James Marcum

This essay examines the metaphysical foundations of the natural sciences and Christian theology in order to complement the epistemic claims from both disciplines. These foundations include Robin Collingwood's notion of presuppositions and Ernan McMullin's epistemic and non-epistemic values. Specifically, the essay investigates the presuppositions and values of science and theology used for guiding and constraining the formation and evaluation of scientific theories and theological doctrines. Practitioners in both disciplines need to keep these presuppositions and values in mind when complementing epistemic claims to form a comprehensive world picture. Complementing scientific and theological claims requires wisdom and restraint in analyzing the presuppositions and values that make such claims possible. For, theology without the input of science, and science without the input of theology, may lead to an impoverished world picture.

What is medical progress? The answer to this question is often associated with advances in diagnostic technology, with greater understanding of disease or pathological mechanisms particularly at the molecular level, or with the discovery of drugs and the developmental of surgical procedures to treat diseases. However, this facile answer can be problematic. In a New York Times Magazine article, for example, Lisa Sanders (2003) recounts a lecture delivered to her first-year class, at a "white-coat" ceremony, by the medical school dean. Half of what we—the faculty—teach you—the students—is nonsense, she was told, but we don't know which half. She illustrates what the dean said, with the following change in advice for ..

In The Structure of Scientific Revolutions, Kuhn claimed that theory choice is a conversion experience and depends upon the personality or psychology of the individual scientist making the choice. Critics charged Kuhn with an irrational and a relativistic position concerning theory choice, arguing he advocated a subjective instead of an objective approach to how scientists choose one theory over another and thereby undercut epistemic accounts for the generation of scientific knowledge. In response to critics Kuhn insisted that his approach, although subjective, was still rational in that the criteria—composed of epistemic values—determining theory choice operate both objectively and subjectively. Recent work in cognitive neuropsychology, particularly in the dual-process theory of cognition, supports Kuhn’s notion of theory choice. In this paper, I initially discuss Kuhn’s approach to theory choice, along with criticism of it and his response to the criticism, followed by an examination of the dual-process theory of cognition. I then explore the application of dual-process theory to Kuhn’s notion of theory choice, especially in terms of a historical case study from the biomedical sciences. I finally discuss briefly the implications of the dual-process theory for contemporary philosophy of science.

Is knowledge in the natural sciences discovered or constructed? For objectivists, scientific knowledge is discovered through investigations into a mind-independent, natural world. For constructivists, such knowledge is produced through negotiations among members of a professional guild. I examine the clash between the two positions and propose that scientific knowledge is the concurrent outcome from investigations into a natural world and from consensus reached through negotiations of a professional guild. Specifically, I introduce the general methodological notion, instituting science, which incorporates both the discovery and the construction processes in the generation of scientific knowledge. To that end, I use a case study from the biomedical sciences to illustrate the notion. I conclude with a discussion of how this methodological notion helps to address the debate between objectivists and constructivists over the generation of scientific knowledge, and of how it compares with others who have also attempted to address the debate.

In this article, I introduce the notion of horizon for scientific practice (HSP), representing limits or boundaries within which scientists ply their trade, to facilitate analysis of scientific discovery and progress. The notion includes not only constraints that delimit scientific practice, e.g. of bringing experimentation to a temporary conclusion, but also possibilities that open up scientific practice to additional scientific discovery and to further scientific progress. Importantly, it represents scientific practice as a dynamic and developmental integration of activities to investigate and analyze the natural world. I use the discovery of the clotting factor, thrombin, and the experiments conducted by the Johns Hopkins physiologist, William Howell, on the enzymatic nature of thrombin to illustrate the notion of HSP. In a concluding section, I compare the notion of HSP to other notions for scientific practice proposed in the history and philosophy of science literature

The book starts with a scandal, that is, Socrates’s mortality as entailed in the Aristotelian syllogism,All men are mortal,Socrates is a man,Therefore, Socrates is mortal. The scandal pertains to the deduction of Socrates’s death from the logical connections of premises, which, according to Braude, renders it “meaningless.” But, what does this scandal have to do with a philosophical defense of intuition in medicine? For Braude, the scandal is emblematic of a crisis in medicine and philosophy—a crisis in which human mortality is severed from its morality. Braude articulates the crisis with the following question:Where, therefore, between the cracks of universal logic and reifying medicine is there a place for the individual patient, for a response to the cry of pain to which medicine responds, or to the voice of injustice upon which moral philosophy is founded? For him, intuition provides a means to answer the question and thereby to resolve the crisis. It serves as “a bridge be ..

