Johannes Persson

Isaac Levi is more interested in inquiry and how it progresses than he is in metaphysics. Questions concerning the role of disposition predicates in inquiry are more central to him than those concerning the nature and reality of dispositions. It has not stopped him from giving me and others very useful metaphysical advice. Currently, where empirical metaphysics is in vogue, there is every reason to see whether the two forms of philosophical interest might interlock substantially. Levi has stimulating ideas indeed on the two forms of philosophical interest, and has recently summarized them in the slogan: “The reality of dispositions is a work in progress”. We can learn much about what kinds of dispositions are acceptable from tracing and comparing the histories of successful and less successful disposition predicates in scientific inquiry. Levi explores one route along which dispositions become real. His idea is that the introduction of dispositions facilitates covering law explanation by increasing the number of laws. The successful disposition predicate eventually becomes integrated in scientific theory, much like an ordinary theoretical term, whereas the unsuccessful does not. My impression is that Levi thinks that this is the only way a disposition can become real. To evaluate this claim, an alternative course suggested by Jon Elster is introduced. I then try to bring out the differences between Levi's and Elster's views on dispositions, partly by suggesting that they resemble two aspects of full explanations discussed by Wesley Salmon. But more about that below

BACKGROUND: Representing is about theories and theory formation. Philosophy of science has a long-standing interest in representing. At least since Ian Hacking's modern classic Representing and Intervening analytical philosophers have struggled to combine that interest with a study of the roles of intervention studies. With few exceptions this focus of philosophy of science has been on physics and other natural sciences. In particular, there have been few attempts to analyse the use of the notion of intervention in other disciplines where intervention studies are important, such as in nursing research. One unintended consequence of this is that the relations between representing and intervening tend to be less understood outside the natural sciences. OBJECTIVES AND DESIGN: This article highlights a number of possible topics on which nursing science and analytic philosophy of science can fruitfully interact. The basic idea is simple. Building on a characterisation of interventions in terms of what is intervened on and with respect to what, we suggest that interventions in nursing research typically are a blend of varieties belonging to the three dimensions of agency, epistemology, and ontology. The details of the blend determine the relation of the particular intervention study to traditional representational categories such as inductivism and hypothetico-deductive method, and have a bearing on its explanatory power and other more theory independent features of research as well. The framework we suggest should be relevant for nurse researchers who want to adopt a more general and analytically entrenched perspective on representing and intervening than the methodological boundaries in nursing research typically allow

A key question for evidence-based medicine is how best to model the way in which EBM should‘[integrate] individual clinical expertise and the best external evidence’. We argue that the formulations and models available in the literature today are modest variations on a common theme and face very similar problems when it comes to risk analysis, which is here understood as a decision procedure comprising a factual assessment of risk, the risk assessment, and the decision what to do based on this assessment, the risk management. Both the early and updated models of evidence-based clinical decisions presented in the writings of Haynes, Devereaux and Guyatt assume that EBM consists of, among other things, evidence from clinical research together with information about patients’ values and clinical expertise. On this A-view, EBM describes all that goes on in a specific justifiable medical decision. There is, however, an alternative interpretation of EBM, the B-view, in which EBM describes just one component of the decision situation and in which, together with other types of evidence, EBM leads to a justifiable clincial decision but does not describe the decision itself. This B-view is inspired by a 100-years older version of EBM, a Swedish standard requiring medical decision-making, professional risk-taking and practice to be in accordance with‘science and proven experience’. In the paper, we outline how the Swedish concept leads to an improved understanding of the way in which scientific evidence and clinical experience can and cannot be integrated in light of EBM. How scientific evidence and clinical experience is integrated influences both the way we do risk assessment and risk management. In addition, the paper sketches the as yet unexplored historical background to VBE and EBM.

Background Positivism is sometimes rejected for the wrong reasons. Influential textbooks on nursing research and in other disciplines tend to reinforce the misconceptions underlying these rejections. This is problematic, since it provides students of these disciplines with a poor basis for making epistemological and methodological decisions. It is particularly common for positivist views on reality and causation to be obscured. Objectives and design The first part of this discussion paper identifies and explains the misconceptions about positivism as they appear in two influential textbooks. The second part pinpoints five mistakes these misconceptions easily result in when the researcher adopts an epistemological and methodological standpoint. What is already known about the topic? There are several impeccable descriptions of positivism in nursing research literature; but a relatively large number of inaccurate or confused views of positivism appear in the nursing research literature as well. Mistakes of the kind identified in this paper have been noted before—for instance, in Shadish. What this paper adds: This paper provides a detailed analysis of two particularly common and influential misconceptions about positivism. It traces the historical roots of these misconceptions and characterizes them more carefully than many earlier attempts have done. The paper shows how and why these misconceptions affect epistemological and methodological decisions negatively, regardless of one’s interest in positivism

