The counterfactual analysis of causation has focused on one particular counterfactual conditional, taking as its starting-point the suggestion that C causes E iff (C E). In this paper, some consequences are explored of reversing this counterfactual, and developing an account starting with the idea that C causes E iff (E C). This suggestion is discussed in relation to the problem of pre-emption. It is found that the 'reversed' counterfactual analysis can handle even the most difficult cases of pre-emption with only (...) minimal complications. The paper closes with a discussion of the wider philosophical implications of developing a reversed counterfactual analysis, especially concerning the differentiation of causes from causal conditions, causation by absences, and the extent to which causes suffice for their effects. (shrink)

ABSTRACTIt is proposed that experts are able to integrate prior contextual knowledge with emergent visual information to make complex predictive judgments about the world around them, often under heightened levels of uncertainty and extreme time constraints. However, limited knowledge exists about the impact of anxiety on the use of such contextual priors when forming our decisions. We provide a novel insight into the combined impact of contextual priors and anxiety on anticipation in soccer. Altogether, 12 expert soccer players were required (...) to predict the actions of an oncoming opponent while viewing life-sized video simulations of 2-versus-2 defensive scenarios. Performance effectiveness and processing efficiency were measured under four conditions: no contextual priors about the action tendencies of the opponent and low anxiety ; no CP and high anxiety ; CP and LA; CP and HA. The provision of contextual priors did not affect processing efficiency, but it improved performance effectiveness... (shrink)

In this article I seek to say what it is for something to count as a neglected disease. I argue that neglect should be defined in terms of efforts at prevention, mitigation and cure, and not solely in terms of research dollars per disability-adjusted life-year. I further argue that the trend towards multifactorialism and risk factor thinking in modern epidemiology has lent credibility to the erroneous view that the primary problem with neglected diseases is a lack of research. A more (...) restrictive contrastive model of disease is endorsed as better suited to the definition of neglected disease. (shrink)

What is medicine? One obvious answer in the context of the contemporary clinical tradition is that medicine is the process of curing sick people. However, this “curative thesis” is not satisfactory, even when “cure” is defined generously and even when exceptions such as cosmetic surgery are set aside. Historian of medicine Roy Porter argues that the position of medicine in society has had, and still has, little to do with its ability to make people better. Moreover, the efficacy of medicine (...) for improving population health has been famously doubted by historians and epidemiologists. The curative thesis demands that we have mostly been stupid, duped, or staggeringly hopeful, given that medicine has not until recently offered more than a handful of effective cures. I suggest, in this article, that the core medical competence is neither to cure, nor to prevent, disease, but to understand and to predict it. I argue that this approach does a better job than the curative thesis at explaining why not all medicine is concerned with curative efforts and that it enjoys historical support from the ancient entanglement of prophecy and medicine and from the fact that medicine thrived for centuries with almost no effective cures and continues to thrive today in various forms that are mostly without curative efficacy. I suggest that this approach grounds a fairer approach to alternative, traditional, and other medical practices, as well as some fresh lessons for the development of mainstream medicine. (shrink)

Societal collapse has been a perennial concern of humanity, at least since the early Greeks. Recent publication of Jared Diamond's Collapse: How Societies Choose to Fail or Succeed and Ervin Laszlo's The Chaos Window: The World at the Crossroads renew this concern. Despite the urgency in these and many similar calls to action, no consensus theory and practice of evolutionary civilization exists. This article calls for collaborative action by the evolutionary systems community and related disciplines to provide insight into what (...) has been dubbed "the most important question in the world today" (Smith, 2005, p. 436). (shrink)

We are pleased to once again present to the readers of Theoretical Medicine and Bioethics papers from the Philosophy of Medicine Roundtable. Previous issues have followed the 3rd and 4th Roundtables, and the current issue presents a selection from the more than 20 papers presented at the 5th Philosophy of Medicine Roundtable, which took place in New York, at Columbia University, in November 2013. Like its predecessors, held in Birmingham, AL, Rotterdam, and San Sebastian, this Roundtable attracted speakers from around (...) the world. It also featured keynote presentations from Rita Charon of Columbia University and Ross Upshur of the University of Toronto.It may seem somewhat odd to feature a special issue on philosophy of medicine in a journal that effectively has philosophy of medicine in its title. However, a review of the contents of this journal and similar ones, such as the Journal of Medicine and Philosophy, will quickly reveal such an issue’s purpose. The dominant content of these j .. (shrink)

