Jon Williamson, Professor of Reasoning, Inference and Scientific Method in the Department of Philosophy, will engage in a debate at the University of Oxford on Monday 27 March 2017, entitled ‘Are Mechanisms Required to Establish Treatment Effects?’
An enduring debate in the history of medicine exists between people who believe that we need to know how a treatment works in order to know that it works and those who believe that careful observation is enough. Celus (25 BC-50 CE) reported differences between ‘Empirics’ (who held that careful observations are enough), and ‘Dogmatics’ (who insisted that we need to understand the underlying causes and mechanisms). Centuries later, Roger Bacon (c.1266 CE) de-emphasised the role of understanding mechanisms and causes, while Descartes (1596 CE-1650 CE) believed that things in the world – including humans – are machines so we need to understand mechanisms to diagnose and treat patients.
More recently, a ‘new mechanical philosophy’ has emerged, with some philosophers of science arguing that unless we have evidence of a mechanism that a treatment works, we do not know whether it works. This philosophical view is opposed to a view commonly held by proponents of Evidence-Based Medicine (EBM) who point out many historical cases ranging from lemons to cure scurvy to aspirin for reducing cancer incidence where we have no idea what the mechanism is yet we believe we know the treatments work.
To be sure, proponents of mechanisms are not against careful observations, they just don’t believe these are enough. Likewise, proponents of EBM do not deny that there are mechanisms or that they can be important, they just don’t think mechanistic evidence is required.
In an epic attempt to resolve this long-standing debate, Jon will argue that we do need to have evidence of mechanisms in order to prove treatments work, while Dr Jeremy Howick (University of Oxford) will argue that, while evidence of mechanisms can be useful, they are not required to establish that a treatment works. The session will be moderated by Professor Jeffrey Aronson (University of Oxford).
This is a free event and members of the public are welcome. To book, please see the page here: www.eventbrite.co.uk/e/debate-are-mechanisms-required-to-establish-treatment-effects-tickets-29574528210