A notion of experimental series is developed, in which experiments or experimental sets are connected through experimental suggestions arising from previous experimental outcomes. To that end, the justification of Howard Temin's DNA provirus hypothesis is examined. The hypothesis originated with evidence from two exploratory experimental sets on an oncogenic virus and was substantiated by including evidence from three additional experimental sets. Collectively these sets comprise an experimental series and the accumulative evidence from the series was adequate to justify the hypothesis by persuading the virology community of its veracity. The notion of crucial experiment is also discussed in terms of experimental series.

A notion of experimental series is developed, in which experiments or experimental sets are connected through experimental suggestions arising from previous experimental outcomes. To that end, the justification of Howard Temin’s DNA provirus hypothesis is examined. The hypothesis originated with evidence from two exploratory experimental sets on an oncogenic virus and was substantiated by including evidence from three additional experimental sets. Collectively these sets comprise an experimental series and the accumulative evidence from the series was adequate to justify the hypothesis by persuading the virology community of its veracity. The notion of crucial experiment is also discussed in terms of experimental series.

The predominant model of the body in modern western medicine is the machine. Practitioners of the biomechanical model reduce the patient to separate, individual body parts in order to diagnose and treat disease. Utilization of this model has led, in part, to a quality of care crisis in medicine, in which patients perceive physicians as not sufficiently compassionate or empathic towards their suffering. Alternative models of the body, such as the phenomenological model, have been proposed to address this crisis. According to the phenomenological model, the patient is viewed as an embodied person within a lived context and through this view the physician comes to understand the disruption illness causes in the patient’s everyday world of meaning. In this paper, I explore the impact these two models of the patient’s body have had on modern medical practice. To that end I first examine briefly the historical origins of the biomechanical and phenomenological models, providing a historical context for the discussion of each model’s main features in terms of machine-world and life-world. Next, I discuss the impact each model has had on the patient–physician relationship, and then I examine briefly the future development of each model. The meaning of illness vis-à-vis each model of the patient’s body is finally examined, especially in terms of how these two models affect the patient’s interpretation of illness. The paper concludes with a discussion of the biomechanical and phenomenological models, in terms of the quality of care crisis in modern western medicine.

The Covid-19 pandemic has challenged both medicine and governments as they have strived to confront the pandemic and its consequences. One major challenge is that evidence-based medicine has struggled to provide timely and necessary evidence to guide medical practice and public policy formulation. We propose an extension of evidence-based corona medicine to an organismic systems corona medicine as a multilevel conceptual framework to develop a robust concept-oriented medical system. The proposed organismic systems corona medicine could help to prevent or mitigate future pandemics by transitioning to a bifocal medicine that extends an empirical evidence-based medicine to a theory-oriented organismic systems medicine.

Robust clinical decision-making depends on valid reasoning and sound judgment and is essential for delivering quality healthcare. It is often susceptible, however, to a clinician’s biases such as towards a patient’s age, gender, race, or socioeconomic status. Gender bias in particular has a deleterious impact, which frequently results in cognitive myopia so that a clinician is unable to make an accurate diagnosis because of a patient’s gender—especially for female patients. Virtue epistemology provides a means for confronting gender bias in clinical decision-making and for correcting or even preventing its impact. The medical literature on cardiovascular and coronary heart disease is used to illustrate the role intellectual virtues can play in redressing the deleterious impact of gender bias on clinical decision-making and practice. Finally, questions are considered surrounding the pedagogy of intellectual virtues for medical students and practicing clinicians in order to provide quality care for patients, regardless of gender.