Alex Broadbent’s Philosophy of Epidemiology is the latest volume in Palgrave Macmillan’s New Directions in the Philosophy of Science series. Other monographs in the series focus on mathematics, biology, astronomy, et al.—the usual topics of discourse when philosophers engage science. The present volume is a welcome addition not just to the series but also for the field of epidemiology. As Broadbent notes, “Although a few philosophers have studied epidemiology, there have been no philosophical studies of epidemiology” . There (...) is one now.As noted in the book’s foreword, the core theme of Philosophy of Epidemiology “has to do with the nature and role of explanation and prediction in epidemiological analyses” . These are practical matters which are familiar to epidemiologists, but being largely mechanical in nature, “this explains why philosophers of science have neglected epidemiology” .Broadbent is a young philosopher, trained at Cam .. (shrink)

Philosophy of epidemiology has recently emerged as a distinct branch of philosophy. The field will surely benefit from pluralism, reflected in the broad range of topics and perspectives in this special issue. Here, I argue that a healthy pluralistic field of philosophy of epidemiology has social responsibilities that require the field as a whole to engage actively with research on social determinants of health and health disparities. Practicing epidemiologists and the broader community of public health scientists have gradually acknowledged that (...) much of their attention ought to be paid to these, i.e. inequitable between-population health variations that largely reflect the world’s inequitable distribution of resources and social conditions. The paper illustrates how and why health disparities and social determinants of health, through no ill will, become de facto secondary concerns in Alex Broadbent’s field-defining Philosophy of Epidemiology, showing the ease with which these topics can be incidentally sidelined. As means for philosophy of epidemiology to meet its social responsibility obligations, I suggest philosophy of epidemiology expand its attention to two particular lines research. First, the paper discusses Geoffrey Rose’s concept of “causes of incidence”—causes of disparities between populations—and argues for the importance of engaging with these causes. Second, the paper argues for the value of engaging with Bruce Link and Jo Phelan’s “fundamental causes” model of how flexible social resources serve as buffers from harms, generating a plethora of shifting and locally-contingent health effects. (shrink)

The case of Semmelweis has been well known since Hempel. More recently, it has been revived by Peter Lipton, Donald Gillies, Alexander Bird, Alex Broadbent, and Raphael Scholl. While these accounts differ on what exactly the case of Semmelweis shows, they all agree that Semmelweis was an excellent reasoner. This widespread agreement has also given rise to a puzzle: why Semmelweis’s views were rejected for so long. I aim to dissolve both this puzzle and the standard view of Semmelweis (...) by showing that, contrary to prevailing opinion, Semmelweis was not the excellent reasoner he has been assumed to be. (shrink)

Philosophy of Medicine has for a long time been preoccupied with analyzing the concepts of health, disease and illness. Relatively speaking, the concept of medicine itself has received very little attention. This paper is a contribution to the relatively neglected debate about the nature of medicine. Building on the work of Alex Broadbent (Broadbent, 2018a, b), Chadwin Harris (Harris, 2018) and Thaddeus Metz (Metz, 2018), in this paper I question the persuasiveness of Broadbent’s account of the “core (...) business” of medicine, The Inquiry Thesis, and propose an alternative: a revised version of The Curative Thesis, which I coin The Best Available Intervention Thesis. Crudely, this suggests that Medicine is the sustained and organised effort to determine and prescribe the best available treatment (curative or preventative) for patients. (shrink)

