What kinds of evidence reliably support predictions of effectiveness for health and social care interventions? There is increasing reliance, not only for health care policy and practice but also for more general social and economic policy deliberation, on evidence that comes from studies whose basic logic is that of JS Mill's method of difference. These include randomized controlled trials, case–control studies, cohort studies, and some uses of causal Bayes nets and counterfactual-licensing models like ones commonly developed in econometrics. The topic (...) of this paper is the 'external validity' of causal conclusions from these kinds of studies. We shall argue two claims. Claim, negative: external validity is the wrong idea; claim, positive: 'capacities' are almost always the right idea, if there is a right idea to be had. If we are right about these claims, it makes big problems for policy decisions. Many advice guides for grading policy predictions give top grades to a proposed policy if it has two good Mill's-method-of difference studies that support it. But if capacities are to serve as the conduit for support from a method-of-difference study to an effectiveness prediction, much more evidence, and much different in kind, is required. We will illustrate the complexities involved with the case of multisystemic therapy, an internationally adopted intervention to try to diminish antisocial behaviour in young people. (shrink)

Global scarcity of COVID-19 vaccines raises ethical questions about their fair allocation between nations. Section I introduces the question and proposes that wealthy nations have a duty of justice to share globally scarce COVID-19 vaccines. Section II distinguishes justice from charity and argues that beneficiaries of unjust structures incur duties of justice when they are systematically advantaged at others expense. Section III gives a case-based argument describing three upstream structural injustices that systematically advantaged wealthy countries and disadvantaged poorer countries, contributing (...) to global disparities of COVID-19 vaccines. Section IV examines more closely the duties of justice owed, including a duty to relinquish holdings, restitute victims, and restore relationships. Section V concludes that wealthy nations have a duty of justice to share COVID-19 vaccines with poor nations and to restore relationships damaged by injustice. All nations should take steps to transform unjust structures. (shrink)

This chapter gives a concrete example of a question of current scientific interest where capacities matter: ‘Do the Bell inequalities describing Einstein–Podolsky–Rosen experiments show that causality is incompatible with quantum mechanics?’ The question cannot be answered if we rely on probabilistic theories of causality and laws of associations alone. It takes the concept of capacity and related notions of how capacities operate even to formulate the problem correctly. Econometrics models with correlated errors, it is shown, can explain the EPR results (...) when the correlations are given a capacity interpretation. (shrink)

There is a takeover movement fast gaining influence in development economics, a movement that demands that predictions about development outcomes be based on randomized controlled trials. The problem it takes up—of using evidence of efficacy from good studies to predict whether a policy will be effective if we implement it—is a general one, and affects us all. My discussion is the result of a long struggle to develop the right concepts to deal with the problem of warranting effectiveness predictions. Whether (...) I have it right or not, these are questions of vast social importance that philosophers of science can, and should, help answer. (shrink)

Should you wash your hands? -- Are workarounds ethical? -- Turfing, bending, and gaming -- Dirty hands and the semiclear conscience -- Problems of humanity -- Ethics without heroics : foreseeing moral problems in complex systems.

Causation is in trouble—at least as it is pictured in current theories in philosophy and in economics as well, where causation is also once again in fashion. In both disciplines the accounts of causality on offer are either modelled too closely on one or another favoured method for hunting causes or on assumptions about the uses to which causal knowledge can be put—generally for predicting the results of our efforts to change the world. The first kind of account supplies no (...) reason to think that causal knowledge, as it is pictured, is of any use; the second supplies no reason to think our best methods will be reliable for establishing causal knowledge. So, if these accounts are all there is to be had, how do we get from method to use? Of what use is knowledge of causal laws that we work so hard to obtain? (shrink)

Pluralism is usually opposed to realism. This paper argues that the two come naturally into conflict only given a third assumption-imperialism, i.e., the doctrine that some one, or some handful, of our favourite theories are universal. This paper attempts to show why that assumption is implausible, even in the case of fundamental theories in physics. It argues first that physics theories are true only in their models: for the most part the successes of a theory are confined to situations that (...) resemble the models. Second it argues specifically for the possibility of peaceful co-existence between quantum and classical physics. (shrink)

A good many models used in physics and economics offer descriptions of imaginary situations, using a combination of mathematics and natural language. The descriptions are both thin - not much about the situation is filled in - and unrealistic - what is filled in is not true of many real situations. Yet we want to use the results of these models to inform our conclusions about a range of actually occurring situations. I propose we interpret many of these models as (...) fables. The actual happenings in the model are only one concrete instantiation of a lesson that is more widely applicable ‘when expressed in more abstract language.' A fable generally comes with the abstract lesson attached; parables, by contrast, usually require an interpretation from outside. Models, then, tend to be more like parables than fables. The right abstract interpretation is not supplied by the model itself. The central problem, then, is where shall it come from? (shrink)

