University of Johannesburg
Department of Philosophy
PhD, 2019
Medford and Somerville, Massachusetts, United States
  • Neonatal sepsis as a cause of retinopathy of prematurity: An etiological explanation
    with Brian Stansfield
    Progress in Retina and Eye Research 98 (101230). 2023.
    Retinopathy of prematurity (ROP) is a complex neonatal disorder with multiple contributing factors. In this paper we have mounted the evidence in support of the proposal that neonatal sepsis meets all requirements for being a cause of ROP (not a condition, mechanism, or even innocent bystander) by means of initiating the early stages of the pathomechanism of ROP occurrence, systemic inflammation. We use the model of etiological explanation, which distinguishes between two overlapping processes i…Read more
  •  239
    In this chapter, I first outline the public health workflow from assessment via goal definition and intervention to evaluation. Further, I discuss the types and subtypes of explanation used in public health research and practice: scientific, justificatory, methodological, and prospective. In doing this, I take the discussion far beyond the usual focus in philosophy of science as answers to “why?”-questions. The chapter ends with a few comments on my proposal.
  •  140
    Health Humanities in Medicina: The Auxiliary Stance
    with Eugenijus Gefenas and Signe Mezinska
    Medicina 58 (3): 411. 2022.
    At the core of medicine is the idea to help fellow human beings by improving or even restoring their health. Let us call this the auxiliary stance of medicine—the motivation of medical intervention by reference to a moral obligation to guide our peers in their attempt to live a healthy and productive life. In parallel, the auxiliary stance is also central to public health, with a focus on prevention and health promotion. Taken together, we can view medicine and public health as the two main huma…Read more
  •  95
    My goal in this paper is twofold. First, I want to analyze two early texts by Vilém Flusser in order to explore what may have been his conceptualization of the relationship between science and philosophy. My analysis suggests that Flusser thought of both as tools to analyze reality by analyzing language. While he saw science as a (sometimes too vigorous) force forward, he viewed philosophy as what can prevent some of the negative consequences of such progress. In direct comparison, Flusser thoug…Read more
  •  156
    Agent-Based Models as Etio-Prognostic Explanations
    Argumenta 7 (1): 19-38. 2021.
    Agent-based models (ABMs) are one type of simulation model used in the context of the COVID-19 pandemic. In contrast to equation-based models, ABMs are algorithms that use individual agents and attribute changing characteristics to each one, multiple times during multiple iterations over time. This paper focuses on three philosophical aspects of ABMs as models of causal mechanisms, as generators of emergent phenomena, and as providers of explanation. Based on my discussion, I conclude that while…Read more
  •  631
    Theory of illness causation is an important issue in all biomedical sciences, and solid etiological explanations are needed in order to develop therapeutic approaches in medicine and preventive interventions in public health. Until now, the literature about the theoretical underpinnings of illness causation research has been scarce and fragmented, and lacking a convenient summary. This interdisciplinary book provides a convenient and accessible distillation of the current status of research into…Read more
  •  301
    Evidence Mapping to Justify Health Interventions
    Perspectives in Biology and Medicine 64 (2): 155-172. 2021.
    In order to support health interventions, biomedical and population health researchers need to collect solid evidence. This article asks what type of evidence this should be and expands on previous work that focused on etiological explanations, or causal-mechanical explanations of why and how illness occurs. The article proposes adding predictive evidence to the explanatory evidence, in order to form a joint evidence set, or JES = [A,B,C,D], which consists of four different types of evidence: as…Read more
  •  39
    The Essence of Authenticity
    with Katja M. Friederichs, Sabine Lebedinski, and Kerstin M. Liesenfeld
    Frontiers in Psychology 11. 2021.
    In this paper, we build upon the model of authenticity proposed by Lehman and colleagues, which includes the dimensions consistency, conformity, and connection. We expand this “3C-view” by adding a fourth dimension, continuity, which results in what we have come to call “4C-view of authenticity.” We discuss our proposal from a process perspective and emphasize that congruence might be a reasonable candidate for a concept that unifies the four dimensions of authenticity.