Our visual experience of the world is one of diverse objects and events, each with particular colors, shapes, and motions. This experience is so coherent, so immediate, and so effortless that it seems to result from a single system that lets us experience everything in our field of view. But however appealing, this belief is mistaken: there are severe limits on what can be visually experienced. -/- For example, in a display for air-traffic control it is important to track all (...) moving items. For a single item, this can be done without problem. Three or four can also be tracked, although some degree of effort may be needed. As the number is increased further, accurate tracking becomes more and more difficult—and eventually, impossible. Performance is evidently affected by a factor within the observer which enables certain kinds of perception to occur, but is limited in some way. This factor is generally referred to as attention. -/- At various times, attention has been associated with clarity of perception, intensity of perception, consciousness, selection, or the allocation of a limited “resource” enabling various operations (see Hatfield, 1998). During the past several decades, considerable progress has been achieved by focusing on the idea of selection (Broadbent, 1982). In particular, attention can be productively viewed as contingently selective processing. This can be embodied in various ways by various processes—there need not be a single quantity identified with all forms of attention, or a single site where it operates (Allport, 1993; Tsotsos, 2011). Although “paying attention” is often considered to be a unitary operation, it may simply refer to the control of one or more selective processes, ideally in a co-ordinated way. While this view has some cost in terms of conceptual simplicity, it can help make sense of a large set of phenomena. -/- This article surveys several of the major issues in our understanding of attention and how it relates to perception. It focuses on vision, since many—if not all—considerations are similar for all sensory modalities, and the level of understanding achieved in this domain is currently the most advanced. (shrink)

Part of a symposium devoted to ‘Prediction, Understanding, and Medicine’, in which Alex Broadbent argues that the nature of medicine is determined by its competences, i.e., which things it can do well. He argues that, although medicine cannot cure well, it can do a good job of enabling people not only to understand states of the human organism and of what has caused them, but also to predict future states of it. From this Broadbent concludes that medicine is (...) (at least in part) essentially a practice of understanding and predicting, not curing. In reply to this bold position, I mount two major criticisms. First, I maintain that the reasons Broadbent gives for doubting that medicine can cure provide comparable reason for doubting that medicine can provide an understanding; roughly, the best explanation of why medicine cannot reliably cure is that we still lack much understanding of health and disease. Second, I object to the claim that a practice is medical only if it facilitates understanding and prediction. Although Broadbent has brought to light certain desirable purposes of medicine that are under-appreciated, my conclusion is that he has not yet provided enough reason to think that understanding and prediction are essential to it. Instead of supposing that medicine has an essence, in fact, I suggest that its nature is best understood in terms of a property cluster. (shrink)

Recently within the critical accounting literature Funnell (1998) has argued that accounting was implicated in the Holocaust. This charge is primarily related to the technical, mathematical nature of accounting and its ability to dehumanise individuals. Broadbent (1998, see also DeMoss and McCann, 1997) has also contended that "accounting logic" excludes emotion. She suggests that a more emancipatory form of accounting could be possible if emotion were given a voice and allowed to be heard within accounting discourse (see also Kjonstad (...) and Wilmott, 1995). This paper contends that emotion should be introduced into accounting education and in particular emotional commitment to other individuals should be encouraged. It is suggested that one way to do this may be through business ethics education. It is also suggested that increasing ethical commitment to other individuals may go some way towards combating the tendency for accountancy to dehumanise other people. While there have been specific studies of ethics and accounting education there has, as yet, been little open debate about what the objectives of accounting ethics education should be or the specific techniques that could be used to meet the desired aims. This paper contends that accountancy has become dangerously dehumanised and that one of the most important objectives for any business ethics education must be to develop an empathy with "the other". The paper studies the developments within the medical, legal and engineering profession in order to suggest some specific methods which could be employed in order to re-humanise accountancy and develop a sense of moral commitment towards other individuals. (shrink)

Blind tasting — tasting without knowing the wine’s producer, origin, or other details obtainable from the wine’s label— has become something of a fetish in the wine world. We are told, repeatedly and insistently, that blind tasting is the best, most neutral, least biased, and most honest evaluative procedure, and one that should be employed to the exclusion of non-blind/sighted tasting (which, in turn, is typically disparaged as confused, biased, or dishonest). Professional evaluators (e.g., the tasting panel of the Wine (...) Spectator, the Grand Jury Europ´een, virtually every judging panel in competitive wine events) routinely advertise that they use blind tasting exclusively. Wine books and tasting manuals at all levels consistently emphasize the importance of blind tasting. Thus, Michael Broadbent, perhaps the most prolific author of tasting notes in history, writes that “It is my firm opinion . . . that to assess the qualities of a wine by tasting it completely blind, without any hint of what it might be, is the most useful and salutary discipline that any self-respecting taster can be given” (quoted in ? , 156). Or, again, Ronald Jackson, in his industry-standard textbook on wine tasting, asserts categorically that “Tastings should always be conducted blind, usually with only the names of the wine noted in advance” ( ? , 334). (shrink)

