Reinforced reasoning in medicine

Abstract

Some philosophers have argued that evidence of underlying mechanisms does not provide evidence for the effectiveness of a medical intervention. One such argument appeals to the unreliability of mechanistic reasoning. However, mechanistic reasoning is not the only way that evidence of mechanisms might provide evidence of effectiveness. A more reliable type of reasoning may be distinguished by appealing to recent work on evidential pluralism in the epistemology of medicine. A case study from virology provides an example of this so‐called reinforced reasoning in medicine. It is argued that in this case study, the available evidence of underlying mechanisms did in fact play a role in providing evidence in favour of a medical intervention. This paper therefore adds a novel and recent case study to the literature in support of evidential pluralism in medicine.

Against Evidential Pluralism in Pharmaceutical Regulation

“…But notice that this is not a response to the concerns raised by the critics; this is simply a restatement of the same argument for evidential pluralism that critics have already found wanting. Though EBM+ advocates have at times attempted to illustrate their view with case studies (Abdin et al 2019; Auker-Howlett and Wilde 2019), they do not consider the types of cases most central to the concerns expressed by critics (i.e., safety and efficacy judgments pertaining to market entry) 3 . Yet not all members of the EBM+ group are similarly acontextual in their advocacy for medical pluralism.…”

The use of mechanistic reasoning in assessing coronavirus interventions

“…Given this more nuanced picture of causal assessment, it can be important to explicitly and systematically scrutinize mechanistic studies when assessing causal claims. This need is now often recognized when assessing the effects of environmental exposures 4 but less so when assessing the effects of interventions 5,6 and of infectious diseases 7 …”

“…Given this more nuanced picture of causal assessment, it can be important to explicitly and systematically scrutinize mechanistic studies when assessing causal claims. This need is now often recognized when assessing the effects of environmental exposures 4 but less so when assessing the effects of interventions 5,6 and of infectious diseases. 7 In this paper, we aim to redress the balance by showing that there is a need to assess mechanistic studies explicitly and systematically when interrogating the effects of interventions in infections with coronaviruses.…”