Miriam Solomon

Epistemological reflections on the art of medicine and narrative medicine.

This article challenges the widespread view that there is both a science and an art of medicine. Through examination of recent work in medical humanities —Jodi Halpern’s From Detached Concern to Empathy (2001), Kathryn Montgomery’s How Doctors Think (2006), and Rita Charon’s Narrative Medicine (2006)—I argue that while a variety of epistemic techniques are important in medicine, it is not helpful to dichotomize them as “science” versus “art.” I assess the epistemic strengths and weaknesses of narrative medicine, a recent exemplar of humanistic medicine.

Legend naturalism and scientific progress: An essay on Philip Kitcher's: The advancement of science

Abstract Philip Kitchers The Advancement of Science sets out, programmatically, a new naturalistic view of science as a process of building consensus practices. Detailed historical case studies—centrally, the Darwinian revolutio—are intended to support this view. I argue that Kitchers expositions in fact support a more conservative view, that I dub ‘Legend Naturalism’. Using four historical examples which increasingly challenge Kitchers discussions, I show that neither Legend Naturalism, nor the less conservative programmatic view, gives an adequate account of scientific progress. I argue for a naturalism that is more informed by psychology and a normative account that is both more social and less realist than the views articulated in The Advancement of Science .

Socially Responsible Science and the Unity of Values

Many philosophers of science in the “science and values” community claim that the ethical and the epistemic are intertwined. This paper explores how Kouranys “thorough integration” of science and values relates to other normative accounts, and presents some reservations about how thoroughly integrated science and values should be.

Naming Migraine and Those Who Have It

Medical language has implications for both public perception of and institutional responses to illness. A consensus panel of physicians, academics, advocates, and patients with diverse experiences and knowledge about migraine considered 3 questions: (1) What is migraine: an illness, disease, syndrome, condition, disorder, or susceptibility? (2) What ought we call someone with migraine? (3) What should we not call someone with migraine? Although consensus was not reached, theresponses were summarized and analyzed quantitatively and qualitatively. Panelists participated in writing and editing the paper. The panelists agreed that “migraine,” not “migraine headache,” was generally preferable, that migraine met the dictionary definition for each candidate moniker, terms with psychiatric valence should be avoided, and “sufferer” should be avoided except in very limited circumstances. Overall, while there was no consensus, “disease” was the preferred term in the most situations, and illness the least preferred. Panelists disagreed strongly whether one ought to use the term “migraineur” at all or if “person with migraine” was preferable. Panelists drew upon a variety of principles when considering language choices, including the extent to which candidate monikers could be defended using biomedical evidence, the cultural meaning of the proposed term, and the context within which the term would be used. Panelists strove to balance the need for terms to describe the best science on migraine, with the desire to choose language that would emphasize the credibility of migraine. The wide range of symptoms of migraine and its diverse effects may require considerable elasticity of language.

Medication adaptation headache.

The purpose of this editorial is to challenge the choice of the term ‘medication overuse headache’ (MOH). MOH is not a new concept, but the name remains controversial. Although it is an improvement on previous labels such as ‘drug abuse headache’ and ‘rebound headache’, there is still more work to be done. Our criticisms of the portrayal of MOH are scientific and, broadly speaking, moral. We survey possible terms and their implications and make a recommendation. A recent review article states that MOH is ‘an avoidable disorder’ (1). The current diagnostic criteria (International Classification of Headache Disorders, second edition, 2004 [ICHD-2]) are:

On ways of knowing in medicine

Evidence-based medicine, translational medicine, narrative medicine, personalized medicine and precision medicine are all specially coined terms that have been used to herald new ways of knowing in medicine. I have listed the terms in chronological order, with evidence-based medicine starting around

Responses to Critics

In this paper I respond to the criticisms of Helen Longino, Alan Richardson, Naomi Oreskes and Sharyn Clough. There is discussion of the character of social knowledge, the goals of scientific inquiry, the connections between Social Empiricism and other approaches in science studies, productive and unproductive dissent, and the distinction between empirical and nonempirical decision vectors.

The Whiptail Lizard Reconsidered

Harry Collins and Trevor Pinchs introductory text, The Golem: What Everyone Should Know About Science (1993), includes a controversy about the significance of pseudosexual behavior in the parthenogenetic whiptail lizard. Collins and Pinch, basing their account on the work of Greg Myers (1990), claim that in this area of biology, experiments are seldom possible and that the debate has battled to an honorable draw. I argue that a closer look at the publications of the scientists involved shows that, at least by the late 1980s, it was widely accepted that pseudosexual behavior is important for reproduction in these lizards. Moreover, a variety of experiments, as well as laboratory and field observations, proved decisive in this acceptance.

Naturalism and generality

Abstract Naturalistic epistemologists frequently assume that their aim is to identify generalities (i.e. general laws) about the effectiveness of particular reasoning processes and methods. This paper argues that the search for this kind of generality fails. Work that has been done thus far to identify generalities (e.g. by Goldman, Kitcher and Thagard) overlooks both the complexity of reasoning and the relativity of assessments to particular contexts (domain, stage and goal of inquiry). Examples of human reasoning which show both complexity and contextuality are given. The paper concludes with a discussion of the kind of multivariate model of reasoning that naturalistic epistemologists can use to evaluate processes and methods for specific domains.