An important question facing contemporary philosophy of science is whether the natural sciences in terms of their historical records exhibit distinguishing developmental patterns or structures. At least two philosophical stances are possible in answering this question. The first pertains to the plurality of the individual sciences. From this stance, the various sciences are analyzed individually and compared with one another in order to derive potential commonalities, if any, among them. The second stance involves a general philosophy of science in which a thorough theory of the natural sciences is developed. The latter stance strives to account for more than possible commonalities among the sciences but also to provide a broad-spectrum philosophical framework to account for, or to explicate, the nature of science itself and its progress. In this paper, the second stance is taken in which an evolutionary philosophy of science is proposed. To that end, Thomas Kuhn’s evolutionary philosophy of science is initially discussed and critiqued. An evolutionary philosophy of science is then proposed based on a revision of Kuhn’s evolutionary philosophy of science in terms of George Gaylord Simpson’s various tempos and modes for biological evolution. Next, two historical case studies from the biological sciences are reconstructed to illustrate the robustness of the proposed evolutionary philosophy of science for explicating the progress of the natural sciences. A concluding section discusses the proposed evolutionary philosophy of science with respect to providing a broad-spectrum framework or general philosophy of science for understanding the nature and progress of the natural sciences.

A definitive and authoritative guide to a vibrant and growing discipline in current philosophy, The Bloomsbury Companion to Contemporary Philosophy of Medicine presents an overview of the issues facing contemporary philosophy of medicine, the research methods required to understand them and a trajectory for the discipline's future. Written by world leaders in the discipline, this companion addresses the ontological, epistemic, and methodological challenges facing philosophers of medicine today, from the debate between evidence-based and person-centered medicine, medical humanism, and gender medicine, to traditional issues such as disease, health, and clinical reasoning and decision-making. Practical and forward-looking, it also includes a detailed guide to research sources, a glossary of key terms, and an annotated bibliography, as well as an introductory survey of research methods and discussion of new research directions emerging in response to the rapid changes in modern medicine. “Philosophy needs medicine', Hillel Braude argues, 'to become more relevant'. By showing how modern medicine provides philosophers with a rich source of material for investigating issues facing contemporary society, The Bloomsbury Companion to Contemporary Philosophy of Medicine introduces the opportunities medicine offers philosophers together with the resources and skills required to contribute to contemporary debates and discussions.

Precision medicine and molecular systems medicine (MSM) are highly utilized and successful approaches to improve understanding, diagnosis, and treatment of many diseases from bench-to-bedside. Especially in the COVID-19 pandemic, molecular techniques and biotechnological innovation have proven to be of utmost importance for rapid developments in disease diagnostics and treatment, including DNA and RNA sequencing technology, treatment with drugs and natural products and vaccine development. The COVID-19 crisis, however, has also demonstrated the need for systemic thinking and transdisciplinarity and the limits of MSM: the neglect of the bio-psycho-social systemic nature of humans and their context as the object of individual therapeutic and population-oriented interventions. COVID-19 illustrates how a medical problem requires a transdisciplinary approach in epidemiology, pathology, internal medicine, public health, environmental medicine, and socio-economic modeling. Regarding the need for conceptual integration of these different kinds of knowledge we suggest the application of general system theory (GST). This approach endorses an organism-centered view on health and disease, which according to Ludwig von Bertalanffy who was the founder of GST, we call Organismal Systems Medicine (OSM). We argue that systems science offers wider applications in the field of pathology and can contribute to an integrative systems medicine by (i) integration of evidence across functional and structural differentially scaled subsystems, (ii) conceptualization of complex multilevel systems, and (iii) suggesting mechanisms and non-linear relationships underlying the observed phenomena. We underline these points with a proposal on multi-level systems pathology including neurophysiology, endocrinology, immune system, genetics, and general metabolism. An integration of these areas is necessary to understand excess mortality rates and polypharmacological treatments. In the pandemic era this multi-level systems pathology is most important to assess potential vaccines, their effectiveness, short-, and long-time adverse effects. We further argue that these conceptual frameworks are not only valid in the COVID-19 era but also important to be integrated in a medicinal curriculum.

For at least the past several decades, medicine has been embroiled in a crisis concerning the nature of its professionalism. The fundamental questions that drive this ongoing crisis are primarily three. First, what is the nature of medical professionalism? Second, who are medical professionals? Third, what does medicine or these professionals profess or promise? In this paper, the professionalism crisis vis-à-vis these questions is examined and analyzed chiefly in terms of both Francis Peabody’s and Edmund Pellegrino’s writings. Based on their writings, I introduce a conceptual framework for professionalism to address the crisis. In addition, I contend that to address the professionalism crisis adequately, medicine’s position within an evolving health care network must also be considered. To that end, I first discuss the genesis of the crisis in terms of the Flexner Report and especially Peabody’s response to it. Next, I explore how the crisis intensified during the twentieth century, particularly in terms of medicine’s ultimate scientification and eventual commercialization, and how Pellegrino reacted to this. I then propose a health care professionalism cycle and a care-competence cycle to provide a conceptual framework for addressing the crisis. I conclude that medicine’s position is no longer as the center of health care but rather as another node within a wider evolving health care network. And the resolution of medicine’s professionalism crisis depends on medicine’s positioning and defining itself in terms of the professionalism for each of the other professions within the health care network.