This paper examines racial discrimination and algorithmic bias in predictive policing algorithms (PPAs), an emerging technology designed to predict threats and suggest solutions in law enforcement. We first describe what discrimination is in a case study of Chicago’s PPA. We then explain their causes with Broadbent’s contrastive model of causation and causal diagrams. Based on the cognitive science literature, we also explain why fairness is not an objective truth discoverable in laboratories but has context-sensitive social meanings that need to (...) be negotiated through democratic processes. With the above analysis, we next predict why some recommendations given in the bias reduction literature are not as effective as expected. Unlike the cliché highlighting equal participation for all stakeholders in predictive policing, we emphasize power structures to avoid hermeneutical lacunae. Finally, we aim to control PPA discrimination by proposing a governance solution—a framework of a social safety net. (shrink)

In this paper I untangle a recent debate in the philosophy of epidemiology, focusing in particular on the Potential Outcomes Approach to causation. As the POA strategy includes the quantification of ‘contrary-to-fact’ outcomes, it is unsurprising that it has been likened to the counterfactual analysis of causation briefly proposed by David Hume, and later developed by David Lewis. However, I contend that this has led to much confusion. Miguel Hernan and Sarah Taubman have recently argued that meaningful causal inferences cannot (...) be drawn from obesity. This paper prompted Alex Broadbent to criticise the POA conception of causation, accusing two of the four theses its proponents are committed to, of circularity and falsity. Here I scrutinise Broadbent’s claims, and suggest that a Popperian approach to causal inference in epidemiology diffuses both of his objections. However, I move on to argue that the POA’s commitment to granting only manipulable conditions causal-status, renders the position implausible as a conceptual analysis of causation. That said, I conclude that the strategy the POA employs is an effective tool for effect-measurement in intervention-cases; if it is a conceptual analysis of causation at all, it must be restricted to the causal analysis of manipulable conditions. The POA’s failure to successfully demarcate causal from non-causal conditions simpliciter should therefore not be viewed as a serious threat. (shrink)

Commonly we distinguish the strike of a match, as a cause of the match lighting, from the presence of oxygen, as a mere condition. In this paper I propose an account of this phenomenon, which I call causal selection. I suggest some reasons for taking causal selection seriously, and indicate some shortcomings of the popular contrastive approach. Chief among these is the lack of an account of contrast choice. I propose that contrast choice is often just the counterfactual scenario in (...) which the effect does not occur: I suggest that if c causes e , then if e hadn't occurred, c wouldn't have occurred. I argue that this is a necessary condition on causation which causes meet but mere conditions fail. (shrink)

In this series of lectures, a distinguished group of international contributors from a variety of disciplines debate the current position of the recent achievements in engineering and computer science. (Technology & Industrial).

This chapter explores the idea that causal inference is warranted if and only if the mechanism underlying the inferred causal association is identified. This mechanistic stance is discernible in the epidemiological literature, and in the strategies adopted by epidemiologists seeking to establish causal hypotheses. But the exact opposite methodology is also discernible, the black box stance, which asserts that epidemiologists can and should make causal inferences on the basis of their evidence, without worrying about the mechanisms that might underlie their (...) hypotheses. I argue that the mechanistic stance is indeed a bad methodology for causal inference. However, I detach and defend a mechanistic interpretation of causal generalisations in epidemiology as existence claims about underlying mechanisms. (shrink)

If there is any value in the idea that disease is something other than the mere absence of health then that value must lie in the way that diseases are classified. This paper offers further development of a view advanced previously, the 'contrastive model' of disease: it develops the account to handle asymptomatic disease ; and in doing so it relates the model to a broadly biostatistical view of health. The developments are prompted by considering cancers featuring viruses as prominent (...) causes, since these appear to amount to cases where the prescriptions of the contrastive model could be followed, but aren't. The resulting irrelevance objection claims that the contrastive model is irrelevant to medical science and practice. The paper seeks to rebut the irrelevance objection. (shrink)

