Regard philosophique sur la causalité en épidémiologie - approche interdisciplinaire

Abstract

Different methods are used by the epidemiologist in order to get as close as possible to the causal nature of the relationship between a factor and a disease. However this is just an interpretation since different circumstances may randomly induce non-causal relationships between factors and disease, but also the effect of other interconnected factors. Philosophy identifies three levels of discussion in the use of causality: the distinction between absolute reality and the one perceived by man given his faculties of knowledge; the difficulty of identifying causes from the observation of natural phenomena because a link between phenomena does not necessarily mean causal succession; the problem of induction, in the sense that more conclusive experiments cannot provide definitive evidence, so that the falsificationists propose challenging the hypothesis by trying new tests to reject it. This interdisciplinary approach enhances the contribution of the philosophical perspective to the epidemiological practice, and more largely to research in biology : among others searching for study contexts adapted to challenge the results, establishing a combination of different and complementary arguments to get closer to causality, which draw a link to the ten causality criteria used by epidemiologists to evaluate and discuss the causal nature of a relationship. In conclusion, having a severe critical look at the result is the only way to add credit to the interpretation of  a statistically significant relationship in terms of causality.