and preferences of the patient. De-emphasizing intuition, clinical expertise, and pathophysiologic rationale emphasizes the need for the intellectual virtues of curiosity, critical thinking, and courage. Evidence-based medicine is a successful clinical practice that can be morally justified by all three major ethical theories. Although its focus on maximizing good health outcomes and integrating respect for individual patients has been emphasized, the role of the intellectual virtues in evidence-based medicine remains highly under-explored. (shrink)

In this article, we explicate evidence-based nursing (EBN), critically appraise its framework and respond to nurses’ concern that EBN sidelines the caring elements of nursing practice. We use resources from care ethics, especially Vrinda Dalmiya’s work that considers care as crucial for both epistemology and ethics, to show how EBN is compatible with, and indeed can be enhanced by, the caring aspects of nursing practice. We demonstrate that caring can act as a bridge between ‘external’ evidence and (...) the other pillars of the EBN framework: clinical expertise; patient preferences and values. Drawing on an influential EBN handbook, section 1 presents the aims and features of EBN, including the normative principle that EBN should take place within a ‘context of caring’. We aim to understand this context and whether it can be neatly detached from the EBN framework, as the handbook seems to suggest. In section 2, we highlight the grounds for resistance to EBN from the nursing community, before mounting the argument that nursing practices can be understood fruitfully through feminist care ethics and/or virtue ethics lenses. In section 3, we deepen that analysis using Dalmiya’s concepts of care-knowing and care as a hybrid ethico-epistemic virtue, which are ideally suited to the complex practices of nursing. In section 4, we bring this rich understanding of care into conversation with EBN, showing that its framework cannot be adequately theorised without paying proper attention to care. Caring can be neither an innocuous background assumption of nor an afterthought to the EBN framework. (shrink)

Mereological nihilism is the thesis that composition never occurs. Some philosophers have thought that science gives us compelling evidence against nihilism. In this article I respond to this concern. An initial challenge for nihilism stems from the fact that composition is such a ubiquitous feature of scientific theories. In response I motivate a restricted form of scientific anti-realism with respect to those components of scientific theories which make reference to composition. A second scientifically based worry for nihilism is (...) that certain specific scientific phenomena might require ineliminable quantification over composite objects. I address these concerns, and argue that there seem to be nihilist-friendly construals of the scientific phenomena in question. (shrink)

ABSTRACT: This paper discusses ancient versions of paradoxes today classified as paradoxes of presupposition and how their ancient solutions compare with contemporary ones. Sections 1-4 air ancient evidence for the Fallacy of Complex Question and suggested solutions, introduce the Horn Paradox, consider its authorship and contemporary solutions. Section 5 reconstructs the Stoic solution, suggesting the Stoics produced a Russellian-type solution based on a hidden scope ambiguity of negation. The difference to Russell's explanation of definite descriptions is that in (...) the Horn Paradox the Stoics uncovered a hidden conjunction rather than a hidden existential sentence. Sections 6 and 7 investigate hidden ambiguities in 'to have' and 'to lose' (including inalienable and alienable possession) and ambiguities of quantification based on substitution of indefinite plural expressions for indefinite or anaphoric pronouns, and Stoic awareness of these. Section 8 considers metaphorical readings and allusions that add further spice to the paradox. (shrink)

COVID-19 demonstrated a global catastrophe that touched everybody, including the scientific community. As we respond and recover rapidly from this pandemic, there is an opportunity to guarantee that the fabric of our society includes sustainability, fairness, and care. However, approaches to environmental health attempt to decrease the population burden of COVID-19, toward saving patients from becoming ill along with preserving the allocation of clinical resources and public safety standards. This paper explores environmental and public health evidence-based practices toward (...) responding to Covid-19. A literature review tried to do a deep dive through the use of various search engines such as Mendeley, Research Gate, CAB Abstract, Google Scholar, Summon, PubMed, Scopus, Hinari, Dimension, OARE Abstract, SSRN, Academia search strategy toward reretrieving research publications, “grey literature” as well as reports from expert working groups. To achieve enhanced population health, it is recommended to adopt widespread evidence-based strategies, particularly in this uncertain time. As only together can evidence-informed decision-making (EIDM) can become a reality which includes effective policies and practices, transparency and accountability of decisions, and equity outcomes; these are all more relevant in resource-constrained contexts, such as Nigeria. Effective and ethical EIDM though requires the production as well as use of high-quality evidence that are timely, appropriate and structured. One way to do so is through co-production. Co-production (or co-creation or co-design) of environmental/public health evidence considered as a key tool for addressing complex global crises such as the high risk of severe COVID-19 in different nations. A significant evidence-based component of environmental/public health (EBEPH) consist of decisions making based on best accessible, evidence that is peer-reviewed; using data as well as systematic information systems; community engagement in policy making; conducting sound evaluation; do thorough program-planning frameworks; as well as disseminating what is being learned. As researchers, scientists, statisticians, journal editors, practitioners, as well as decision-makers strive to improve population health, having a natural tendency toward scrutinizing the scientific literature aimed at novel research findings serving as the foundation for intervention as well as prevention programs. The main inspiration behind conducting research ought to be toward stimulating and collaborating appropriately on public/environmental health action. Hence, there is need for a “Plan B” of effective behavioural, environmental, social as well as systems interventions (BESSI) toward reducing transmission. (shrink)

