Evidence based or person centered? An ontological debate

Evidence based medicine (EBM) is under critical debate, and person centered healthcare (PCH) has been proposed as an improvement. But is PCH offered as a supplement or as a replacement of EBM? Prima facie PCH only concerns the practice of medicine, while the contended features of EBM also include methods and medical model. I here argue that there are good philosophical reasons to see PCH as a radical alternative to the existing medical paradigm of EBM, since the two seem committed to conflicting ontologies. This paper aims to make explicit some of the most fundamental assumptions that motivate EBM and PCH, respectively, in order to show that the choice between them ultimately comes down to ontological preference. While EBM has a solid foundation in positivism, or what I here call Humeanism, PCH is more consistent with causal dispositionalism. I conclude that if there is a paradigmatic revolution on the way in medicine, it is first of all one of ontology

Three dogmas of 'if'

In this paper I argue that a truth functional account of conditional statements ‘if A then B’ not only is inadequate, but that it eliminates the very conditionality expressed by ‘if’. Focusing only on the truth-values of the statements ‘A’ and ‘B’ and different combinations of these, one is bound to miss out on the conditional relation expressed between them. But this is not a flaw only of truth functionality and the material conditional. All approaches that try to treat conditionals as mere functions of their antecedents and consequents will end up in some sort of logical atomism where causal matters simply are reduced to the joint occurrence of A and B. What we need is a non-extensional approach to conditionals that can account for hypotheticality, potentiality, and dependency, none of which can be understood by looking to the antecedent or consequent per se

Conditionals and Truth Functionality

The material interpretation of conditionals is commonly recognized as involving some paradoxical results. I here argue that the truth functional approach to natural language is the reason for the inadequacy of this material interpretation, since the truth or falsity of some pair of statements ‘p’ and ‘q’ cannot per se be decisive for the truth or falsity of a conditional relation ‘if p then q’. This inadequacy also affects the ability of the overall formal system to establish whether or not arguments involving conditionals are valid. I also demonstrate that the Paradox of Indicative Conditionals does not actually involve a paradox, but instead contains some paralogistic elements that make it appear to be a paradox. The discussion of the paradox in this paper further reveals that the material interpretation of conditionals adversely affects the treatment of disjunctions. Much has been said about these matters in the literature that point in the same direction. However, there seems to be some reluctance against fully complying with the arguments against the truth functional account of conditionals, since many of the alternative accounts rely on the material conditional, or at least on an understanding of the conditional as a function of antecedent and consequent in a similar sense as the material conditional. My argument against truth functionality indicates that it may in general involve similar problems to treat conditionals as such functions, whether one deals with theories of truth, assertability or probability

Because you’ll find out anyway, your wife is having an affair - If and Because

In an explanation ‘y because x’, because can be used to express an explanatory relation between an explanandum ‘y’ and an explanans ‘x’. But because can also be used to express the speaker’s reason for uttering ‘y’. This difference will be elucidated by connecting it with the distinction between the at-issue dimension and the speaker dimension of meaning. There are also internal relations between if and because that can help us find and analyse different uses of because, and thus also different types of explanatory relations

Logic - a map of language?

This is the trial lecture for Anjum's doctoral defence in 2005 at University of Tromsø

Potencias como hacedores de verdad causales

[EN]Most theories of causation assume that it must involve some kind of necessity, or that the cause must be entirely sufficient for the effect. Others have already suggested that it should be possible to get a theory of causation from a theory of powers or dispositions. Such a project is far from complete but even here we find that the key point in a dispositional theory of causation has been lacking. This paper attempts to establish some of the most important principles of such a theory and in so doing turn the existing discussion in a new direction.[ES]La mayoría de las teorías de causación asumen que debe envolverse algún tipo de necesidad, o que la causa debe ser enteramente suficiente para el efecto. Otros ya han sugerido que debería de ser posible obtener una teoría de causación a partir de una teoría de poderes o disposiciones. Un proyecto tal está muy lejos de estar completo, pero incluso aquí encontramos que ha faltado el punto clave en una teoría dispositiva de causación. Este escrito intenta establecer algunos de los principios más importantes de una teoría tal, y al hacerlo inclina la discusión existente en una nueva dirección

Double prevention and powers

Does A cause B simply if A prevents what would have prevented B? Such a case is known as double prevention: where we have the prevention of a prevention. One theory of causation is that A causes B when B counterfactually depends on A and, as there is such a dependence, proponents of the view must rule that double prevention is causation.\u3cbr\u3e\u3cbr\u3eHowever, if double prevention is causation, it means that causation can be an extrinsic matter, that the cause and effect need not be connected by a continuous chain of events, that there can be causation by absence, and that there can be causation at a distance. All of these implications jar with strong intuitions we have about the nature of causation. There is, on the other hand, a theory of causation based on an ontology of real dispositions, where causation involves the passing around of powers. This theory in contrast entails that double prevention is not causation and, on this issue, it can claim a victory over the counterfactual dependence account

All men are animals: hypothetical, categorical, or material?

The conditional interpretation of general categorical statements like ‘All men are animals’ as universally quantified material conditionals ‘For all x, if x is F, then x is G’ suggests that the logical structure of law statements is conditional rather than categorical. Disregarding the problem that the universally quantified material conditional is trivially true whenever there are no xs that are F, there are some reasons to be sceptical of Frege’s equivalence between categorical and conditional expressions. Now many philosophers will claim that the material conditional interpretation of laws statements, dispositions ascriptions, or any causal claim is generally accepted as wrong and outdated. Still, there seem to be some basic logical assumptions that are shared by most of the participants in the debate on causal matters which at least stems from the traditional truth functional interpretation of conditionals. This is indicated by the vocabulary in the philosophical debate on causation, where one often speaks of ‘counterfactuals’, ‘possible worlds’ and ‘necessity’ without being explicit on whether or to what extent one accepts the logical-technical definition of these notions. To guarantee a non-Humean and non-extensional approach to causal relations, it is therefore important to be aware of the logical and metaphysical implications of the technical vocabulary. In this paper we want to show why extensional logic cannot deal with causal relations. Via a logical analysis of law-like statements ‘All Fs are Gs’ we hope to throw some new light on interrelated notions like causation, laws, induction, hypotheticality and modality. If successful, our analysis should be of relevance for a deeper understanding of any type of causal relations, whether we understand them to be laws, dispositions, singulars or categoricals

Conditional probability from an ontological point of view

This paper argues that the technical notion of conditional probability, as given by the ratio analysis, is unsuitable for dealing with our pretheoretical and intuitive understanding of both conditionality and probability. This is an ontological account of conditionals that include an irreducible dispositional connection between the antecedent and consequent conditions and where the conditional has to be treated as an indivisible whole rather than compositional. The relevant type of conditionality is found in some well-defined group of conditional statements. As an alternative, therefore, we briefly offer grounds for what we would call an ontological reading: for both conditionality and conditional probability in general. It is not offered as a fully developed theory of conditionality but can be used, we claim, to explain why calculations according to the RATIO scheme does not coincide with our intuitive notion of conditional probability. What it shows us is that for an understanding of the whole range of conditionals we will need what John Heil (2003), in response to Quine (1953), calls an ontological point of view