@article {1931551, title = {Evidence-based medicine and progress in the medical sciences}, journal = {Journal of evaluation in clinical practice}, volume = {17}, number = {5}, year = {2011}, pages = {852{\textendash}856}, abstract = {

The question what scientific progress means for a particular domain such as medicine seems importantly different from the question what scientific progress is in general. While the latter question received ample treatment in the philosophical literature, the former question is hardly discussed. I argue that it is nonetheless important to think about this question in view of the methodological choices we make. I raise specific questions that should be tackled regarding scientific progress in the medical sciences and demonstrate their importance by means of an analysis of what evidence-based medicine (EBM) has, and has not, to offer in terms of progress. I show how critically thinking about EBM from the point of view of progress can help us in putting EBM and its favoured methodologies in the right perspective. My conclusion will be that blindly favouring certain methods because of their immediately tangible short-term benefits implies that we parry the important question of how best to advance progress in the long run. This leads us to losing sight of our general goals in doing research in the medical sciences.

}, issn = {1356-1294}, doi = {http://dx.doi.org/10.1111/j.1365-2753.2011.01715.x}, author = {De Vreese, Leen} } @article {1054981, title = {Explanatory pluralism in the medical sciences: theory and practice}, journal = {Theoretical Medicine and Bioethics}, volume = {31}, number = {5}, year = {2010}, pages = {371{\textendash}390}, abstract = {

Explanatory pluralism is the view that the best form and level of explanation depends on the kind of question one seeks to answer by the explanation, and that in order to answer all questions in the best way possible, we need more than one form and level of explanation. In the first part of this article, we argue that explanatory pluralism holds for the medical sciences, at least in theory. However, in the second part of the article we show that medical research and practice is actually not fully and truly explanatory pluralist yet. Although the literature demonstrates a slowly growing interest in non-reductive explanations in medicine, the dominant approach in medicine is still methodologically reductionist. This implies that non-reductive explanations often do not get the attention they deserve. We argue that the field of medicine could benefit greatly by reconsidering its reductive tendencies and becoming fully and truly explanatory pluralist. Nonetheless, trying to achieve the right balance in the search for and application of reductive and non-reductive explanations will in any case be a difficult exercise.

}, issn = {1386-7415}, doi = {http://dx.doi.org/10.1007/s11017-010-9156-7}, author = {De Vreese, Leen and Weber, Erik and Van Bouwel, Jeroen} } @article {732259, title = {Epidemiology and causation}, journal = {Medicine, health care and philosophy}, volume = {12}, number = {3}, year = {2009}, pages = {345{\textendash}353}, abstract = {

Epidemiologists{\textquoteright} discussions on causation are not always very enlightening with regard to the notion of {\textquoteleft}cause{\textquoteright} in epidemiology. Epidemiologists rightly work from a science-based approach to causation in epidemiology, but largely disagree about the matter. Disagreement may be partly due to confusion of the question of useful concepts for causal inference in epidemiological practice with the question of the metaphysical presuppositions of causal concepts used in epidemiology. In other words, epidemiologists seem to confuse the practical results of epidemiological research at the population level with the metaphysical views about the reality of disease causation at the individual level in their writings on causation.

}, issn = {1386-7423}, doi = {http://dx.doi.org/10.1007/s11019-009-9184-0}, author = {De Vreese, Leen} }