A key question for evidence-based medicine is how best to model the way in which EBM should “[integrate] individual clinical expertise and the best external evidence”. We argue that the formulations and models available in the literature today are modest variations on a common theme and face very similar problems. For example, both the early and updated models of evidence-based clinical decisions presented in Haynes, Devereaux and Guyatt assume that EBM consists of, among other things, evidence from clinical research and clinical expertise. On this A-view, EBM describes all that goes on in a specific justifiable medical decision. There is, however, an alternative interpretation of EBM, the B-view, in which EBM describes just one component of the decision situation and in which, together with other types of evidence, EBM leads to a justifiable clincial decision but does not describe the decision itself. This B-view is inspired by a 100-years older version of EBM, a Swedish standard requiring medical decision-making and practice to be in accordance with ‘science and proven experience’. In the paper we outline how the Swedish concept leads to an improved understanding of the way in which scientific evidence and clinical experience can and cannot be integrated in light of EBM. In addition the paper sketches the as yet unexplored historical background to EBM.

The paper is concerned with the existence of objective uncertainties. What would it take for objective uncertainties to exist, and what would be the consequences for our understanding of the world we live in? We approach these questions by considering two common theories on how we are to understand the being of propensities and how it pertains to possible outcomes that remain unmanifested. It is argued that both or these theories should be rejected, and be replaced with a theory we call unrestricted actualism according to which the possible outcomes of propensities are denizens of the actual world.

Proven experience can be shared. Given this, we cannot assume that the character of proven experience is always manifest as a physical token in each individual sharing it. But the token might still exist somewhere. Perhaps that is a condition of the proven experience’s existence. Something similar could have been accepted as true of scientific knowledge, especially if those who argued that scientific claims were only shorthand for more complicated claims about observations had been right. But it seems that they were not. Hence there might be an ontological difference explaining why there will always be a netto divergence between science and proven experience.

Recently the importance of addressing values in discussions of risk perception and adaptation to climate change has become manifest. Values-based approaches to climate change adaptation and the cultural cognition thesis both illustrate this trend. We argue that in the wake of this development it is necessary to take the dynamic relationship between values and beliefs seriously, to acknowledge the possibility of bi-directional relationships between values and beliefs, and to address the variety of values involved. The dynamic relationship between values and beliefs, we claim, highlights the need to bring ethical considerations to bear on climate change communication. In particular, we must ask whether it is acceptable to tailor information about the risks of climate change in an effort to maximize communicative effectiveness given the values of the target group.

The Swedish medico-legal concept of “science and proven experience” is both legally important and ambiguous. The conceptual uncertainty associated with it can hamper effective assessment of medical evidence in legal proceedings and encourage medical professionals to distrust legal regulation. We examine normative criteria a functioning medico-legal notion should presumably meet, e.g. clarity, acceptability and consistency with existing laws. We also survey healthcare professionals to see how they understand science and proven experience and thus determine the extent to which their understanding meets the normative criteria. The survey suggests that medical professionals feel more certain about “science and proven experience” in the medical context than they do in a legal context. They still have substantial trust in the legal use of the notion, but they do not believe that legal professionals should be allowed to determine the meaning of “science and proven experience” in the legal context. With these results in mind, we argue that the best way to meet the normative criteria and resolve conceptual uncertainty is to specify sub-questions that clarify the notion. We recommend an analytical-deliberative approach that will close the gap between the medical and legal professions’ perceptions of how law and medicine relate.

