{"title":"Medical nihilism: The limits of a decontextualised critique of medicine","authors":"Arjun Devanesan","doi":"10.1016/j.shpsc.2019.101189","DOIUrl":"10.1016/j.shpsc.2019.101189","url":null,"abstract":"<div><p>In a new and interesting book entitled Medical Nihilism (2018), Jacob Stegenga attempts to convince us that modern medical therapies are less effective than we think. Given the heterogeneity of hypotheses in medicine and the evidence for or against them, I argue that such a decontextualised critique cannot be made unless substantially weakened. Instead, I put forward an alternative, more nuanced and defensible epistemic view of medicine. According to this view, evaluating medical evidence requires analysis of both the methods of research e.g. randomised controlled trial (RCT), and context-specific information. This is because the way a trial (even an RCT) is conducted e.g. the population recruited and how it is intervened on, will vary and will have significant effects on the likelihood of a positive outcome. Moreover, the relationship between the positive outcome of a trial and the actual effectiveness of an intervention (the trial validity) will depend on these context specific factors. I argue for this position against nihilism by showing how each of Stegenga's individual claims about medical trials (trials are biased in favour of positive outcomes etc) can be questioned by taking the context into consideration.</p></div>","PeriodicalId":48557,"journal":{"name":"Studies in History and Philosophy of Science Part C-Studies in History and Philosophy of Biological and Biomedical Sciences","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.shpsc.2019.101189","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76200472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"","authors":"Claire Edington","doi":"10.1016/j.shpsc.2019.101205","DOIUrl":"https://doi.org/10.1016/j.shpsc.2019.101205","url":null,"abstract":"","PeriodicalId":48557,"journal":{"name":"Studies in History and Philosophy of Science Part C-Studies in History and Philosophy of Biological and Biomedical Sciences","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.shpsc.2019.101205","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89988912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"","authors":"Hans Pols","doi":"10.1016/j.shpsc.2019.101203","DOIUrl":"10.1016/j.shpsc.2019.101203","url":null,"abstract":"","PeriodicalId":48557,"journal":{"name":"Studies in History and Philosophy of Science Part C-Studies in History and Philosophy of Biological and Biomedical Sciences","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.shpsc.2019.101203","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55052241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Kant, organisms, and representation","authors":"Patrick R. Leland","doi":"10.1016/j.shpsc.2019.101223","DOIUrl":"10.1016/j.shpsc.2019.101223","url":null,"abstract":"<div><p>Some interpreters claim Kant distinguishes between organisms and living things. I argue this claim is underdetermined by the textual evidence. Once this is recognized, it becomes a real possibility that Kant's various remarks about the essential properties of living things generalize to organisms as such. This, in turn, generates a puzzle. Kant repeatedly claims that the capacity for representation is essential to the nature of a living thing. If he does not distinguish between living things and organisms, then how might the capacity for representation be essential to the latter? Drawing on the writings of Kant and his contemporaries, I reconstruct a framework within which representational capacities might conceivably be thought to play this role. On this view, what distinguishes an organism from mechanically explicable products of nature is its capacity for endogenous behavior that is instinctual and representationally mediated.</p></div>","PeriodicalId":48557,"journal":{"name":"Studies in History and Philosophy of Science Part C-Studies in History and Philosophy of Biological and Biomedical Sciences","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.shpsc.2019.101223","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81344216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Epistemic risks in cancer screening: Implications for ethics and policy","authors":"Justin B. Biddle","doi":"10.1016/j.shpsc.2019.101200","DOIUrl":"10.1016/j.shpsc.2019.101200","url":null,"abstract":"<div><p><span><span>Cancer screening<span> is the subject of much debate; while screening has the potential to save lives by identifying and treating cancers in early stages, it is also the case that not all cancers cause symptoms, and the diagnosis of these cancers can lead to unnecessary treatments and subsequent side-effects and complications. This paper explores the relationships between epistemic risks in cancer diagnosis and screening, the social organization of </span></span>medical research and practice, and policy making; it does this by examining 2018 recommendations by the United States Preventative Services Task Force that patients make individualized, autonomy-based decisions about cancer screening on the basis of discussions with their physicians. While the paper focuses on </span>prostate cancer<span> screening, the issues that it raises are relevant to other cancer screening programs, especially breast cancer. The paper argues that prostate cancer screening—and, more generally, the process of risk assessment for prostate cancer—is pervaded by epistemic risks that reflect value judgments and that the pervasiveness of these epistemic risks creates significant and under-explored difficulties for physician-patient communication and the achievement of autonomous patient decision making.