Experimental Philosophy and Evidence Based Medicine: Two criticized ways of doing science

Stéphanie Van Droogenbroeck

Onderzoeksoutput: Meeting abstract (Book)


Short abstract
Experimental philosophy (EP) and evidence based medicine (EBM) are hot topics in the current philosophical and/or medical debates. They have both been criticized for several reasons. We will examine the methodological properties of EBM and EP. By doing so our first point will be made and it will become clear that some of the objections against them aren't grounded when we analyze what they exactly are and could be in practice. The second issue is taking the problem to a different level by showing the possibility of a cooperation of both disciplines in the light of narratives and qualitative research.

Extended abstract
Experimental philosophy (EP) and evidence based medicine (EBM) are two methodologies to solve a problem. The first one tries to answer the question of what people's intuitions are on philosophical issues by using empirical evidence. This is a standard definition on EP (Knobe and Nichols 2008). The second discipline is the integration of best research evidence with clinical expertise and patient values to find a correct diagnosis for a patient with some medical complaints. (Sackett et al. 2000)

To investigate the methodologies we need to know exactly what EBM and EP are; and what their purposes are. We will show that the major arguments on the two methodologies are not grounded. Two common arguments against EP and EBM are: (i) EP cannot be useful and (ii) EBM is a new positivistic account on diagnosing: (i) Knowing that a population has an intuition X instead of an intuition Y can be important for the policy makers. And knowing how most people come to knowledge can be the starting point of applied philosophical research. These are just two contra-arguments on the critique on EP. (ii) The critique on EBM that it is a purely positivistic account on medical diagnostics is not true when we analyze the standard definition of Sackett et al. (2000). Moreover it is not possible in our society that a physician neglects the clinical expertise and patient values. Ethical guidelines and the rising patient empowerment make it very hard for a doctor to neglect patient values. And diagnosing without clinical expertise would probably raise the amount of misdiagnoses. An experiment by Montgomery (2006) shows that young practitioners know that the more experienced/older physician, the better they become. On top of this everyone knows that physicians are not always calculating the probabilities a certain disease while diagnosing. When a GP has a patient with common symptoms of the flu, (s)he will just prescribe some rest and drugs for a flu. Another example that will be discussed is the ER physician who has only a very limited amount of time to decide which diagnosis is the right one.

By showing this, EP and EBM can be redefined; even in such a way that they become useful to each other. EBM can be approached as a way of handling medical information, diagnosing and treating whereby clinical expertise and patient values get a much larger role than in plenty of definitions on EBM that exist at this time. There are four possible stands on EBM: (1) it is magnificent and the idea is the only way of doing diagnostics, (2) it is positivistic, so the idea will be abandoned, (3) it is useful in several situations. The second stance (2) has already been falsified. Idea (1) is not workable in practice as unified theories that work in every situation are impossible due to the context-dependency. It is for example thinkable that the ER doctor is very busy and reacts in a purely experience related way without considering the latest research on a topic relevant for her/his patient. Stance (3) is the most pragmatic way of handling EBM and will be defended as we will show that it is the best available solution in the discussion on EBM. (1) and (2) both lead to an extreme view on EBM and are not desirable in medical practice. The definition on Sackett will be defended in a way that is described above.

EP can also be redefined. The definition of Knobe and Nichols can be extended to: trying to answer the question of what the people's intuitions are about philosophical issues by using quantitative and qualitative empirical evidence. The experiments done in EP are quantitative ones. These can give answers on how many people have a certain intuition on a philosophical idea. But what misses is qualitative research that can answer why-questions. Flyvbjerg (2001) shows that the social sciences must go back trying to answer why X is the case. EP uses quantitative social scientific methods, but neglects the qualitative possibilities, although philosophy in general is focused on why-questions. It will not be claimed that EP must always be on qualitative research, but an extension of EP can broaden the results of this kind of scientific research. And why is this so? By doing qualitative research the sample will be smaller than in situation of quantitative research, but it will deliver examples of why X is the case in practice. Examples on their turn can be used to get deeper insight in X. These insights are useful for the researchers of the sample, but can also be used by the population that has been investigated.

This brings us back to EBM. Physicians use their experience in medical practice and they teach their pupils experience knowledge. This is a indispensable element in becoming a physician. Learning by example is a major learning strategy and clinical internship plays an important role in it. The rising importance of narratives in medicine also shows the rising importance of experiential knowledge. This implies that EBM cannot be a way of doing science without being affected by personal experience- and even without being affected by the teacher's point of view on medicine and medical cases. This leads to the idea that qualitative research on learning by experience is an interesting starting point to do qualitative philosophical research on (i) knowledge gathering and (ii) processing- and more specific in the light of EBM. Plenty of philosophical theories exist on these last two elements, but they have not been investigated yet in the light of qualitative philosophical experimental research.
Originele taal-2English
Titel14th Congress of Logic, methodology and philosophy of science – Nancy
StatusPublished - 2011
EvenementUnknown -
Duur: 1 jan 2011 → …

Publicatie series

Naam14th Congress of Logic, methodology and philosophy of science – Nancy


Periode1/01/11 → …


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