Abstract

At least historically, it was common for medical practitioners to believe causal hypotheses on the basis of standalone mechanistic reasoning. However, it is now widely acknowledged that standalone mechanistic reasoning is insufficient for appropriately believing a causal hypothesis in medicine, thanks in part to the so-called problem of masking. But standalone mechanistic reasoning is not the only type of mechanistic reasoning. When exactly then is it appropriate to believe a causal hypothesis on the basis of mechanistic reasoning? In this paper, I argue that it has proved difficult to provide a satisfying answer to this question. I also argue that this difficulty is predicted by recent work in knowledge-first epistemology. I think this shows that recent work in epistemology has important implications for practice in the philosophy of science. It is therefore worth paying closer attention in the philosophy of science to this recent work in knowledge-first epistemology.

Highlights

  • At least historically, it was common for medical practitioners to believe causal hypotheses on the basis of standalone mechanistic reasoning

  • I argue that it has proved difficult to provide a satisfying answer to the following principal question: When is it appropriate to believe a causal hypothesis on the basis of mechanistic reasoning? I maintain that this difficulty is predicted by recent work in knowledge-first epistemology (Williamson 2000)

  • It is not possible to provide a satisfying answer to the principal question

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Summary

Introduction

It was common for medical practitioners to believe causal hypotheses on the basis of standalone mechanistic reasoning. After believing the causal hypothesis on the basis of such standalone mechanistic reasoning, it remains possible that the intervention does not make the relevant overall difference to the health outcome, because it remains possible that there exists some masking mechanism by which the intervention cancels out any difference made by way of the particular established mechanism. Some other type of mechanistic reasoning may yet be sufficient for appropriately believing a causal hypothesis, as long as that reasoning satisfies additional constraints to standalone mechanistic reasoning

High‐quality mechanistic reasoning
Knowledge‐first epistemology
Conclusion
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