Interdisciplinary research within the field of sustainability studies often faces incompatible ontological assumptions deriving from natural and social sciences. The importance of this fact is often underrated and sometimes leads to the wrong strategies. We distinguish between two broad approaches in interdisciplinarity: unificationism and pluralism. Unificationism seeks unification and perceives disciplinary boundaries as conventional, representing no long-term obstacle to progress, whereas pluralism emphasizes more ephemeral and transient interdisciplinary connections and underscores the autonomy of the disciplines with respect to one another. Both approaches have their merits and pitfalls. Unification runs the risk of scientific imperialism, while pluralism can result in insurmountable barriers between disciplines. We made a comparison of eight distinct interdisciplinary attempts at integration of knowledge across social and natural sciences. The comparison was carried out as four pairwise comparisons: environmental economics versus ecological economics, environmental history versus historical ecology, resilience theory versus political ecology, and socio-biology versus actor-network theory. We conclude by showing that none of these prominent eight interdisciplinary fields in and of itself manages to provide, in a satisfactory way, such an integrated understanding of sustainability. We argue for pluralism and advocate complex ways of articulating divergent ontological assumptions. This is not equivalent to pursuing knowledge unification either through scientific imperialism or by catering to the requirements of narrow practical utility. It means prioritizing interdisciplinary integration by simultaneously acknowledging the role of societal and natural factors in accounting for sustainability issues.

Facts are once again put to work in philosophical enterprises. The discussion in this paper is conducted under the presumption that we for this reason need to examine the nature of facts anew. To some extent it has been taken for granted that the question of properties and particulars is the primary problem to solve, and that the question of facts is secondary. This approach naturally leads to many of the old problems of facts and complexes. By taking facts as truly basic, we should see how we can construct the particulars and universals we still have need for. In order to further this idea, I suggest that facts may be though of as tropes or once-for-all occurrent properties. However, this characterisation of facts is acceptable only if tropes manage without substances or "thin" particulars for their instantiation.

According to Jon Elster, mechanisms are frequently occurring and easily recognizable causal patterns that are triggered under generally unknown conditions or with indeterminate consequences. In the absence of laws, moreover, mechanisms provide explanations. In this paper I argue that Elster’s view has difficulties with progressing knowledge. Normally, filling in the causal picture without revising it should not threaten one’s explanation. But this seems to be Elster’s case. The critique is constructive in the sense that it is built up from a discussion of a mechanism that might explain ‘unwarranted’ risk taking in connection with swimming—a mechanism that is mirrored in the proverb: The best swimmers drown

The calls for evidence-based public policy making have increased dramatically in the last decades, and so has the interest in evidence-based sustainability studies. But questions remain about what “evidence” actually means in different contexts and if the concept travels well between different domains of application. Some of the most relevant questions asked by sustainability studies are not, and in some cases cannot be, directly answered by relying on research evidence of the kinds favored by the evidence-based movement. Therefore, sustainability studies must also harness other forms of knowledge, based on forms of practical experience. How to integrate these two sources of knowledge is one of the most fundamental epistemological and practical problems society is facing. Identifying what kind of practical experience and research evidence we need to integrate is another challenging question. We draw on examples from our research in the Global South and suggest an efficient principle, problem-feeding, for harnessing practical experience within an adapted version of evidence-based sustainability studies.

The overall aim of this paper is to examine the claim that explanation is asymmetrical because causation is asymmetrical. The link between causal and explanatory asymmetry is focussed on. It is argued that many theories of causation account for causal asymmetry in a way that stops a causal model from contributing to our understanding of explanatory asymmetry. What appears to be generally advantageous with causal approaches is normally true only of a few specific causal accounts. These remaining alternatives, however, may well have some less attractive features that would never be brought to mind in the familiar explanatory contexts of balloons, flag poles, and the like—and with a standard concept of causation.

The functional separation of risk assessment and risk management has long been at the heart of risk analysis structures. Equally long it has been criticized for creating technocratic risk management due to valuations being done in the risk assessment to which the stakeholders do not have access. The criticism has mostly been of an ethical nature. Arguably, in separating risk assessment and risk management, one hopes to fulfil two requirements: Social requirement: we want risk management to meet the goals and needs of society. Scientific requirement: we do not want political views to influence the assessment of facts. We ask in this paper whether it is, in principle, possible to separate risk assessment from risk management. The crucial distinction between risk assessment and risk management we take to be between what kinds of values are involved in them and that separation is meant to shield risk assessment from risk management values and vice versa. Risk assessment is judged to be a scientific activity that should only involve scientific values. We go through a paradigmatic example of good science to see what those scientific values are and whether they are the only ones influencing science. We also present an example of a risk assessment in order to compare it to science. We conclude that the values involved in both science and risk assessment are of the same kind and that they both involve extra-scientific values. The paper ends with a short discussion of whether the above requirements can be met even though risk assessment and risk management are interdependent.