</span></p></div>","PeriodicalId":48557,"journal":{"name":"Studies in History and Philosophy of Science Part C-Studies in History and Philosophy of Biological and Biomedical Sciences","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.shpsc.2019.101200","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75773360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Best behaviour: A proposal for a non-binary conceptualization of behaviour in biology","authors":"Eric Muszynski, Christophe Malaterre","doi":"10.1016/j.shpsc.2019.101222","DOIUrl":"10.1016/j.shpsc.2019.101222","url":null,"abstract":"<div><p>Behaviour is a widespread object of research in biology, yet it is often left undefined, and the variety of existing definitions have not led to a consensus. We argue that the fundamental problem in defining behaviour has been the assumption that the concept must be categorical: either a phenomenon is a behaviour or it is not. We propose instead that ‘behaviour’ is best understood as a spectrum concept. We have identified three major characteristics of phenomena which, we argue, fuel the intuitions of biologists regarding the classification of cases as behaviour. All are related to the mechanistic explanations put forth to account for the phenomena, and are (i) the complexity of the mechanism, (ii) the stability of the constitutive entities, and (iii) the quantity and significance of the inputs to the underlying mechanism. We illustrate this new conceptualisation through a three-dimensional behaviour-space which highlights the apparently different conceptualizations of behaviour attributed to humans, animals and plants, showing that they, in fact, all partake of a unified, malleable understanding of a single concept.</p></div>","PeriodicalId":48557,"journal":{"name":"Studies in History and Philosophy of Science Part C-Studies in History and Philosophy of Biological and Biomedical Sciences","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.shpsc.2019.101222","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84409364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"","authors":"Junko Kitanaka","doi":"10.1016/j.shpsc.2019.101204","DOIUrl":"10.1016/j.shpsc.2019.101204","url":null,"abstract":"","PeriodicalId":48557,"journal":{"name":"Studies in History and Philosophy of Science Part C-Studies in History and Philosophy of Biological and Biomedical Sciences","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.shpsc.2019.101204","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48155423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Social evolution and the individual-as-maximising-agent analogy.","authors":"C. Paternotte","doi":"10.1016/j.shpsc.2019.101225","DOIUrl":"https://doi.org/10.1016/j.shpsc.2019.101225","url":null,"abstract":"","PeriodicalId":48557,"journal":{"name":"Studies in History and Philosophy of Science Part C-Studies in History and Philosophy of Biological and Biomedical Sciences","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80821712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pandora's box closed: The Royal Air Force Institute of Aviation Medicine and Nazi medical experiments on human beings during World War II","authors":"James Mills","doi":"10.1016/j.shpsc.2019.101190","DOIUrl":"10.1016/j.shpsc.2019.101190","url":null,"abstract":"<div><p>In the months before and after the final surrender of Nazi Germany on 8 May 1945, British aviation medicine<span> specialists were sent to the European continent to learn the progress that German aviation medicine had made since September 1939. For the medical officers at the Royal Air Force Institute of Aviation Medicine at Farnborough in Hampshire, the dilemma over whether the medical data from the Nazi aviation medicine experiments at Dachau concentration camp should be exploited presented profound moral and ethical problems. Their deliberations paralleled those of the 1945-46 Nuremberg Trial, which revealed the crimes that were committed under the Nazi regime. At the same time, the British medical establishment debated the morality of publishing the Nazi medical research to serve humanity. This article shows that on the basis of British wartime and post-war research, and determinations that were made by the British Advisory Committee for the Investigation of German Medical War Crimes, by 1948 the RAF IAM had essentially rejected the results of the Nazi aviation medicine experiments on scientific and ethical grounds.</span></p></div>","PeriodicalId":48557,"journal":{"name":"Studies in History and Philosophy of Science Part C-Studies in History and Philosophy of Biological and Biomedical Sciences","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.shpsc.2019.101190","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77490354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"“The Invention of Madness by Emily Baum: Reply by the author”","authors":"Emily Baum","doi":"10.1016/j.shpsc.2019.101206","DOIUrl":"https://doi.org/10.1016/j.shpsc.2019.101206","url":null,"abstract":"","PeriodicalId":48557,"journal":{"name":"Studies in History and Philosophy of Science Part C-Studies in History and Philosophy of Biological and Biomedical Sciences","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.shpsc.2019.101206","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89988913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}