Svein Lie

We claim that if a complete philosophy of evidence-based practice is intended, then attention to the nature of causation in health science is necessary. We identify how health science currently conceptualises causation by the way it prioritises some research methods over others. We then show how the current understanding of what causation is serves to constrain scientific progress. An alternative account of causation is offered. This is one of dispositionalism. We claim that by understanding causation from a dispositionalist stance, many of the processes within an evidence-based practice framework are better accounted for. Further, some of the problems associated with the health research, e.g. external validity of causal findings, dissolve.

This paper analyses Steven Vogel's claim that his account of a post-natural environmental philosophy solves the dualism problem within the field. Through what I will call a novel critique of social constructionism, this paper examines whether Vogel's attempt succeeds or whether it reinforces the problem he wants to solve. Could the ontological foundations of social constructivism themselves be in conflict with Vogel's stated aim of overcoming the human/nature dualism? The last part of the paper focuses on the significance and role of a post-natural environmental philosophy for the field of environmental philosophy in general.

The book "Philosophy of Nature: Rethinking Naturalness" is an effort to develop a philosophically plausible and practically viable concept of naturalness in such a way that this issue can be generally discussed and considered. The goal is to show why naturalness has been abandoned in modern academic discourse, why it is important to explicitly re-establish some kind of meaning for the concept and what that meaning ought to be. In our times, when asking the question, “What does or should restrict the human rearrangement of non-human nature?” we have two main resources to inform our response. The first resource is science, which will give you an answers by pointing to the physical boundaries in non-human nature. Such boundaries are those of 'necessary relations in nature' and are in fact surprisingly few. Although important there are very few boundaries "in itself", and sometimes that is exactly what provokes the public to turn to the second resource, namely religion and/or ethics. For instance: what is wrong with the mice walking around with a human ear on its back? What could be wrong about cutting down the Amazon rainforest? From the perspective of science, nothing. From the perspective of ethics, there may be a plurality of responses pointing to there being something wrong. What this something may be remains however notoriously difficult to agree upon. Between what is instrumentally possible and ethically right and attractive, there seems to be nothing. That is, there is nothing “in nature” that tells us not to do something that is physically or instrumentally possible to do. Religious and/or ethical answers are therefore the only answers we can give whenever we are confronted with questions about the "rearrangement of nature". However, such answers are often thought to be subjective; they tell us something about ourselves, but - again - nothing about nature. It is only science, it is assumed, that can tell us the objective truth about “nature itself”, which brings us back to "the physically possible", or what is called possible-I-nature in the book. Ontology is the area of philosophy concerned with the fundamental ways that things are. As such, it has the potentiality to provide us with a vocabulary with which to address this unsatisfying disjunction between the resources of science and those of morality. By articulating an ontology of naturalness, I offer a way to bridge the gap between instrumental and ethical answers. Arguing that naturalness can be understood in light of a dispositional ontology, I maintain that it is possible for someone to claim that there is a right and a wrong way to manipulate nature. The “ought” that follows from this position is “normative”, but not moral. It is grounded by the scientific assumptions that are built into a proper concept of naturalness, not by an appeal to moral or religious principles. As in: "you ought to lift the stone this way, and not that way". The main ontological question raised in the book is focused around the issue of the so-called "compossibility" of nature. What can we say about how nature is and can be related? The prevailing view on this question is that "things are connected either by necessity or by coincidence (contingency)". This view is called modal dualism. The ontology of dispositions offers a third modality, and it is remarkable what kind of difference this modality can make for the question and understanding of naturalness. This book is not an attempt to reestablish Aristotelianism. That would be contrary to an informed understanding of the historical logic that is underlying this issue, since it is exactly the strong association between naturalness and Aristotelianism that has gridlocked the concept of naturalness into the homeless void where we find it today. The “rebirth” signaled in the book’s title must come from an ontology of naturalness that is in line with the task of doing modern-type science. After endless attempts to bring forward theories and opinions that could heal and amend our relationship with nature from an ethical point of view, it is time to see the issue from an ontological point of view. This book is devoted to the task of making the problem of what we mean by “natural” more transparent in general, but also to the task of working out a particular concept of naturalness that can serve as a guide to understand the real limits of our manipulations in times where our powers to rearrange nature reaches new levels every week.

What is the connection between dispositions and ethics? Some might think very little and those who are interested in dispositions tend to be metaphysicians whose interests are far from value. However, we argue in this paper that dispositions and dispositionality are central to ethics, indeed a precondition. Ethics rests on a number of notions that are either dispositional in nature or involve real dispositions or powers at work. We argue for a dispositional account of value that offers an alternative to the traditional fact-value dichotomy. We explain the place of value within a structure that explains the possibility of ethics. Elsewhere in this structure, we argue that moral responsibility is a precondition for ethics and that it is a dispositional notion depending critically on what Mumford and Anjum have called the dispositional modality. Moral responsibility in turn depends on there being both agency and normativity. We argue that intentionality and agency are preconditions for agency and that value is a precondition of normativity. All these notions are dispositional and make best sense if there are real dispositions or causal powers of agents.

Medically unexplained symptoms (MUS) remain recalcitrant to the medical profession, proving less suitable for homogenic treatment with respect to their aetiology, taxonomy and diagnosis. While the majority of existing medical research methods are designed for large scale population data and sufficiently homogenous groups, MUS are characterised by their heterogenic and complex nature. As a result, MUS seem to resist medical scrutiny in a way that other conditions do not. This paper approaches the problem of MUS from a philosophical point of view. The aim is to first consider the epistemological problem of MUS in a wider ontological and phenomenological context, particularly in relation to causation. Second, the paper links current medical practice to certain ontological assumptions. Finally, the outlines of an alternative ontology of causation are offered which place characteristic features of MUS, such as genuine complexity, context-sensitivity, holism and medical uniqueness at the centre of any causal set-up, and not only for MUS. This alternative ontology provides a framework in which to better understand complex medical conditions in relation to both their nature and their associated research activity