What is commonly called Reichenbach’s “Principle of the Common Cause” is not a general criterion for a common cause, as many philosophers nowadays suppose. Examples include W. Salmon in his accounts of causal processes and Bas van Fraassen in his new book on quantum mechanics, in which he argues that the quantum world has no causal structure. This does not matter for Reichenbach’s purposes. Indeed it should not be surprising from his point of view that in different situations we need (...) different criteria or different methods for testing for the same phenomenon. The third thesis begins from a question: Where do probabilistic criteria for causality come from? (shrink)

Knowledge of causal laws is expensive and hard to come by. But we work hard to get it because we believe that it will reduce contingency in planning policies and in building new technologies: knowledge of causal laws allows us to predict reliably what the outcomes will be when we manipulate the factors cited as causes in those laws. Or do they? This paper will argue that causal laws have no special role here. As economists from JS Mill to Robert (...) Lucas and David Hendry stress, along recently with philosophers like James Woodward and Sandra Mitchell, they can do the job only if they are invariant under the manipulations proposed. But then, I shall argue, anything that is invariant under the proposed manipulations will do this job equally well. There seems to be nothing special about causal-law knowledge in and of itself that makes it particularly valuable for policy and technology prediction. What seems to matter is invariance alone, not causality. But what guarantees invariance and how do we know when it will obtain? Here certain kinds of causal laws do have a special place – those underwritten either by what I have called ‘nomological machines’ or by what I have called ‘capacities’. Capacities and nomological machines have a double virtue that makes them invaluable for policy planning. First, the causal laws they give rise to will be invariant so long as they obtain; and second, they typically have visible markers we can come to recognize that tell us when they obtain. The markers for nomological machines are shakier than those for capacities, though, since capacities are often tied to markers by well-established empirical laws. Capacities have their own drawback however, which is the final topic of this paper: the causal laws that are guaranteed by a capacity connect the obtaining (or triggering) of a capacity with its exercise. But Hume argued (mistakenly I suggest) that no distinction can be made between the obtaining of a power and its exercise. (shrink)

People who lack decision‐making capacity may be able to communicate preferences, which can and should inform surrogate decision‐making on their behalf. It is unclear whether making a further distinction about “capacity for preferences,” as Jason Wasserman and Mark Navin propose in this issue of the Hastings Center Report, would improve the process of surrogate decision‐making. Anyone who is regularly involved in surrogate decision‐making or who has worked to articulate decision‐making standards and processes can think of cases in which a patient's (...) voice was ignored or his or her preferences and ability to communicate them overlooked. However, we can also think of cases in which it was unclear whether information provided by a patient, recently or in the past, should have been characterized as a preference relevant to a medical decision that the patient lacked the capacity to make. We should also recognize that clear preferences of a patient who lacks decision‐making capacity may conflict with the limits of another person or of a family's resources such that these preferences cannot guide a surrogate's decision. This patient will not get what he wants. A situation in which preferences are known and make sense but cannot be applied in a feasible way demonstrates the limits of the medical decision‐making framework concerning care that is not covered by medical insurance. (shrink)

An underlying assumption of default-interventionist dual-process theory (DI-DPT) of reasoning is that humans tend to act as cognitive misers. Although miserly cognitive processing occurs when indiv...

Empiricism has traditionally been concerned with two questions: What is the source of our concepts and ideas? and How should claims to empirical knowledge be judged? The empiricist answer to the first question is ‘From observation or experience.’ The concern in the second question is not to ground science in pure observation or in direct experience, but rather to ensure that claims to scientific knowledge are judged against the natural phenomena themselves. Questions about nature must be settled by nature — (...) not by faith, nor metaphysics, nor mathematics, and not by convention or convenience either. From Francis Bacon to Karl Popper empiricists have wanted to police the methods of scientific enquiry. (shrink)

In addition to the notion of causal law, the concept of capacity, modelled on Mill's notion of tendency, is required to make sense of standard methods in econometrics and standard accounts of probabilistic causality. General causal claims are shown to be ascriptions of capacities while causal laws are local causal claims, relative to a test population. Capacities are at a higher level of modality and are not reducible to causal laws, as causal laws are not reducible to laws of association (...) that describe mere regularities; but unlike laws of association, capacities are real. (shrink)