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Synthese

, Volume 196, Issue 11, pp 4363–4390 | Cite as

Philosophers on drugs

  • Bennett HolmanEmail author
S.I.: Medical Knowledge

Abstract

There are some philosophical questions that can be answered without attention to the social context in which evidence is produced and distributed. Abstracting away from social context is an excellent way to ignore messy details and lay bare the underlying structure of the limits of inference. Idealization is entirely appropriate when one is essentially asking: In the best of all possible worlds, what am I entitled to infer? Yet, philosophers’ concerns often go beyond this domain. As an example I examine the debate on mechanistic evidence and then reevaluate a canonical case study in this debate. I show that for the assessment of actual evidence, produced in a world that is far from ideal, omission of the social aspects of medical epistemology (e.g. commercial drivers of medical research) leads philosophers to draw the wrong lessons from cases they take as paradigmatic cases for their views. I close by arguing that social epistemology provides an avenue to incorporate these complications and provides the necessary framework to understand medical evidence.

Keywords

Medical epistemology Social epistemology Industry-funded science Mechanistic evidence Russo–Williamson thesis 

Notes

Acknowledgements

Drafts of this paper have been circulating for four years now, which has left me with a long list of people who have each made it incrementally better. I am particularly grateful for the feedback and comments of Jeff Barrett, Nancy Cartwright, Sir Iain Chalmers, Christopher ChoGlueck, Joseph Gabriel, Manuela Fernández Pinto, Jonathan Fuller, Timothy Fuller, Phillip Holman, Mark Robinson, Kyle Stanford, Jacob Stegenga, and David Teira. I also benefitted from the audiences at SRPoiSE 2015, Medical Knowledge in a Social World, the Cologne Medical Epistemology Workshop, and the EBM+ consortium at the University of College London, especially from the helpful comments of Heather Douglas, Joyce Havstad, Miriam Solomon, Sven Bernecker, Brendan Clarke, Phyllis Illari, and Jon Williamson. I am also thankful for the opportunity afforded to me by Richard Price to hold a trial run of a “mega session” with a final draft of this paper on academia.edu and for the many thoughtful comments and corrections to embarrassing mistakes it received as a result. Though I reached out to her as a stranger, Dawn Altman was tremendously kind with her time, looking through her vast collection of images to locate the strip used in Fig. 3. Finally, I wish to thank the two anonymous reviewers for their extremely helpful referee reports and especially for their encouragement to elaborate a positive view, which now appears as Sect. 6. All remaining errors remain my own.

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© Springer Nature B.V. 2017

Authors and Affiliations

  1. 1.History and Philosophy of Science, Underwood International CollegeYonsei UniversitySeoulKorea

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