Formal semantics has so far focused on three categories of quantifiers, to wit, Q-determiners (e.g. 'every'), Q-adverbs (e.g. 'always'), and Q-auxiliaries (e.g. 'would'). All three can be analyzed in terms of tripartite logical forms (LF). This paper presents evidence from verbs with distributive affixes (Q-verbs), in Kalaallisut, Polish, and Bininj Gun-wok, which cannot be analyzed in terms of tripartite LFs. It is argued that a Q-verb involves discourse reference to a distributive verbal dependency, i.e. an episode-valued function that sends (...) different semantic objects in a contextually salient plural domain to different episodes. (shrink)

To obtain effective fusion results of multi source evidences with different importance, an evidence fusion method with importance discounting factors based on neutrosopic probability analysis in DSmT framework is proposed. First, the reasonable evidence sources are selected out based on the statistical analysis of the pignistic probability functions of single focal elements. Secondly, the neutrosophic probability analysis is conducted based on the similarities of the pignistic probability functions from the prior evidence knowledge of the (...) reasonable evidence sources. Thirdly, the importance discounting factors of the reasonable evidence sources are obtained based on the neutrosophic probability analysis and the reliability discounting factors of the real-time evidences are calculated based on probabilistic-based distances. Fourthly, the real-time evidences are discounted by the importance discounting factors and then the evidences with the mass assignments of neutrosophic empty sets are discounted by the reliability discounting factors. Finally, DSmT+PCR5 of importance discounted evidences is applied. Experimental examples show that the decision results based on the proposed fusion method are different from the results based on the existed fusion methods. Simulation experiments of recognition fusion are performed and the superiority of proposed method is testified well by the simulation results. (shrink)

The aim of this paper is to apply the accuracy based approach to epistemology to the case of higher order evidence: evidence that bears on the rationality of one's beliefs. I proceed in two stages. First, I show that the accuracy based framework that is standardly used to motivate rational requirements supports steadfastness—a position according to which higher order evidence should have no impact on one's doxastic attitudes towards first order propositions. The argument for this (...) will require a generalization of an important result by Greaves and Wallace for the claim that conditionalization maximizes expected accuracy. The generalization I provide will, among other things, allow us to apply the result to cases of self-locating evidence. In the second stage, I develop an alternative framework. Very roughly, what distinguishes the traditional approach from the alternative one is that, on the traditional picture, we're interested in evaluating the expected accuracy of conforming to an update procedure. On the alternative picture that I develop, instead of considering how good an update procedure is as a plan to conform to, we consider how good it is as a plan to make. I show how, given the use of strictly proper scoring rules, the alternative picture vindicates calibrationism: a view according to which higher order evidence should have a significant impact on our beliefs. I conclude with some thoughts about why higher order evidence poses a serious challenge for standard ways of thinking about rationality. (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)

Medicine, like law, is a pragmatic, probabilistic activity. Both require that decisions be made on the basis of available evidence, within a limited time. In contrast to law, medicine, particularly evidence-based medicine as it is currently practiced, aspires to a scientific standard of proof, one that is more certain than the standards of proof courts apply in civil and criminal proceedings. But medicine, as Dr. William Osler put it, is an "art of probabilities," or at best, a (...) "science of uncertainty." One can better practice medicine by using other evidentiary standards in addition to the "scientific." To employ only the scientific standard of proof is inappropriate, if not impossible; furthermore, as this review will show, its application in medicine is fraught with bias. Evidence is information. It supports or undermines a proposition, whether a hypothesis in science, a diagnosis in medicine, or a fact or point in question in a legal investigation. In medicine, physicians marshal evidence to make decisions on how to best prevent, diagnose, and treat disease, and improve health. In law, courts decide the facts and render justice. Judges and juries assess evidence to establish liability, to settle custody and medical issues, and to determine a defendant's guilt or innocence. (shrink)

