Explanatory pluralism in the medical sciences: Theory and practice
Tóm tắt
Explanatory pluralism is the view that the best form and level of explanation depends on the kind of question one seeks to answer by the explanation, and that in order to answer all questions in the best way possible, we need more than one form and level of explanation. In the first part of this article, we argue that explanatory pluralism holds for the medical sciences, at least in theory. However, in the second part of the article we show that medical research and practice is actually not fully and truly explanatory pluralist yet. Although the literature demonstrates a slowly growing interest in non-reductive explanations in medicine, the dominant approach in medicine is still methodologically reductionist. This implies that non-reductive explanations often do not get the attention they deserve. We argue that the field of medicine could benefit greatly by reconsidering its reductive tendencies and becoming fully and truly explanatory pluralist. Nonetheless, trying to achieve the right balance in the search for and application of reductive and non-reductive explanations will in any case be a difficult exercise.
Tài liệu tham khảo
Marcum, James A. 2008. Reflections on humanizing biomedicine. Perspectives in Biology and Medicine 51(3): 392–405.
Marcum, James A. 2008. An introductory philosophy of medicine: Humanizing modern medicine. New York: Springer.
Park, Alice. 2008. Lung cancer genes identified. Time, April 2. http://www.time.com/time/health/article/0,8599,1727161,00.html. Accessed 1 Jul 2010.
Hung, Rayjean J., James D. McKay, Valerie Gaborieau, et al. 2008. A susceptibility locus for lung cancer maps to nicotinic acetylcholine receptor subunit genes on 15q25. Nature 452: 633–637.
Thorgeirsson, Thorgeir E., Frank Geller, Patrick Sulem, et al. 2008. A variant associated with nicotine dependence, lung cancer and peripheral arterial disease. Nature 452: 638–642.
Amos, Christopher I., Xifeng Wu, Peter Broderick, et al. 2008. Genome-wide association scan of tag SNPs identifies a susceptibility locus for lung cancer at 15q25.1. Nature Genetics 40(5): 616–622.
Van Bouwel, Jeroen, and Erik Weber. 2008. A pragmatic defence of non-relativistic explanatory pluralism in history and social science. History and Theory 47: 168–182.
Van Fraassen, Bas. 1980. The scientific image. Oxford: Oxford University Press.
Vanderbeeken, Robrecht, and Erik Weber. 2002. Dispositional explanations of behavior. Behavior and Philosophy 30: 43–59.
Weber, Erik, and Robrecht Vanderbeeken. 2005. The functions of intentional explanations of actions. Behavior and Philosophy 33: 1–16.
Weber, Erik, and Jeroen Van Bouwel. 2002. Can we dispense with the structural explanation of social facts? Economics and Philosophy 18: 259–275.
Van Bouwel, Jeroen, and Erik Weber. 2002. Remote causes, bad explanations? Journal for the Theory of Social Behavior 32(4): 437–449.
Van Bouwel, Jeroen. 2004. Explanatory pluralism in economics: Against the mainstream? Philosophical Explorations 7(3): 299–315.
Pearce, Neil. 1996. Traditional epidemiology, modern epidemiology, and public health. American Journal of Public Health 86(5): 678–683.
Mitchell, Sandra, and Michael Dietrich. 2006. Integration without unification: An argument for pluralism in the biological sciences. The American Naturalist 168: S73–S79.
Mitchell, Sandra. 2009. Unsimple truths: Science, complexity and policy. Chicago: The University of Chicago Press.
Craver, Carl, and William Bechtel. 2007. Top-down causation without top-down causes. Biology and Philosophy 22: 547–563.
Craver, Carl. 2007. Explaining the brain: Mechanisms and the mosaic unity of neuroscience. Oxford: Oxford University Press.
Susser, Mervyn, and Ezra Susser. 1996. Choosing a future for epidemiology: I. Eras and paradigms. American Journal of Public Health 86(5): 668–673.
Brandt, A.M., and M. Gardner. 2000. Antagonism and accommodation: Interpreting the relationship between public health and medicine in the United States during the 20th century. American Journal of Public Health 90(5): 707–715.
Borrell-Carrió, Francesc, Anthony L. Suchman, and Ronald M. Epstein. 2004. The biopsychosocial model 25 years later: Principles, practice, and scientific inquiry. Annals of Family Medicine 2(6): 576–582.
Suls, Jerry, and Alex Rothman. 2004. Evolution of the biopsychosocial model: Prospects and challenges for health psychology. Health Psychology 23(2): 119–125.
Link, Bruce G., and Jo C. Phelan. 1995. Social conditions as fundamental causes of disease. Journal of Health and Social Behavior 35(extra issue): 80–94.
Cockerham, William C. 2007. Social causes of health and disease. Cambridge: Polity Press.
Bendelow, Gillian. 2009. Health, emotion and the body. Cambridge: Polity Press.
