Exam III

Question 1

main aim of bird’s article?

Answer 1

To support Hoyningen-Huene’s thesis that science correlates with systematicity, using clinical medicine as a case study.

Question 2

How does Bird define “systematicity”?

Answer 2

—sciences are systematic in different but overlapping ways, often involving method, order, or a drive toward completeness.

Question 3

What everyday concept does Bird use to illustrate the family resemblance nature of systematicity?

Answer 3

The concept of a “book”—defined by a range of features (written, virtual, long, etc.), but not all features apply to every individual book.

Question 4

Q4: According to Hoyningen-Huene, what do all sciences have in common?

Answer 4

A: They are all systematic, though the nature of their systematicity may differ.

Question 5

Q5: What are Bird’s 9 features of systematicity?

Answer 5

Descriptions

Explanations

Predictions

Defense of knowledge claims

Critical discourse

Epistemic connectedness

Ideal of completeness

Generation of new knowledge

Representation of knowledge

Question 6

Q6: Why does Bird emphasize that ordinary experience is unsystematic?

Answer 6

Because it is more prone to error and bias, such as relying on anecdotes or incomplete observations (e.g., the MMR vaccine-autism myth).

Question 7

What role does systematicity play in the reliability of scientific claims?

Answer 7

Systematicity makes scientific claims more reliable—i.e., more likely to be true—by minimizing bias and increasing epistemic rigo

Question 8

What was the historical state of medicine according to Bird?

Answer 8

For much of history, medicine did more harm than good; benefits were often due to placebo effects, not effective treatments (e.g., bloodletting, mercury, heroin).

Question 9

What was the basis of clinical knowledge before modern scientific medicine?

Answer 9

Personal experience and authoritative texts (e.g., Galen), which were highly vulnerable to cognitive biases.

Question 10

Why does Bird say certain kinds of medical knowledge require systematic inquiry?

Answer 10

Because everyday reasoning lacks the rigor to uncover complex causal relationships like vaccine safety or disease mechanisms.

Question 11

What are some other developments that increased systematicity in medicine?

Answer 11

Objective measurements (e.g., pustule counts for smallpox)

Standardized forms and tables for data

Use of control groups in experiments

Question 12

How does Bird relate systematicity to the scientific status of medicine?

Answer 12

Medicine becomes more scientific as it becomes more systematic; EBM (Evidence-Based Medicine) is a key example of this trend.

Question 13

muson focuses on the critique:

Answer 13

A critique of the view that medicine can be reduced to science, focusing on key differences in aims, criteria for success, and moral obligations.

Question 14

What are the internal and external aims of science?

Answer 14

Internal aim: Acquisition of knowledge and understanding of the natural world.

External aims: Applications like technology, prestige, and wealth (but these are secondary to knowledge).

Question 15

What are the internal and external aims of medicine?

Answer 15

Internal and external aims are the same: To promote health through disease prevention and treatment.

Question 16

How is success defined in science?

Answer 16

Success in science is defined by discovering truth, even if the truth is relative to paradigms (Kuhn’s view on scientific progress).

Question 17

success in medicine?

Answer 17

Success is defined by achieving control over disease, with effective treatments, even without full understanding (e.g., psychiatric drugs, Semmelweis’ handwashing).

Question 18

what are the moral obligations in science and medicine

Answer 18

Science: Honesty and avoiding data fabrication to maintain valid knowledge.

Medicine: In addition to honesty, physicians have a stricter obligation to act in the patient’s best interest, prioritizing patient welfare over personal or social benefits.

Question 19

Can medicine be reduced to biology? What is Munson’s argument?

Answer 19

Munson: Medical concepts can be reduced to biological terms (e.g., disease), but medicine as a whole institution can’t be reduced because it involves moral and social components that biology alone can’t explain.

• external social aims (health outcomes)

Medicine may involve scientific methods and concepts, but it is not a science due to its practical aims, moral obligations, and social role. Sciences are subjects for reduction, but social activities like medicine cannot be fully reduced.