  •  582
    Bradford Hill (1965) highlighted nine aspects of the complex evidential situation a medical researcher faces when determining whether a causal relation exists between a disease and various conditions associated with it. These aspects are widely cited in the literature on epidemiological inference as justifying an inference to a causal claim, but the epistemological basis of the Hill aspects is not understood. We offer an explanatory coherentist interpretation, explicated by Thagard's ECHO model …Read more
  •  16
    This book covers the overlap between informatics, computer science, philosophy of causation, and causal inference in epidemiology and population health research. Key concepts covered include how data are generated and interpreted, and how and why concepts in health informatics and the philosophy of science should be integrated in a systems-thinking approach. Furthermore, a formal epistemology for the health sciences and public health is suggested. Causation in Population Health Informatics and D…Read more
  • Hill's Heuristics and Explanatory Coherentism in Epidemiology
    American Journal of Epidemiology 187 (1): 1-6. 2018.
    In this essay, I argue that Ted Poston's theory of explanatory coherentism is well-suited as a tool for causal explanation in the health sciences, particularly in epidemiology. Coherence has not only played a role in epidemiology for more than half a century as one of Hill's viewpoints, it can also provide background theory for the development of explanatory systems by integrating epidemiologic evidence with a diversity of other error-independent data. I propose that computational formalization …Read more
  •  11
    The Epistemological Weight of Randomized-Controlled Trials Depends on Their Results
    with Ryan F. Flanagan
    Perspectives in Biology and Medicine 61 (2): 157-173. 2018.
    Biomedical research and study design have recently been examined in detail by philosophers of science, who, like biomedical researchers, are concerned with the ability to accurately represent causal relationships through scientific study and apply these relationships to improve the health of individuals and populations. Epistemology—defined by the OED as "the theory of knowledge, especially with regard to its methods, validity, and scope, and the distinction between justified belief and opinion"…Read more
  •  21
    The Etiological Stance: Explaining Illness Occurrence
    Perspectives in Biology and Medicine 60 (2): 151-165. 2017.
    Models of illness causation play a crucial role in medicine and public health. In their recent paper on this topic, Michael Kelly, Rachel Kelly, and Federica Russo state that the integration of social, biological, and behavioral causes in one and the same etiologic mechanism remains to be clarified. In particular, they think that current models of illness causation do not appreciate "the truly integrated nature of bio-social-behavioral pathogenesis". In brief, Kelly, Kelly, and Russo suggest tha…Read more
  •  672
    Perinatal Brain Damage Causation
    Developmental Neuroscience 29. 2007.
    The search for causes of perinatal brain damage needs a solid theoretical foundation. Current theory apparently does not offer a unanimously accepted view of what constitutes a cause, and how it can be identified. We discuss nine potential theoretical misconceptions: (1) too narrow a view of what is a cause (causal production vs. facilitation), (2) extrapolating from possibility to fact (potential vs. factual causation), (3) if X, then invariably Y (determinism vs. probabilism), (4) co-occurrenc…Read more
  •  15
    The Perfect Storm: Preterm Birth, Neurodevelopmental Mechanisms, and Autism Causation
    with Carmina Erdei
    Perspectives in Biology and Medicine 57 (4): 470-481. 2014.
    Explaining the causal mechanisms that contribute to autism spectrum disorder occurrence remains a conundrum in developmental medicine, neuroscience, and child psychiatry. Recent research has resulted in agreement on behavioral definitions and their underlying cognitive processes, early diagnosis and standardized assessments, evidence-based interventions, systems-level approaches to neurobiology, and identification of genetic variants and their interaction with epigenetic and environmental factor…Read more
  •  24
    Causality, mosaics, and the health sciences
    Theoretical Medicine and Bioethics 37 (2): 161-168. 2016.
    Thinking about illness causation has a long and rich history in medicine. After a hiatus in the 1990s, the last one-and-a-half decades have seen a surge of publications on causality in the biomedical sciences. Interestingly, this surge is visible not only in the medical, epidemiological, bioinformatics, and public health literatures, but also among philosophical publications. In this essay, I review and discuss one most recent addition to the literature, "Causality: Philosophical Theory Meets Sc…Read more
  •  20
    Evidence, illness, and causation: An epidemiological perspective on the Russo–Williamson Thesis
    with Alexander R. Fiorentino
    Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences 54 1-9. 2015.
    According to the Russo-Williamson Thesis, causal claims in the health sciences need to be supported by both difference-making and mechanistic evidence. In this article, we attempt to determine whether Evidence-based Medicine can be improved through the consideration of mechanistic evidence. We discuss the practical composition and function of each RWT evidence type and propose that exposure-outcome evidence provides associations that can be explained through a hypothesis of causation, while mech…Read more