This paper takes it as a premise that a distinction between matters of fact and of law is important in the causal inquiry. But it argues that separating factual and legal causation as different elements of liability is not the best way to implement the fact/law distinction. What counts as a cause-in-fact is partly a legal question; and certain liability-limiting doctrines under the umbrella of “legal causation” depend on the application of factual-causal concepts. The contrastive account of factual causation proposed (...) in this paper improves matters. This account more clearly distinguishes matters of fact from matters of law within the cause-in-fact inquiry. It also extends the scope of cause-in-fact to answer some questions currently answered by certain doctrines of legal causation—doctrines that, it is argued, are more naturally seen as applications of our ordinary causal concept than as noncausal liability-limiting devices. (shrink)

We commonly distinguish causes from mere conditions, for example by saying that the strike caused the match to light but by failing to mention the presence of oxygen. Philosophers from Mill to Lewis have dismissed this common practice as irrelevant to the philosophical analysis of causation. In this paper, however, I argue that causal selection poses a puzzle of just the same form as Hume's sceptical challenge to the notion of necessary connection. I then propose a solution in terms of (...) a simple counterfactual. (shrink)

This paper considers an important recent contribution by Miguel Hernán to the ongoing debate about causal inference in epidemiology. Hernán rejects the idea that there is an in-principle epistemic distinction between the results of randomized controlled trials and observational studies: both produce associations which we may be more or less confident interpreting as causal. However, Hernán maintains that trials have a semantic advantage. Observational studies that seek to estimate causal effect risk issuing meaningless statements instead. The POA proposes a solution (...) to this problem: improved restrictions on the meaningful use of causal language, in particular “causal effect”. This paper argues that new restrictions in fact fail their own standards of meaningfulness. The paper portrays the desire for a restrictive definition of causal language as positivistic, and argues that contemporary epidemiology should be more realistic in its approach to causation. In a realist context, restrictions on meaningfulness based on precision of definition are neither helpful nor necessary. Hernán’s favoured approach to causal language is saved from meaninglessness, along with the approaches he rejects. (shrink)

The possibility that our universe was initiated intentionally is a compelling philosophical and scientific question that can be evaluated probabilistically based on four primary considerations: finetuning in our universe, hypotheses about the multiverse, the likelihood that intelligent life may be able to initiate a universe, and the possibility that we live in a simulation. This paper offers an equation analogous to the noteworthy Drake equation that is intended to be used as a structured thought experiment to help identify factors related (...) to the initiation of our universe and to facilitate examining each in terms of what we know, do not know, and potentially could know about them. (shrink)

Philosophy of Medicine provides a fresh and comprehensive treatment of the topic. It offers a novel theory of the nature of medicine, and proposes a new attitude to medicine, aimed at improving the quality of debates between medical traditions and facilitating medicine's decolonization.

When graduate students start their studies, they usually have sound knowledge of some areas of philosophy, but the overall map of their knowledge is often patchy and disjointed. There are a number of topics that any contemporary philosopher working in any part of the analytic tradition needs to grasp, and to grasp as a coherent whole rather than a rag-bag of interesting but isolated discussions. This book answers this need, by providing a overview of core topics in metaphysics and epistemology (...) that is at once accessible and nuanced. Ten core topics are explained, and their relation to each other is clearly set out. The book emphasizes the utility of the concepts and distinctions it covers for philosophy as a whole, not just for specialist discussions in metaphysics or epistemology. The text is highly readable and may be used as the basis of a course on these topics. Recommendations for reading are included at the end of each chapter, divided into essential and further readings. The text is also suitable for people approaching philosophy from other disciplines, as an accessible primer to the central topics, concepts and distinctions that are needed to engage meaningfully in contemporary philosophical debate. (shrink)

This paper takes issue with those commentators of Heidegger's philosophy whose point of entry into his thinking is the inherited prejudices of others. It demonstrates that if prior judgments are suspended, so that Heidegger's texts are permitted to speak for themselves, the truth of his `position', more a wege than a static motionless point, gradually and inexorably begins to emerge. I take Pope Benedict's first encyclical, Deus Caritas Est, to draw the theological contours of a truly post-modern ethic. I then (...) hold up Heidegger's philosophy, as this is characterized principally though not exclusively in his lecture Der Satz Der Identität, to consider possible symmetries. Finally I offer an answer to the question: does Heidegger's thought have ethical consequences? (shrink)

This article is a reply to two critics of my “Prediction, Understanding, and Medicine,” published elsewhere in this journal issue. In that essay, I argued that medicine is best understood not as essentially a curative enterprise, but rather as one essentially oriented towards prediction and understanding. Here, I defend this position from several criticisms made of it.