In 1964 the Wisconsin virologist Howard Temin proposed the DNA provirus hypothesis to explain the mechanism by which a cancer-producing virus containing only RNA infects and transforms cells. His hypothesis reversed the flow of genetic information, as ordained by the central dogma of molecular biology. Although there was initial opposition to his hypothesis it was widely accepted, after the discovery of reverse transcriptase in 1970. Most accounts of Temin's hypothesis after the discovery portray the hypothesis as heretical, because it challenged the central dogma. Temin himself in his Nobel Prize speech of 1975 narrates a similar story about its reception. But are these accounts warranted? I argue that members of the virology community opposed Temin's provirus hypothesis not simply because it was a counterexample to the central dogma, but more importantly because his experimental evidence for supporting it was inconclusive. Furthermore, I propose that these accounts of opposition to the DNA provirus hypothesis as heretical, written by Temin and others after the discovery of reverse transcriptase, played a significant role in establishing retrovirology as a specialized field

The reticulated model of scientific rationality includes the goal of the investigation, the method by which the goal is achieved, and the epistemic values needed to assess whether the goal was achieved by the applied method. I expand this model of rationality to include metaphysical assumptions and commitments that inform the origins of epistemic claims. I then explore the rational boundaries between the natural sciences and Christian theology in terms of goals, methods, and metaphysics. Finally, I discuss the advantages and problems of exploring the rational boundaries between science and theology

Approaches to the analysis of theory choice in science studies often focus either on objective criteria or subjective values for evaluating theories or on critical experiments for testing theories. In the present article a historical case study in the biomedical sciences is reconstructed, in which experimentation was performed to choose between two competing theories of blood coagulation. Analysis of this case study reveals that experimentation exhibits a particular structure, composed of design, execution, and results, and specific characteristics, consisting of controllability, reproducibility, plasticity, and fecundity. Although this structure and these characteristics are not used to replace objective criteria or subjective values of theory evaluation or to define critical experiments, they are instrumental for analyzing and understanding theory choice.

Over the past decade, a number of accounting and financial reporting frauds have led to lost stock wealth, destroyed public trust, and a worldwide recession that called for necessary reform. Regulatory responses and systemic reforms quickly followed, and we show that, while necessary, these reforms are insufficient. The purpose of this paper is to forward virtuous professionalism as a necessary path toward restoring financial reporting systems. We take the position of external observer and analyze the accounting profession over time to assess what has transpired within our financial reporting systems. Our analysis reveals that the combined influence of commercialism and regulatory response has led to a systemic decline in accounting’s professional ideals and, as a result, an erosion of public trust. We then propose virtuous professionalism as a necessary process for restoring financial reporting systems based on sociological, professional, and philosophical theories. We argue that virtuous professionalism is necessary for restoring the public servant identity of the accounting professional. We conclude that efforts to restore financial reporting systems should begin with reforms that restore professional identity shaped by virtues.

Moti Mizrahi (2015) examines whether there are “good arguments” to support Kuhn’s taxonomic incommensurability (TI) thesis. He concludes that there is neither “valid deductive” nor “strong inductive” support for the thesis and that consequently TI should not be believed or accepted. In response, Lydia Patton (2015) claims that the most “influential” arguments within the history of science are abductive or inference to the best explanation (IBE) rather than deductive or inductive arguments. After reviewing and analyzing this exchange, I propose that although argumentation is important for supporting Kuhn’s TI thesis, it is not the only type of support—or possibly even the most persuasive. I contend that the historian’s personal or psychological experience of accessing a revolutionary change in science—as illustrated in Kuhn’s own experience of laboring to understand the Aristotelian idea of motion while assuming a Newtonian idea of motion—represents a compelling type of support for TI. To that end, I reconstruct briefly a case history from the biomedical sciences and discuss how it supports TI vis-à-vis the Mizrahi-Patton exchange.