Journal of evaluation in clinical practice
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Evidence-based medicine has claimed to be science on a number of occasions, but it is not clear that this status is deserved. Within the philosophy of science, four main theories about the nature of science are historically recognized: inductivism, falsificationism, Kuhnian paradigms, and research programmes. If evidence-based medicine is science, knowledge claims should be derived using a process that corresponds to one of these theories. ⋯ In the final section, possible counter arguments are considered. It is argued that the knowledge claims valued by evidence-based medicine are not justified using inductivism, falsificationism, Kuhnian paradigms, or research programmes. If these are the main criteria for evaluating if something is science or not, evidence-based medicine does not meet these criteria.
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This paper analyses the methods of the International Agency for Research on Cancer (IARC) for evaluating the carcinogenicity of various agents. I identify two fundamental evidential principles that underpin these methods, which I call Evidential Proximity and Independence. ⋯ I suggest a way to resolve this problem: admit a general exception to Independence and treat the implementation of Evidential Proximity more flexibly where this exception applies. I show that this suggestion is compatible with the general principles laid down in the 2019 version of IARC's methods guide, its Preamble to the Monographs.
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Evidence-based medicine (EBM) calls for medical practitioners to "integrate" our best available evidence into clinical practice. A significant amount of the literature on EBM takes this integration to be unproblematic, focusing on questions like how to interpret evidence and engage with patient values, rather than critically looking at how these features of EBM can be implemented together. ⋯ In particular, I introduce an epistemological issue for this integration problem, which I call the epistemic integration problem. This is essentially the problem of how we can use information that is both general (eg, about a population sample) and descriptive (eg, about what expected outcomes are) to reach clinical judgements that are individualized (applying to a particular patient) and normative (about what is best for their health).
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In this article, we offer an extended critical review of a new conception of bioethics, presented by Darlei Dall'Agnol, in the book Care and Respect in Bioethics. ⋯ Dall'Agnol offers an insightful and persuasive account of how the single attitude of respectful care can express practical moral knowledge in healthcare. In this paper, we evaluate, criticize, and suggest refinements. One of them concerns Dall'Agnol's interpretation about Stephen Darwall's views on care and respect as two attitudes supported, respectively, by a third- and a second-personal moral point-of-view. Other is about the Dall'Agnol's Wittgensteinian description of the moral language-games of Clinical Bioethics, adding to the approach the "language-game of rights."
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In this paper, I will consider, from a number of philosophical and real-life perspectives, what happens to us when we fall ill and what the experience of falling ill tells us about the nature of our being. I will take up the oft used Myth of the Cave from Plato's Republic and use this as a means to interpret the experience of falling ill. Plato gave us the allegory to show that what we think we know might not be all there is to know and that what we take for truth may not, at least, be the whole truth. ⋯ To make the argument, I will use examples from my own experience of illness and some of those other which have been recounted to me. I will also refer to the work of Havi Carel on illness and mortality, the conception of illness as leading to a feeling of not-being-at-home with our bodies (unheimlich) discussed by Frederick Svenaeus, and Gadamer's notion of illness as a loss of equilibrium. Underpinning the argument throughout will be Heidegger's existential analysis of dying in which he discusses the experience of anxiety and the way that separates us from the world of involvements.