Michael Loughlin

Evidence-based healthcare, clinical knowledge and the rise of personalised medicine

Professor of Public Health Education & Policy, Editor-in-Chief, Journal of Evaluation in Clinical Practice & National Director: UK Key Advances in Clinical Practice Series, Faculty of Medicine, Medical School, University of Buckingham, London Campus, UK Reader in Applied Philosophy, Manchester Metropolitan University, Cheshire, UK Consultant Medical Oncologist, Mount Vernon Hospital, Middlesex, UK

Models in the balance: evidence‐based medicine versus evidence‐informed individualized care

Editor-in-Chief, Journal of Evaluation in Clinical Practice, World Health Organisation Collaborating Centre for Public Health Education and Training, Imperial College London UK and Centre for Interdisciplinary Research and Intervention in Clinical Decision Making, University of Milan, Italy Reader in Applied Philosophy, Manchester Metropolitan University, and Visiting Professor in Philosophy applied to Medicine, University of Buckingham, England, UK

Philosophy, ethics, medicine and health care: the urgent need for critical practice

Reader in Applied Philosophy, Department of Interdisciplinary Studies, MMU Cheshire, Crewe, UK Director, University of Toronto Joint Centre for Bioethics, Toronto, Ontario, Canada Assistant Professor, Department of Philosophy, University of Guelph, Guelph, Ontario, Canada Assistant Professor, Department of Philosophy and Religious Studies, Old Dominion University, Norfolk, Virginia, USA Assistant Professor, Department of Philosophy, Dalhousie University, Halifax, Nova Scotia, Canada

Science, Practice and Mythology: A Definition and Examination of the Implications of Scientism in Medicine

Scientism is a philosophy which purports to define what the world ‘really is’. It adopts what the philosopher Thomas Nagel called ‘an epistemological criterion of reality’, defining what is real as that which can be discovered by certain quite specific methods of investigation. As a consequence all features of experience not revealed by those methods are deemed ‘subjective’ in a way that suggests they are either not real, or lie beyond the scope of meaningful rational inquiry. This devalues capacities that (we argue) are in fact essential components of good reasoning and virtuous practice. Ultimately, the implications of scientism for statements of value undermine value-judgements essential for science itself to have a sound basis. Scientism has implications, therefore, for ontology, epistemology and also for which claims we can assert as objective truths about the world. Adopting scientism as a world view will have consequences for reasoning and decision-making in clinical and other contexts. We analyse the implications of this approach and conclude that we need to reject scientism if we are to avoid stifling virtuous practice and to develop richer conceptions of human reasoning.

Reason and value: making reasoning fit for practice

Reader in Applied Philosophy, Department of Interdisciplinary Studies, MMU Cheshire, Crewe, UK Assistant Professor, Department of Philosophy and Religious Studies, Old Dominion University, Norfolk, VA, USA Associate Professor, Department of General Practice, University of Auckland, Auckland, New Zealand Director, University of Toronto Joint Centre for Bioethics, Toronto, ON, Canada Assistant Professor, Department of Philosophy, University of Guelph, Guelph, ON, Canada Assistant Professor, Department of Philosophy, Dalhousie University, Halifax, NS, Canada Professor of Values in Health Care, Associate Director, Social Dimensions of Health Institute, University of Dundee, Dundee, UK Research Fellow, King’s College Centre for Humanities and Health/Department of Philosophy; King’s College London, London, UK

Arguments at cross-purposes: moral epistemology and medical ethics

Different beliefs about the nature and justification of bioethics may reflect different assumptions in moral epistemology. Two alternative views (put forward by David Seedhouse and Michael H Kottow) are analysed and some speculative conclusions formed. The foundational questions raised here are by no means settled and deserve further attention.

Philosophy, freedom and the public good: a review and analysis of ‘Public Health Ethics’ Holland, S. (2007)

Keywords: autonomy; behaviour modification; bioethics; communitarianism; community; conceptual analysis; consequentialism; deontology; epidemiology; epistemology; ethics; evidence; health promotion; immunisation; Kant; liberalism; liberty; measurement; philosophy; principlism; public health; rationing; screening; underdetermination; utilitarianism; value; virtue ethics

Reasoning, evidence, and clinical decision-making: The great debate moves forward

When the editorial to the first philosophy thematic edition of this journal was published in 2010, critical questioning of underlying assumptions, regarding such crucial issues as clinical decision making, practical reasoning, and the nature of evidence in health care, was still derided by some prominent contributors to the literature on medical practice. Things have changed dramatically. Far from being derided or dismissed as a distraction from practical concerns, the discussion of such fundamental questions, and their implications for matters of practical import, is currently the preoccupation of some of the most influential and insightful contributors to the on-going evidence-based medicine debate. Discussions focus on practical wisdom, evidence, and value and the relationship between rationality and context. In the debate about clinical practice, we are going to have to be more explicit and rigorous in future in developing and defending our views about what is valuable in human life.

Philosophy, medicine and health care – where we have come from and where we are going

Professor of Applied Philosophy, Department of Interdisciplinary Studies, MMU Cheshire, Crewe, UK Associate Professor, Department of Philosophy and Religious Studies, Old Dominion University, Norfolk, VA, USA PhD student, Faculty of Medicine, University of Toronto, Toronto, ON, Canada Associate Professor, Department of General Practice, University of Auckland, Auckland, New Zealand Director, Department of Family and Community Medicine, University of Toronto Joint Centre for Bioethics, Toronto, ON, Canada Assistant Professor, Department of Philosophy, Dalhousie University, Halifax, NS, Canada Assistant Professor, Department of Philosophy, University of Guelph, Guelph, Ontario, Canada Senior Lecturer, Department of Philosophy, University of Southampton, Southampton, UK Socrates Professor in Philosophy and Technology, Technical University, Eindhoven, The Netherlands

Theory, experience and practice

Despite its potential hazards, the activity of questioning theoretical frameworks and proposing solutions is necessary if progress is even to be possible. Intellectual history has by no means ended, so we cannot expect to have all the answers, and from time to time the activity of critical questioning will be frustrating. But intellectual progress requires us to continue the process of asking fundamental questions. The alternative to thinking in this way is indeed unthinkable.