Medical Nihilism

by Jacob Stegenga

Overview

This book argues that if we consider the ubiquity of small effect sizes in medicine, the extent of misleading evidence in medical research, the thin theoretical basis of many interventions, and the malleability of empirical methods, and if we employ our best inductive framework, then our confidence in medical interventions ought to be low.

Product Details

ISBN-13:	9780191064104
Publisher:	OUP Oxford
Publication date:	03/08/2018
Sold by:	Barnes & Noble
Format:	eBook
Pages:	240
File size:	846 KB

About the Author

Jacob Stegenga is a Lecturer in the Department of History and Philosophy of Science at the University of Cambridge. He received a Ph.D. from the University of California San Diego, and he has held fellowships at the University of Toronto and the Institute of Advanced Study at Durham University. His research focuses on philosophy of science, including methodological problems of medical research, conceptual questions in evolutionary biology, and fundamental topics in reasoning and rationality.

Table of Contents

• 1: Introduction
• Part I. Concepts
• 2: Effectiveness of Medical Interventions
• 3: Effectiveness and Medicalization
• 4: Magic Bullets
• Part II. Methods
• 5: Down with the Hierarchies
• 6: Malleability of Meta-Analysis
• 7: Assessing Medical Evidence
• 8: Measuring Effectiveness
• 9: Hollow Hunt for Harms
• Part III. Evidence and Values
• 10: Bias and Fraud
• 11: Medical Nihilism
• 12: Conclusion
• Appendix 1. Bayes' Theorem and Screening
• Appendix 2. Measurement Scales
• Appendix 3. Epistemic Proof of Superiority of RD over RR
• Appendix 4. Decision-Theoretic Proof of Superiority of RD over RR
• Appendix 5. Modeling the Measurement of Effectiveness

Editorial Reviews

"Ultimately, medical nihilism is an important topic in healthcare today, and the present book is a significant addition to that topic, which deserves wide readership and engagement." — James A. Marcum, Theoretical Medicine and Bioethics

"a much needed call to temper our enthusiasm about the enterprise of medical therapy." — Mathew Mercuri, Metapsychology Online Reviews

"This book is philosophy with a bite. Should we trust medicine? Stegenga shows there is much to be sceptical of. This is a scary thesis, all the more so because Stegenga's arguments are persuasive and his accounts of the empirical facts seem fair and well balanced. The underlying problem that the book tackles in medicine -how to distinguish compelling science from chaff- is not only at the heart of philosophy of science but at the heart of every science. Here Stegenga shows how we can address this problem in a particular scientific context by understanding the fine details of research. This is first-rate philosophy applied to one of our most important sciences."—Nancy Cartwright, University of California San Diego & Durham University

"Jacob Stegenga's book is timely as it arrives when many doctors feel medicine is in crisis. We have become unsure what medicine is for and have over-reached ourselves; and despite the appearance of evidence-based medicine 20 years ago there is deep anxiety now about the quality and completeness of the evidence that underpins medicine. The best doctors, I believe, have always been medical nihilists, aware that many new interventions are oversold, but the depth and scope of this book can help doctors move beyond their present crisis."—Richard Smith, Former Chief Editor, BMJ

From the Publisher