Due to Gӧdel’s incompleteness results, the categoricity of a sufficiently rich mathematical theory and the semantic completeness of its underlying logic are two mutually exclusive ideals. For first- and second-order logics we obtain one of them with the cost of losing the other. In addition, in both these logics the rules of deduction for their quantifiers are non-categorical. In this paper I examine two recent arguments –Warren (2020), Murzi and Topey (2021)– for the idea that the natural deduction rules for (...) the first-order universal quantifier are categorical, i.e., they uniquely determine its semantic intended meaning. Both of them make use of McGee’s open-endedness requirement and the second one uses in addition Garson’s (2013) local models for defining the validity of these rules. I argue that the success of both these arguments is relative to their semantic or infinitary assumptions, which could be easily discharged if the introduction rule for the universal quantifier is taken to be an infinitary rule, i.e. non-compact. Consequently, I reconsider the use of the ω-rule and I show that the addition of the ω-rule to the standard formalizations of first-order logic is categorical. In addition, I argue that the open-endedness requirement does not make the first-order Peano Arithmetic categorical and I advance an argument for its categoricity based on the inferential conservativity requirement. (shrink)

The once animated efforts in medical phenomenology to integrate the art and science of medicine (or to humanize scientific medicine) have fallen out of philosophical fashion. Yet the current competing medical discourses of evidencebased medicine and patient-centered care suggest that this theoretical endeavor requires renewed attention. In this paper, I attempt to enliven the debate by discussing theoretical weaknesses in the way the “lived body” has operated in the medical phenomenology literature—the problem of the absent body—and highlight how evidence- (...) class='Hi'>based medicine has refigured medical phenomenology’s historical nemesis, “biomedicine.” What we now need is a phenomenology of the embodied subject in the age of evidence-based medicine. (shrink)

This essay introduces a puzzle about the interaction between quantifiers and epistemic modals. The puzzle motivates the idea that whether an object satisfies an epistemically modalized predicate depends on the mode of presentation of the domain of quantification. I compare two ways of implementing this idea, one using counterpart theory, the other using Aloni's 'conceptual covers' theory, and then provides some evidence in favor of the former.

Quantification, Negation, and Focus: Challenges at the Conceptual-Intentional Semantic Interface Tista Bagchi National Institute of Science, Technology, and Development Studies (NISTADS) and the University of Delhi Since the proposal of Logical Form (LF) was put forward by Robert May in his 1977 MIT doctoral dissertation and was subsequently adopted into the overall architecture of language as conceived under Government-Binding Theory (Chomsky 1981), there has been a steady research effort to determine the nature of LF in language in light of (...) structurally diverse languages around the world, which has ultimately contributed to the reinterpretation of LF as a Conceptual-Intentional (C-I) interface level between the computational syntactic component of the faculty of language and one or more interpretive faculties of the human mind. While this has opened up further possibilities of research in phenomena such as quantifier scope and scope interactions between negation, quantification, and focus, it has also given rise to a few real challenges to linguistic theory as well. Some of these are: (i) the split between lexical meaning – a matter supposedly belonging to the phase-wise selection of lexical arrays – and issues of semantic interpretation that arise purely from binding and scope phenomena (Mukherji 2010); (ii) partially relatedly, the level at which theta role assignment can be argued to take place, an issue that is taken up by me in Bagchi (2007); and (iii) how supposedly “pure” scopal phenomena relating to quantifiers, negation, and emphasizing expressions such as only and even (comparable to, e.g., Urdu/Hindi hii and bhii, Bangla –i and –o) also have dimensions of both focus and discourse reference. While recognizing all of these challenges, this talk aims to highlight particularly challenge (iii), both in terms of scholarship in the past and for the rich prospects for research on languages of south Asia with the semantics of quantification, negation, and focus in view. The scholarship of the past that I seek to relate this issue to is where, parallel to (and largely independently of) the research on LF that had been happening, Barwise and Cooper were developing their influential view of noun phrases as generalized quantifiers, culminating in their key 1981 article “Generalized Quantifiers and Natural Language” while, independently, McCawley, in his 1981 book Everything that Linguists have Always Wanted to Know about Logic, established through argumentation that all noun phrases semantically behave like generalized quantified expressions (further elaborated by him in the second – 1994 – revised edition of his book). I seek to demonstrate, based on limited data analysis from selected languages of south Asia, that our current understanding of quantification, negation, and focus under the Minimalist view owes something significant to the two major, but now largely marginalized, works of scholarship, and that for the way forward it is essential to adopt a more formal-semantic approach as adopted by them and also by later works such as Denis Bouchard’s (1995) The Semantics of Syntax, Mats Rooth’s work on focus (e.g., Rooth 1996, “Focus” in Shalom Lappin’s Handbook of Contemporary Semantic Theory), Heim and Kratzer’s Semantics in Generative Grammar (1998), and Yoad Winter’s (2002) Linguistic Inquiry article on semantic number, to cite just a few instances. (shrink)

