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Broadening the scope of our understanding of mechanisms: lessons from the history of the morning-after pill

  • Christopher ChoGlueckEmail author
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Abstract

Philosophers of science and medicine now aspire to provide useful, socially relevant accounts of mechanism. Existing accounts have forged the path by attending to mechanisms in historical context, scientific practice, the special sciences, and policy. Yet, their primary focus has been on more proximate issues related to therapeutic effectiveness. To take the next step toward social relevance, we must investigate the challenges facing researchers, clinicians, and policy makers involving values and social context. Accordingly, we learn valuable lessons about the connections between mechanistic processes and more fundamental reasons for (or against) medical interventions, particularly moral, ethical, religious, and political concerns about health, agency, and power. This paper uses debates over the controversial morning-after pill (emergency contraception) to gain insight into the deeper reasons for the production and use of mechanistic knowledge throughout biomedical research, clinical practice, and governmental regulation. To practice socially relevant philosophy of science, I argue that we need to account for mechanistic knowledge beyond immediate effectiveness, such as how it can also provide moral guidance, aid ethical categorization in the clinic, and function as a political instrument. Such insights have implications for medical epistemology, including the value-laden dimensions of mechanistic reasoning and the “epistemic friction” of values. Furthermore, there are broader impacts for teaching research ethics and understanding the role of science advisors as political advocates.

Keywords

Mechanism Pharmacology Medical epistemology Therapeutic effectiveness Science and values Socially relevant philosophy of science 

Notes

Acknowledgements

I gave an earlier version of this paper at the 2017 International Society for History, Philosophy and Social Studies of Biology in Sao Paulo, Brazil, and received many helpful comments from the audience. Special thanks to Elisabeth Lloyd and Jutta Schickore for advice and support. Additional thanks to Robyn Bluhm, Sandy Gliboff, Kate Grauvogel, Nora Hangel, Bennett Holman, Ashley Graham Kennedy, Naomi Oreskes, Emanuele Ratti, David Teira, and two anonymous reviewers for helpful comments and engaging conversations.

Funding

This material is based upon work supported by the National Science Foundation Graduate Research Fellowship Program under Grant No. 1342962. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the author and do not necessarily reflect the views of the National Science Foundation.

Compliance with ethical standards

Conflict of interest

The author declares that he has no conflict of interest.

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© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Department of Communication, Liberal Arts, and Social SciencesNew Mexico Institute of Mining and TechnologySocorroUSA

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