About a year ago the ‘Philosophy and Public Affair’ group (Philosophy Department, University of Amsterdam), invited me to contribute to their seminar. I intended to talk about ‘The political dimension of evidence’, as I wanted to raise the question of whether and how epistemological and methodological debates about evidence bear on etico-political questions, or may affect issues at the etico-political level. Due to chronic lack of time I didn’t develop these issues in the direction I originally intended. Eventually the talk developed more on the ways in which philosophers (of science) ought to engage with scientists, with the public, or with teaching.
The topic proved attractive to a number of colleagues and so I was asked to follow that up at the seminar of the Erasmus Institute for Philosophy and Economics. My reflections went in the direction of pleading philosophy to get out of its ‘comfort zone’, and engage with other areas. So we should continuously ask what the relevance of our philosophical questions is, rather than their potential impact. I used evidential pluralism and the EBM+ consortium as my personal experience in trying to make philosophy of science relevant to science, to policy, and to communication with the broader public. Sharp and stimulating comments from the audience and from Attilia Ruzzene led me to think through this further.
The last step in this series of talk has been an invited lecture at the OZSW graduate conference in theoretical philosophy. The topic of the conference was ‘How Philosophy Meet the World’. I suggested that the ‘gap’ between philosophy and the world is quite a recent phenomenon, partly due to the overspecialization of the sciences and of philosophy. It is clearly not possible to go back to a model whereby the same person is a chief scientist, a chief ethicist, a chief political theorist, and states person. If one person cannot be all these things at once, the way to go is to collaborate and to ask questions that facilitate dialogue and collaboration between science, epistemology and the etico-political philosophy.
I departed quite substantially from the initial idea of reflecting on whether and how these evidence debates I contribute to should cross paths with debates at the etico-political level. I haven’t given up on the intention, though.
Last week I attended a workshop organized by Sabina Leonelli and her group on ‘Data journeys in biomedicine’. David Teira discussed evidential pluralism in the context of pharma regulation, in particular the recent 21st Century Cure Act (21CCA) in the US. 21CCA will force the Food and Drug Administration to adopt a pluralistic stance, in the interest of safety and efficacy of new treatment. EBMplussers should rejoice. Teira, however, analyses the question from a different perspective. What kind of political view is at the basis of such regulation? He thinks that the old 1962 FDA Act is paternalistic, in the sense it requires the highest standard of safety and does not allow patients to access those treatments that meet those standards. This form of ‘regulatory paternalism’, is continues Teira, de facto relaxed if 21CCA is enforced. Is this a consequence we are happy, willing, or ready to accept? Under what conditions? A talk that seemed about evidential pluralism – and therefore about medical methodology – turned out to be a talk in political philosophy that seriously engages with both science AND philosophy of science.
The question that looms large here is one that STS scholarship (including feminist and postcolonial studies) have been raising for decades now: etico-political values are part and parcel of science and they may drive epistemic values in one direction, or another.
EBM+ has contributed substantially to bring together scientists, philosophers of science, policymakers and other stakeholders. It is high time to broaden the scope of these discussions and to include an explicit reflection of the ethical and political values at stake.
Words by Federica Russo.