Evidence based medicine. What evidence, whose medicine, and on what basis?

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Rani Lill Anjum

The evidence-based medicine movement was intended as a methodological revolution. Its proponents suggested the best way to establish the effectiveness of treatment and new criteria to choose between available treatments without bias. Philosophically, however, these changes were not so innocent, at least not ontologically speaking. In bringing itself closer to science, medicine has become less suitable for dealing with complex illnesses, individual variations and, as I will argue, with causation in general. Continue reading “Evidence based medicine. What evidence, whose medicine, and on what basis?”

Capturing the Colour: Classification and its Consequences

Author Eivind Hasvik
(#5 in the Whole Person reflections series)

Gazing through my window, I’m enriched by a muted but beautiful December twilight-palette. The remains of autumn covered by a thin layer of snow. It’s said that every culture has its own sense of the different hues. I’m reading a beautiful passage in White by Kenya Hara about the traditional Japanese way of naming colours. Contrary to the modern way of categorizing a given spectrum of light, such as greens, magentas or yellows, it’s said that red, blue, white and black were the only basic colour adjectives in 8th century Japan. The tradition was not to classify, but to describe and texturize, capturing the seasons and surroundings. This narrative heritage is beautifully documented in the book The traditional colours of Japan.

I’m imagining a metaphorical link from all this to the difficulties of describing experience—sensations, emotions, pain or pleasure. Continue reading “Capturing the Colour: Classification and its Consequences”

Glasses and Blind Spots: Through the Eyes of a Tester

Author Wenche Schrøder Bjorbækmo
(#4 in the Whole Person reflections series)

The test’s glasses and blind spots – seen through the confession and experience of a tester. Continue reading “Glasses and Blind Spots: Through the Eyes of a Tester”

Does your regular GP know you – as a person? And if so, does it matter?

Written by Bente Prytz Mjølstad
(#3 of the Whole Person reflections series)

Have you ever thought about whether your regular GP knows more about you than your blood pressure or cholesterol levels? If so, might such knowledge be of any medical relevance?

Most of us visit our regular GP once or twice a year for more or less trivial complaints, and you are probably most interested in the GPs medical skills, and not so concerned about whether the doctor knows you as person or not. However, if you got seriously ill or had a chronic illness, would it still not matter? Continue reading “Does your regular GP know you – as a person? And if so, does it matter?”

CauseHealth workshop N=1 is now a section in JECP special issue.

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The Journal of Evaluation in Clinical Practice has dedicated a section of its latest special issue to collect seven contributions which were previously presented in the CauseHealth workshop N=1. A further contribution from the same workshop was published by the same journal last year. Continue reading “CauseHealth workshop N=1 is now a section in JECP special issue.”

What if…

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Author Anna Luise Kirkengen
(#2 of the Whole Person reflections series)

What if one would weave a text by means of threads coloured by the recent topics of the on-going CauseHealth project. One thread would be causality, and how it is understood and applied in current biomedicine. Another would be ontology in the sense of how a human being and the human body is conceptualised in medicine and how this concept underpins the Western health care systems. A third thread would be methodology, and how the predominant methods for knowledge production, group based, randomised trials often including thousands of patients, might be radically challenged by the concept of N=1. A fourth thread would be stories in the sense of biographies before a person fell ill, and stories in the sense of testimonies of being ill – and how these have been systematically avoided as possible source of contamination in medical knowledge production. A fifth thread would then be knowledge condensates as these have grown both in number and normativity in the shape of clinical guidelines in all medical specialties during the latest years. Together, these threads can form quite different pictures, dependent on the frame applied. Continue reading “What if…”

What is the Guidelines Challenge?

Rani Lill Anjum

CauseHealth recently organised a conference in Oxford called The Guidelines Challenge: Philosophy, Practice, Policy.

For those who missed the event, podcasts of the talks are available on our YouTube channel, and there is also a summary from each of the two days on Storify (day 1, day 2). There is also a Twitter hashtag, #GuidelinesChallenge.
Continue reading “What is the Guidelines Challenge?”

Philosophy of Pharmacology Symposium at ECAP9 (LMU Munich, Aug 2017)

WP_20170822_16_24_14_Pro_LIPart of the CauseHealth team went to ECAP9 and spoke about why deep understanding of causation, mechanisms and the local context is essential for drug safety. We were also excited to be in a session with Ralph Edwards, former Director of the Uppsala Monitoring Centre for drug safety, which acts as the official advisor for the World Health Organisation (WHO). Thanks for having us, Barbara!

rpoellinger's avatarPhilPharm: Safety, Statistical Standards, and Evidence Amalgamation

The symposium “Philosophy of Pharmacology: Theoretical Foundations, Methodological Evolution, and Public Health Policy” took place at LMU Munich on 22 August, 2017, as part of the Ninth Congress of Analytic Philosophy  (ECAP9) of the European Society of Analytic Philosophy (ESAP). The congress was jointly organized by Barbara Osimani, Jürgen Landes, and Roland Poellinger. The program featured contributions by four speakers:

  1. Barbara Osimani (Ancona / LMU)
  2. Rani Lill Anjum (Norwegian University)
  3. Elena Rocca (Norwegian University)
  4. Ralph Edwards (Uppsala Monitoring Centre of the World Health Organization)

At the overlap of philosophy and health science, this symposium offered a panorama of the complex network of interests found in pharmacology (financial, reputational etc.) as well as the scientific and social ecosystem in which pharmacology is embedded. A special focus was on current debates regarding 1) standards for evidence evaluation, 2) methodological evolution, and 3) pragmatics as well as epistemic asymmetry of causal assessment of risk…

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New CauseHealth paper about risk assessment of genetically modified plants

by Elena Rocca

One idea promoted by CauseHealth is that, when evaluating evidence, pre-existing theoretical frameworks count as much as the data. For instance, data from a certain trial assume a particular significance depending on the general background theoretical understanding we have when we interpret them. In this new CauseHealth article, Elena Rocca and Fredrik Andersen show that, when evaluating health risks related to the use of genetically modified plants in agriculture, different ontological starting points play an essential role for the final risk evaluation. Continue reading “New CauseHealth paper about risk assessment of genetically modified plants”

Imagination and its Companions

Author Brian Broom
(#1 of the Whole Person reflections series)

How is it possible to be whole person-oriented and still feel that our work is manageable? Surely, we can’t be all things to all people? Continue reading “Imagination and its Companions”