Diez-Roux, Ana V. 2007. Integrating social and biologic factors in health research: A systems view. Annals of Epidemiology 17(7): 569–574.
Shostak, Sara. 2003. Locating gene–environment interaction: At the intersections of genetics and public health. Social Science and Medicine 56: 2327–2342.
Strohman, Richard C. 2003. Genetic determinism as a failing paradigm in biology and medicine: Implications for health and wellness. Journal of Social Work Education 39(2): 169–191.
Chaufan, Claudia. 2007. How much can a large population study on genes, environments, their interactions and common diseases contribute to the health of the American people? Social Science and Medicine 65: 1730–1741.
Ahn, Andrew C., Muneesh Tewari, Chi-Sang Poon, and Russell S. Phillips. 2006. The limits of reductionism in medicine: Could systems biology offer an alternative? PLoS Medicine 3(6): 709–713.
McMichael, Anthony J. 1995. The health of persons, populations, and planets: Epidemiology comes full circle. Epidemiology 6(6): 633–636.
Susser, Mervyn. 1996. Choosing a future for epidemiology: II. From black box to Chinese boxes and eco-epidemiology. American Journal of Public Health 86: 674–677.
House, James S. 2002. Understanding social factors and inequalities in health: 20th century progress and 21st century prospects. Journal of Health and Social Behavior 43(2): 125–142.
Pearce, Neil. 2007. The rise and rise of corporate epidemiology and the narrowing of epidemiology’s vision. International Journal of Epidemiology 36: 713–717.
Fee, Elizabeth, and Nancy Krieger. 1993. Understanding AIDS: Historical interpretations and the limits of biomedical individualism. American Journal of Public Health 83(10): 1477–1486.
Smith, Timothy W., and John M. Ruiz. 2002. Psychosocial influences on the development and course of coronary heart disease: Current status and implications for research and practice. Journal of Consulting and Clinical Psychology 70(3): 548–568.
Vinetz, Joseph M., Bruce A. Wilcox, Alonso Aguirre, et al. 2005. Beyond disciplinary boundaries: Leptospirosis as a model of incorporating transdisciplinary approaches to understand infectious disease emergence. Ecohealth 2: 291–306.
Nassir Ghaemi, S. 2010. The rise and fall of the biopsychosocial model: Reconciling art & science in psychiatry. Baltimore: The John Hopkins University Press.
Hawthorne, Susan. 2007. ADHD drugs: Values that drive the debates and decisions. Medicine, Health Care and Philosophy 10: 129–140.
Nigg, Joel T. 2007. What causes ADHD? Understanding what goes wrong and why. New York: The Guilford Press.
Searight, H. Rusell and A. Lesley McLaren. 1998. Attention deficit hyperactivity disorder: The medicalization of misbehavior. Journal of Clinical Psychology in Medical Settings 5: 467–495.
Cooper, Paul. 2001. Understanding AD/HD: A brief critical review of literature. Children and Society 15: 387–395.
Scheidt, Stephen. 2000. The current status of heart–mind relationships. Journal of Psychosomatic Research 48: 317–320.
Conrad, Peter. 1975. The discovery of hyperkinesis: Notes on the medicalization of deviant behavior. Social Problems 23(1): 12–21.
Gannett, Lisa. 1999. What’s in a cause? The pragmatic dimensions of genetic explanations. Biology and Philosophy 14(3): 349–374.
Eide, Brock L., and Fernette F. Eide. 2006. The mislabeled child. The New Atlantis 12: 46–59.
Hedgecoe, Adam. 1998. Geneticization, medicalisation and polemics. Medicine, Health Care and Philosophy 1: 235–243.
Bancroft, John. 1974. Deviant sexual behaviour: Modification and assessment. Oxford: Clarendon.
Dekkers, Wim, and Marcel Olde Rikkert. 2006. What is a genetic cause? The example of Alzheimer’s disease. Medicine, Health Care and Philosophy 9: 273–284.
Verlinsky, Yury, Svetlana Rechitsky, Oleg Verlinsky, Christina Masciangelo, Kevin Lederer, and Anver Kuliev. 2002. Preimplantation diagnosis for early-onset Alzheimer disease caused by V717L mutation. Journal of the American Medical Association 287: 1018–1021.
Tuszynski, Mark H. 2007. Nerve growth factor gene delivery: Animal models to clinical trials. Developmental Neurobiology 67(9): 1204–1215.
Waters, C. Kenneth. 2007. Molecular genetics. In The Stanford encyclopedia of philosophy. http://plato.stanford.edu/. Accessed 1 Jul 2010.
Waters, C. Kenneth. 2006. A pluralist interpretation of gene-centered biology. In Scientific pluralism vol. XIX of Minnesota studies in the philosophy of science, ed. Stephen H. Kellert, Helen E. Longino, and C. Kenneth Waters. Minneapolis: University of Minnesota Press.
Keller, Evelyn Fox. 2000. Century of the gene. Cambridge, MA: Harvard University Press.