Question 20

What are the two main crises Engel identifies in medicine and psychiatry, and how are they related to the medical model?

Answer 20

Engel identifies a crisis in medicine due to its exclusion of psychosocial factors and a crisis in psychiatry over its struggle to define its place in medicine (either adopting the medical model or being excluded). Both crises stem from an overemphasis on biological explanations and neglect of the psychosocial aspects of illness.

Question 21

What two assumptions of the medical model does Engel criticize, and why are they problematic?

Answer 21

Engel criticizes reductionism and mind-body dualism. Reductionism assumes that biological phenomena can be fully explained by chemistry and physics, while mind-body dualism separates the mind from the body, ignoring the psychological and social factors of illness. These assumptions limit understanding of complex health conditions.

Question 22

How does the medical model limit the understanding of diseases like schizophrenia and diabetes?

Answer 22

The medical model focuses primarily on the biochemical and genetic factors of diseases, ignoring the psychosocial influences. For example, both the onset and progression of schizophrenia and diabetes can be influenced by social and psychological factors, which are not addressed in a purely biomedical approach.

Question 23

How does the biopsychosocial (BPS) model differ from the medical model, and what advantages does it offer in diagnosis and treatment?

Answer 23

he BPS model incorporates biological, psychological, and social factors in understanding illness. It avoids misdiagnosis when patients don’t feel sick and ensures that psychosocial factors are considered in treatment, improving overall health outcomes. The model acknowledges that illness is not just a biochemical problem but a complex interaction of multiple dimensions.

Question 24

What are the negative consequences of an over-reliance on the biomedical approach to medicine, according to Engel?

Answer 24

Over-reliance on the biomedical model can lead to unnecessary hospitalizations, excessive drug use, and unnecessary surgeries. It also neglects the social and psychological factors that influence health and can harm patients by failing to address the full scope of their illness.

Question 25

What are the challenges to integrating psychosocial knowledge into medical practice, and how does Engel propose overcoming them?

Answer 25

Engel notes that physicians must be trained in both biomedical and psychosocial aspects, but financial and structural limitations in healthcare systems may hinder this integration. He argues that changes in medical education and resource allocation are needed to embrace a more holistic approach to healthcare, shifting away from exclusive reliance on biomedicine.

Question 26

Why does Ghaemi argue the Biopsychosocial (BPS) model never fully succeeded in medicine, and how did it fare in psychiatry?

Answer 26

Ghaemi claims that the BPS model was seen as easily incorporated into the biomedical model, which limited its impact. However, it gained relative popularity in psychiatry as it emphasized the importance of biological, psychological, and social factors in mental health.

Question 27

What is Ghaemi’s criticism of the BPS model as a research framework?

Answer 27

Ghaemi argues that the BPS model lacks specificity and fails to provide a clear framework for research. It suggests mental disorders are caused by a mix of factors but doesn’t specify how these factors interact or what their relative importance is, leading to either eclecticism or dogmatism in practice.

Question 28

What are the consequences of the BPS model leading to eclecticism and dogmatism, according to Ghaemi?

Answer 28

Eclecticism leads to unsystematic picking and choosing from different approaches without clear boundaries, while dogmatism causes adherence to one approach at the expense of others. Both result in a lack of coherent guidance for treatment and research.

Question 29

What concerns does Ghaemi raise about the lack of boundaries in the BPS model?

Answer 29

Ghaemi worries that without clear boundaries, the BPS model can include anything, even unscientific ideas like alien abduction theories for PTSD, leading to a lack of scientific rigor. He compares the BPS model to a list of ingredients without a recipe, making it unclear how to proceed in practice.

Question 30

What is Ghaemi’s argument about the need for specificity in scientific research and how the BPS model falls short?