In Swedish law, the notion of ‘science and proven experience’ defines the gold standard for public decision-making and practice, especially in medicine. The notion is notoriously vague but nevertheless plays an important role in the distribution of rights and duties of patients and healthcare workers. For example, failure to provide care in accordance with this standard can lead to penal responsibility. The notion also helps to define Swedish patients’ right to reimbursement for cross-border healthcare. From a legal point of view, the notion is especially intriguing because it appears to import medical standards into the legal conceptual apparatus. The purpose of this article is to explore the mechanisms of this andkindred ‘importing notions’ by investigating the role that the notion of science and proven experience plays in Swedish law and in the transfer of information between the legal and medical fields.

In medical research, it is not unusual that risks are ruled out without any specification the exact risk that was ruled out. This makes it difficult to balance expected health benefits and risk of harm when choosing between alternative treatment options. International guidelines for reporting medical research results are sufficiently specific when it comes to establishing health benefits. However, there is a lack of standards for reporting on ruling out risks. We argue that transparency is needed, as in the case of non-inferiority trials. The Consolidated Standards of Reporting Trials and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statements should be revised accordingly.

Although contentious, the concept of resilience is common in sustainability research. Critique of the concept have often focused on the content of the concept. In this paper we focus on another feature of concepts, namely how they are defined. We distinguish between concepts that are ostensively defined, that aim to point to some phenomena, and stipulatively defined concepts, where the content of the concept is given in the definition itself. We argue that although definitions themselves are similar across many different disciplines where resilience is used?most notably psychology and ecology?they differ in how. This has interesting consequences for how different disciplines can be connected and integrated. Notably, integration on basis of ostensively defined concepts turn on sharing the extension of the concept, but not necessarily the intension, whereas integration on basis of stipulatively defined concepts work in the opposite way.

The purpose of this paper is to clarify the role of value uncertainty and value instability in decision-making that concerns morally controversial issues. Value uncertainty and value instability are distinguished from moral uncertainty, and several types of value uncertainty and value instability are defined and discussed. The relations between value uncertainty and value instability are explored, and value uncertainty is illustrated with examples drawn from the social sciences, medicine and everyday life. Several types of factor producing value uncertainty and/or value instability are then identified. They are grouped into three categories and discussed under the headings ‘value framing’, ‘ambivalence’ and ‘lack of self-knowledge’. The paper then discusses the role of value uncertainty in decision-making. The concluding remarks summarize what has been achieved and what remains to be done in this area.

Interdisciplinary research within the field of sustainability studies often faces incompatible ontological assumptions deriving from natural and social sciences. The importance of this fact is often underrated and sometimes leads to the wrong strategies. We distinguish between two broad approaches in interdisciplinarity: unificationism and pluralism. Unificationism seeks unification and perceives disciplinary boundaries as conventional, representing no long-term obstacle to progress, whereas pluralism emphasizes more ephemeral and transient interdisciplinary connections and underscores the autonomy of the disciplines with respect to one another. Both approaches have their merits and pitfalls. Unification runs the risk of scientific imperialism, while pluralism can result in insurmountable barriers between disciplines. We made a comparison of eight distinct interdisciplinary attempts at integration of knowledge across social and natural sciences. The comparison was carried out as four pairwise comparisons: environmental economics versus ecological economics, environmental history versus historical ecology, resilience theory versus political ecology, and socio-biology versus actor-network theory. We conclude by showing that none of these prominent eight interdisciplinary fields in and of itself manages to provide, in a satisfactory way, such an integrated understanding of sustainability. We argue for pluralism and advocate complex ways of articulating divergent ontological assumptions. This is not equivalent to pursuing knowledge unification either through scientific imperialism or by catering to the requirements of narrow practical utility. It means prioritizing interdisciplinary integration by simultaneously acknowledging the role of societal and natural factors in accounting for sustainability issues.

We tested two consequences of a currently influential theory based on the notion of seeing adaptations to climate change as local adjustments to deal with changing conditions within the constraints of the broader economic–social–political arrangements. The notion leaves no explicit role for the strength of personal beliefs in climate change and adaptive capacity. The consequences were: adaptive action to climate change taken by an individual who is exposed to and sensitive to climate change is not influenced to a considerable degree by their strength of belief in climate change and adaptive action to climate change taken by an individual who is exposed to and sensitive to climate change is not influenced to a considerable degree by their strength of belief in an adaptive capacity. Data from a 2004 questionnaire of 1950 Swedish private individual forest owners, who were assumed exposed to and sensitive to climate change, were used. Strength of belief in climate change and adaptive capacities were found to be crucial factors for explaining observed differences in adaptation among Swedish forest owners.