In writing the article on the Philosophy of
Epidemiology, we spoke with Alex Broadbent, philosopher at
the University of Johannesburg. In that conversation and in some
of Broadbent’s writing, we were struck by the unexpected ways in
which he formulated and expressed familiar ideas in epidemiology
or articulated new ones. Below are some excerpts from our readings
and conversations with him.
On Epi
“Epidemiology employs the methods of natural
sciences, but it is so closely tied with human concerns that in
some forms it might also be seen as a social science.”
On Dangers
“…epidemiologists cannot be simply technicians.
They must also have some appreciation of the conceptual
foundations of the discipline, and in particular of the issues
arising in the [philosophical] areas. If they do not, then they
are likely to commit errors, such as exhibiting an unwarranted
bias towards the null hypothesis, failing to properly balance the
risk of different kinds of errors, making bad causal inferences,
of failing to make good ones.”
On Causality
“It is important to continue to stress that there
is no formal or algorithmic method of causal inference, and that
causation itself is not well-conceptualized or understood. Any
claims to the contrary are false, and, in the context of
epidemiology, dangerous.”
On Concepts
“…appreciation of the conceptual foundations of the
discipline, and of the persistently informal, unalgorithmic nature
of key components of its methodology, is essential to its
success.”
“If working epidemiologists and policy makers
possess some understanding of the live conceptual debates in
epidemiology then they will be better able to avoid erroneous
certainty.”
On Risk
“The epidemiological use of the word “risk” often
does not correspond to risk as it is commonly understood, or as it
is understood by philosophers studying risk.”
“As epidemiologists use the term, “risk” has no
application to the individual.”
More On Epi
“Epidemiology is a particularly uncertain activity,
because epidemiologists are often studying associations about
which little is known.”
“…epidemiology
has elements in common with both natural and social sciences. Its
methods may be scientific, but is objectives are often thoroughly
human.”
“Epidemiology is in large part a collection of
methods for finding things out on the basis of scant evidence, and
this by its nature is difficult.”
On Methods
“It is important that epidemiologists and
epidemiology students, appreciate that there are methodological
problems in their discipline which have not been solved, and where
conceptual work is still necessary to reach even the most
pragmatic goals.”
On Population Data
“…there is an
open philosophical question about what the exact rational bearing
of population level data on an individual is.”
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