This paper describes quantificational structures in Greenlandic Eskimo (Kalaallisut), a language where familiar quantificational meanings are expressed in ways that are quite different from English. Evidence from this language thus poses some formidable challenges for cross-linguistic theories of compositional semantics.

Over the past several decades, we devoted much energy to generating, reviewing and summarizing evidence. We have given far less attention to the issue of how to thoughtfully apply the evidence once we have it. That’s fine if all we care about is that our clinical decisions are evidence-based, but not so good if we also want them to be well-reasoned. Let us not forget that evidence based medicine (EBM) grew out of an interest (...) in making medicine ‘rational’, with the idea that rational clinical evaluations should be evidence-based. I agree with the uncontroversial statement that the best decision is supported, at least in part, by the best available evidence. Rationality, however, is constituted by reasoning, not evidence. Complete arguments are necessary for rational evaluations, arguments that begin with general evidence and end in a conclusion about a particular patient. In order to traverse these inferential gaps, medicine must address the issue of how to establish, as an intermediate premise, what the evidence has to say about the efficacy of an intervention for particular patients in a particular practice setting. (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)

Because “evidence” is at issue in evidence-based medicine (EBM), the critical responses to the movement have taken up themes from post-positivist philosophy of science to demonstrate the untenability of the objectivist account of evidence. While these post-positivist critiques seem largely correct, I propose that when they focus their analyses on what counts as evidence, the critics miss important and desirable pragmatic features of the evidence-based approach. This article redirects critical attention toward EBM’s rigid (...) hierarchy of evidence as the culprit of its objectionable epistemic practices. It reframes the EBM discourse in light of a distinction between objectivist and pragmatic epistemology, which allows for a more nuanced analysis of EBM than previously offered: one that is not either/or in its evaluation of the decision-making technology as either iconoclastic or creedal. -/- . (shrink)

Epistemologists spend a great deal of time thinking about how we should respond to our evidence. They spend far less time thinking about the ways that evidence can be acquired in the first place. This is an oversight. Some ways of acquiring evidence are better than others. Many normative epistemologies struggle to accommodate this fact. In this article I develop one that can and does. I identify a phenomenon – epistemic feedback loops – in which evidence (...) acquisition has gone awry, with the result that even beliefs based on the evidence are irrational. Examples include evidence acquired under the influence of confirmation bias and evidence acquired under the influence of cognitively penetrated experiences caused by implicit bias. I then develop a theoretical framework which enables us to understand why beliefs that are the outputs of epistemic feedback loops are irrational. Finally, I argue that many popular approaches to epistemic normativity may need to be abandoned on the grounds that they cannot comfortably explain feedback loops. The scope of this last claim is broad: it includes almost all contemporary theories of justified/rational belief and of the epistemology of cognitive penetration. (shrink)

How do archaeologists make effective use of physical traces and material culture as repositories of evidence? Material Evidence is a collection of 19 essays that take a resolutely case-based approach to this question, exploring key instances of exemplary practice, instructive failures, and innovative developments in the use of archaeological data as evidence. The goal is to bring to the surface the wisdom of practice, teasing out norms of archaeological reasoning from evidence. -/- Archaeologists make compelling (...) use of an enormously diverse range of material evidence, from garbage dumps to monuments, from finely crafted artifacts rich with cultural significance to the inadvertent transformation of landscapes over the long term. Each contributor to Material Evidence identifies a particular type of evidence with which they grapple and considers, with reference to concrete examples, how archaeologists construct evidential claims, critically assess them, and bring them to bear on pivotal questions about the cultural past. -/- Historians, cultural anthropologists, philosophers, and science studies scholars are increasingly interested in working with material "things" as objects of inquiry and as evidence – and they acknowledge on all sides just how challenging this is. One of the central messages of the book is that close analysis of archaeological best practice can yield constructive guidelines for practice that have much to offer practitioners within archaeology and well beyond. (shrink)