Answer 30

Ghaemi argues that research needs to be precise and specific for hypotheses to be testable. The BPS model’s vague approach to the causes of mental disorders does not allow for specific, testable hypotheses, leading to a lack of direction in research.

Question 31

ghaemi's view on reductionism?

Answer 31

Ghaemi asserts that reductionism is not always wrong. He believes that determining when reductionism is justified is key, as some mental health conditions may require a reductionist approach, while others may benefit from a more holistic view, which the BPS model does not adequately address.

Question 32

What is Ghaemi’s critique of the BPS model’s approach to treatment?

Answer 32

Ghaemi argues that the BPS model leads to a “one-size-fits-all” approach where every mental illness gets biological, psychological, and social treatments, regardless of what is most appropriate. This approach wastes resources, increases side effects, and lacks prioritization of the most relevant treatment method for each condition.

Question 33

What does Ghaemi see as the problem with psychopharmacology practices in psychiatry?

Answer 33

Ghaemi critiques that psychopharmacology is often symptom-based rather than diagnosis-driven, leading to over-prescription of medications. He argues this approach is unscientific and could be improved by a better diagnosis-first philosophy.

Question 34

How does Ghaemi differentiate pluralism from eclecticism in psychiatry?

Answer 34

Pluralism is method-based and emphasizes using the most appropriate theories for specific phenomena. Eclecticism, on the other hand, involves picking and choosing from various approaches without a systematic method, which can lead to inefficiency and a lack of focus in treatment.

Question 35

What is the core concern with using AI in medical decisions?

Answer 35

AI systems, especially deep learning networks, function as black boxes—they produce decisions that are often more accurate than human experts but are not explainable in terms of causal reasoning.

Question 36

What is London’s main thesis about black-box AI?

Answer 36

London argues that requiring AI to be explainable holds it to an unfairly high standard since much of medicine already relies on brute associations rather than theoretical understanding.

Question 37

What epistemic model does London use to support his thesis?

Answer 37

Aristotle’s distinction between the empiric (knows that) and the theorist (knows why); London claims medicine is more like the empiric—focused on what works, even if the “why” is unclear.

Question 38

How does London respond to critics who say medicine should be like engineering?

Answer 38

He argues medicine lacks the causal clarity of engineering, so demanding theoretical explanations from AI (or anyone) is unrealistic and could harm patients.

Question 39

What does London propose as a better standard than explainability?

Answer 39

accuracy based on real-world validation—AI should be used only for decisions where its empirical success is demonstrated.

Question 40

According to London, what is the danger in requiring interpretability?

Answer 40

it might block the use of highly accurate tools simply because they can't explain themselves—potentially worsening patient outcomes.

Question 41

What is B&B’s central concern with AI in medicine?

Answer 41

AI may conflict with the ideals of patient-centered medicine, which emphasizes shared understanding, autonomy, and doctor-patient communication.

Question 42

Why do B&B think black-box AI undermines patient autonomy?

Answer 42

Without being able to explain the AI's decision, physicians can't help patients understand their options or make rational, informed decisions.

Question 43

What role does trust play in B&B’s critique?

Answer 43

Trust is built through explanation. If decisions are based on opaque AI outputs, patients may distrust the medical advice, undermining care. -- human experts can explain their decision

Question 44

How do London and B&B differ on the value of explainability in medicine?

Answer 44

London sees explainability as less essential and even harmful if it blocks accurate decisions. B&B see it as central to ethical, patient-centered care.

Question 45

What does Levy challenge in his paper?

Answer 45

The Brain Disease Model of Addiction (BDMA), popularized by Alan Leshner, which frames addiction as a neurological disorder.

Question 46

Why is the BDMA considered compassionate?

Answer 46

It moves away from the moral model that blames addicts for their condition, treating addiction as a disease rather than a failure of will.

Question 47

What does Levy aim to do in his critique of BDMA?

Answer 47

Show that BDMA might not be the only compassionate approach, and that describing addiction as a brain disease might be misleading or unhelpful.