The True Causal Effect

Do medical scientists need philosophers of medicine like birds need ornithologists? A quotation often attributed to Richard Feynman claims that “philosophy of science is as useful to scientists as ornithology is to birds”. Feynman, never the intellectual slouch, acutely discounts the value of philosophy of science to him, without actually claiming that philosophers are useless, valueless, …

The Dismal Disease: Temozolomide and the Interaction of Evidence

“I think the challenge is really that we still, not only in glioblastoma, but in oncology at large, treat the majority of patients with a one-size-fits-all approach.” — Roger Stupp    Blockbuster drugs are rare. To be a blockbuster, a drug must shift over $1bn worth in one year. There …

Against “Effective Treatments”

I am agitating for philosophers of medicine and philosophically-minded clinicians to lead the charge against the term “effective treatment”. This phrase has become ubiquitous in the medical and philosophical literature. But it is a misguided choice which misleads the public and practitioners alike. In general, I want to promote talk about …

Two Dogmas of Evidence Hierarchies

Hierarchies of evidence in Evidence-Based Medicine (EBM) come in many varieties and have been very influential in medical practice and policy since the late 1990s. However, two fundamental problematic assumptions underpin the use of hierarchies of any kind in clinical practice: (1) that evidence can and should be appraised in …