In the literature on health, naturalism and normativism are typically characterized as espousing and rejecting, respectively, the view that health is objective and value-free. This article points out that there are two distinct dimensions of disagreement, regarding objectivity and value-ladenness, and thus arranges naturalism and normativism as diagonal opposites on a two-by-two matrix of possible positions. One of the remaining quadrants is occupied by value-dependent realism, holding that health facts are value-laden and objective. The remaining quadrant, which holds that they (...) are non-objective but value-free, is unexplored. The article endorses a view in the latter quadrant, namely, the view that health is a secondary property. The article argues that a secondary property framework provides the resources to respond to the deepest objections to a broadly Boorsean account of natural function, and so preserves the spirit, though not the letter, of that account. Treating health as a secondary property permits a naturalistic explanation—specifically, an evolutionary explanation—of the health concept, in terms of the assistance such a concept might have provided to the survival and reproduction of those organisms that had it. This provides the explanation, missing from Boorse's account, for the fact that function is determined with reference to the contribution to the goals of survival and reproduction, relative to the age of the sex of the species, rather than some other equally natural goals or reference classes. _1_ Introduction _2_ Two Ways to Disagree about Health _3_ Secondary Properties _4_ Health as a Secondary Property _5_ Conclusion. (shrink)

This paper puts forward a general framework for thought about human information processing. It is intended to avoid some of the problems of pipeline or stage models of function. At the same time it avoids the snare of supposing a welter of indefinitely many separate processes. The approach is not particularly original, but rather represents the common elements or presuppositions in a number of modern theories. These presuppositions are not usually explicit, however, and making them so reduces the danger of (...) slipping back into earlier modes of thought.The key point is to distinguish between persisting representations and the processes that translate one representation into another. Various classes or groups of persisting representations can be distinguished by the experimental treatments that interfere with them. In particular, there now seem to be several kinds of short-term or temporary storage, different from each other as well as from longterm memory; the translating processes also have several different modes or kinds. A particularly important aspect of the current position is that a model of this general type no longer requires some external agent to direct and control long sequences of behaviour. (shrink)

This paper argues that bioethics requires analysis, which is not explicitly ethical in character. The first part of the paper argues the general point, that ethical problems can arise not only on occasions when moral values make conflicting recommendations, but also in understanding the facts. I suggest that this is particularly so where the facts are provided by the biomedical sciences, since it is often not clear how to relate their conceptual framework to that in which we frame our value (...) judgements. In the second part, I illustrate the argument by criticizing the moral conclusions drawn by the authors of a recent widely publicized study of paediatric obesity. There is a failure to translate properly these results into the language we use for moral evaluation. The case therefore illustrates exactly the analytic gap which I suggest bioethics might do more to fill. (shrink)

This paper puts forward a general framework for thought about human information processing. It is intended to avoid some of the problems of pipeline or stage models of function. At the same time it avoids the snare of supposing a welter of indefinitely many separate processes. The approach is not particularly original, but rather represents the common elements or presuppositions in a number of modern theories. These presuppositions are not usually explicit, however, and making them so reduces the danger of (...) slipping back into earlier modes of thought.The key point is to distinguish between persisting representations and the processes that translate one representation into another. Various classes or groups of persisting representations can be distinguished by the experimental treatments that interfere with them. In particular, there now seem to be several kinds of short-term or temporary storage, different from each other as well as from longterm memory; the translating processes also have several different modes or kinds. A particularly important aspect of the current position is that a model of this general type no longer requires some external agent to direct and control long sequences of behaviour. (shrink)

Epidemiology is one of the fastest growing and increasingly important sciences. This thorough analysis lays out the conceptual foundations of epidemiology, identifying traps and setting out the benefits of properly understanding this fascinating and important discipline, as well as providing the means to do so.