According to factive accounts of the norm of belief and decision-making, you should not believe or base decisions on a falsehood. Even when the evidence misleadingly suggests that a false proposition is true, you should not believe it or base decisions on it. Critics claim that factive accounts are counterintuitive and badly mischaracterize our ordinary practice of evaluating beliefs and decisions. This paper reports four experiments that rigorously test the critic’s accusations and the viability of factive accounts. The results (...) undermine the accusations and provide the best evidence yet of factive norms of belief and decision-making. The results also help discriminate between two leading candidates for a factive norm: truth and knowledge. Knowledge is the superior candidate. (shrink)

While most of healthcare research and practice fully endorses evidence-based healthcare, a minority view borrows popular themes from philosophy of science like underdetermination and value-ladenness to question the legitimacy of the evidence-based movement’s philosophical underpinnings. While the feminist origins go unacknowledged, those critics adopt a feminist reading of the “gap argument” to challenge the perceived objectivism of evidence-based practice. From there, the critics seem to despair over the “subjective elements” that values introduce to clinical (...) reasoning, demonstrating that they do not subscribe to feminist science studies’ normative program——where contextual values can enable good science and justified decisions. In this paper, I investigate why it is that the critics of evidence-based medicine adopt feminist science’s characterization of the problem but resist the productive solutions offered by those same theorists. I suggest that the common feminist empiricist appeal to idealized epistemic communities is impractical for those working within the current biomedical context and instead offer an alternate stream of feminist research into the empirical content of values (found in the work of Elizabeth Anderson and Sharyn Clough) as a more helpful recourse for facilitating the important task of legitimate and justified clinical decision-making. I use a case study on clinical decision-making to illustrate the fruitfulness of the latter feminist empiricist framework. -/- See response by Sharyn Clough: http://wp.me/p1Bfg0-1aN See reply by Maya Goldenberg: http://wp.me/p1Bfg0-1oY. (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)

Evidence-based medicine relies on the execution of clinical practice guidelines and protocols. A great deal of of effort has been invested in the development of various tools which automate the representation and execution of the recommendations contained within such guidelines and protocols by creating Computer Interpretable Guideline Models (CIGMs). Context-based task ontologies (CTOs), based on standard terminology systems like UMLS, form one of the core components of such a model. We have created DAML+OIL-based CTOs for (...) the tasks mentioned in the WHO guideline for hypertension management, drawing comparisons also with other related guidelines. The advantages of CTOs include: contextualization of ontologies, providing ontologies tailored to specific aspects of the phenomena of interest, dividing the complexity involved in creating ontologies into different levels, providing a methodology by means of which the task recommendations contained within guidelines can be integrated into the clinical practices of a health care set-up. (shrink)

The investigation of the degree of amotivation and subsequent intervention towards the motivation of undergraduate vocational and technical education (VTE) students has not received the same amount of attention as other disciplines. Despite the negative impact of a lack of volitional drive on students' practical skills learning, there is scarcity of literature on amotivation among VTE undergraduate students. This study aimed to demonstrate the effectiveness of problem-based learning (PBL) in transitioning undergraduate students from a state of being amotivated to (...) motivated. The study utilized a quasi-experimental research design and selected 168 students in their penultimate and final years majoring in agricultural education, business education, computer education, home economics, and industrial technical education who met the study's inclusion criteria. The intervention consisted of eight weeks of treatment and four weeks of follow-up meetings. An existing academic motivation scale was adapted for use, and data was collected through a self-report questionnaire. Data analysis was conducted using independent sample t-tests, and paired sample t-tests. The findings revealed that the level of amotivation among the students was high, and PBL had a significant impact on transitioning VTE students from being amotivated to motivated in the treatment group compared to those in the control group. Furthermore, the positive gains were maintained by the treatment group at follow-up. The study suggests that a PBL program can effectively address students' lack of volitional drive to engage in academic activities among undergraduate students majoring in agricultural education, business education, computer education, home economics, and industrial technical in Nigeria. (shrink)