Alex Broadbent, a young British-trained philosopher of science with a faculty appointment at the University of Johannesburg, clearly believes in the potential value of philosophy for epidemiology, and has set out to prove it. His forays into the field are now evident from the work he has published as guest editor of a themed-section of peer-reviewed essays in Preventive Medicine on Philosophy and Epidemiology, to which eminent figures from epidemiology and statistics as well as philosophy contributed, and as principal author of a new report from the PHG foundation entitled “Epidemiology, risk, and causation—Conceptual and methodological issues in public health science”.

These publications are not solo contributions but rather the products of a series of workshops which Broadbent helped to organize in 2009-10 on Epidemiology, Risk, and Genomics hosted at the University of Cambridge, Department of History and Philosophy of Science and sponsored by the PHG Foundation. He has also organized an international conference on the topic in December 2011, with funds from the South African government.

Doubts About Philosophy

In the introduction to his PHG report, Broadbent is candid about the skepticism which he believes may confront his endeavors in the epidemiology community. He states, “Doubt is often expressed when philosophers purport to contribute to the scientific enterprise…Epidemiology is a useful activity, and there is ample evidence in epidemiological journals and text books that philosophical problems arise in the course of doing it. The motivation of this project was to identify some of these problems, and to begin the process of solving them.”

Philosophical Problems

Before enumerating the problems of interest in epidemiology, Broadbent was asked to clarify what constitutes a philosophical problem. He told the Epidemiology Monitor that such problems are those which people disagree about, where the disagreements are persistent yet reasonable, and for which further empirical evidence will not get you an answer. He stated that ethical problems are a type of philosophical problem that are easier to recognize than other types because we have pre-existing ideas about right and wrong.

According to Broadbent, where concepts such as causation, risk, uncertainty, and causal inference have seemed too vague to use, epidemiologists have developed well-defined substitutes. However, it is not always clear how to relate these well-defined concepts back to the vague ones in which we think when deciding on courses of action or making evaluative judgments. Moreover, inconsistencies in our innate, “Stone Age” thinking are often brought out when epidemiologists seek to apply and extend the Stone Age concepts. Evidence cannot be brought to bear to resolve the difficulties, which are conceptual. It is in these areas where a philosophical approach could be helpful.

Philosophers Training

If philosophical problems have no definite solutions, why should philosophers be expected to be more helpful than epidemiologists? According to Broadbent, philosophers are trained in tackling such questions and have skills which better enable them to identify the problems to begin with, make distinctions, and clarify them. Given these skills, philosophers may not settle issues definitively, however, their approach can help “to close down some options and avoid inconsistencies,” says Broadbent.

Epidemiologists Not Trained

Broadbent told the Epidemiology Monitor that he has observed epidemiologists struggling with thorny philosophical issues in epidemiology. In one case, he observed an epidemiologist author taking a very authoritarian approach to explaining causation, asserting “this is how it is”. Philosophers would take a completely different approach, said Broadbent, a non-authoritarian, more exploratory one in which coherent options or alternatives are identified and discussed. For these types of questions which may not have a final answer, this is “a better approach” according to Broadbent.

Hitting Too Hard

Broadbent contrasts the philosophical approach with the one taken by scientists in yet another way. “Scientists tend to hit these problems too hard,” according to Broadbent, “closing off options and moving on when it is too soon to close options down without really understanding the position you are taking.” He added that, in contrast to scientists, philosophers are not typically trying “to get on with something”. [AB1]  Philosophy can pay off for epidemiology in   a number of ways: by reducing methodological inconsistencies, raising awareness o