Search

Rationale: Although precision medicine is seen by many as one of the most promising advances in the field of medicine, it has also raised critical questions at various levels. Many of these concerns revolve around an observation described by Kimmelman and Tannock as the ‘paradox of precision medicine’: somewhat surprisingly, uncertainty seems to be a key characteristic of precision medicine in practice. Aims and Objective: To better understand this concept and the underlying issues, a scoping review was undertaken to search for factors stated in the literature as contributing to or being aspects of uncertainty in precision medicine. Methods: A systematic search of the literature was conducted in three databases (Pubmed, Web of Science, and Jstor) and complemented with a systematic hand-search. The initial search provided 1.252 items of which 51 articles for selected as eligible for further analysis. These articles were coded with MAXQDA and categorized into four main themes (a–d) of uncertainty. The main results were summarized and discussed with a view to the interrelations between different aspects and implications for precision medicine in practice. Results: The mapping of different aspects and sources of uncertainty leads to the key result that ‘uncertainty’ should be understood as a cluster concept. Uncertainties are identified in many different respects and situated at different levels: Most complexity-related issues (theme a) can best be understood as ontological (‘world-sided’) aspects of the uncertainty paradox. Conceptual (theme b) and evidence-related uncertainties (theme c) are situated on an epistemological or methodological level, addressing foundational and normative challenges related to knowledge production in precision medicine. Finally, theme (d) targets issues on the level of material precision medicine practices. These levels are helpful to understand the different dimensions of the uncertainty paradox. Conclusions: Uncertainty may not merely be a transient effect of the novelty of the precision medicine paradigm. Rather, it should be seen as a consequence of the ontological, epistemological and practical complexity of precision medicine, implying that uncertainty will not necessarily be reduced by more research. This finding encourages further investigations to better understand the interactions among various factors and aspects of uncertainty in precision medicine and the resulting implications for research and medical practice.

This paper argues that research on normative issues in the life sciences will benefit from a tighter integration of philosophy of science. We examine research on ethical, legal and social issues in the life sciences (“ELSI”) and discuss three illustrative examples of normative issues that arise in different areas of the life sciences. These examples show that important normative questions are highly dependent on epistemic issues which so far have not been addressed sufficiently in ELSI, RRI and related areas of research. Accordingly, we argue for the integration of research on the epistemic aspects of the relevant areas of science into ELSI research to provide a better basis for addressing normative questions.

We analyse insufficient epistemic pluralism and associated problems in science-based policy advice during the COVID-19 pandemic drawing on specific arguments in Paul Feyerabend’s philosophy. Our goal is twofold: to deepen our understanding of the epistemic shortcomings in science-based policy during the pandemic, and to assess the merits and problems of Feyerabend’s arguments for epistemic pluralism as well as their relevance for policy-making. We discuss opportunities and challenges of integrating a plurality of viewpoints from within and outside science into policy advice thus contributing to discussions about normative issues concerning evidence and expertise in policy-making.

In this paper, we use the case of the COVID-19 pandemic in Europe to address the question of what kind of knowledge we should incorporate into public health policy. We show that policy-making during the COVID-19 pandemic has been biomedicine-centric in that its evidential basis marginalised input from non-biomedical disciplines. We then argue that in particular the social sciences could contribute essential expertise and evidence to public health policy in times of biomedical emergencies and that we should thus strive for a tighter integration of the social sciences in future evidence-based policy-making. This demand faces challenges on different levels, which we identify and discuss as potential inhibitors for a more pluralistic evidential basis.

This article is a reply to Richard Lauer’s “Is Social Ontology Prior to Social Scientific Methodology?” and an attempt to contribute to the meta-social ontological discourse more broadly. In the first part I will give a rough sketch of Lauer’s general project and confront his pragmatist approach with a fundamental problem. The second part of my reply will provide a solution for this problem rooted in a philosophy of the social sciences in practice.

This paper uses the example of the COVID-19 pandemic to analyse the danger associated with insufficient epistemic pluralism in evidence-based public health policy. Drawing on certain elements in Paul Feyerabend’s political philosophy of science, it discusses reasons for implementing more pluralism as well as challenges to be tackled on the way forward.

Despite aspirations to substitute animal experimentation with alternative methods and recent progress in the area of non-animal approaches, such as organoids and organ(s)-on-a-chip technologies, there is no extensive replacement of animal-based research in biomedicine. In this paper, I will analyse this state of affairs with reference to key institutional and socio-epistemic barriers for the development and use of non-animal approaches in the context of biomedical research in Europe. I will argue that there exist several factors that inhibit change in this context. In particular, there is what I call “scientific inertia”, i.e. a certain degree of conservatism in scientific practice regarding the development and use of non-animal approaches to replace animal experimentation. This type of inertia is facilitated by socio-epistemic characteristics of animal-based research in the life sciences and is a key factor in understanding the status quo in biomedical research. The underlying reasons for scientific inertia have not received sufficient attention in the literature to date because the phenomenon transcends traditional disciplinary boundaries in the study of animal experimentation. This paper addresses this issue and seeks to contribute to a better understanding of scientific inertia by using a methodology that looks at the interplay of institutional, epistemic, and regulatory aspects of animal-based research.

In this article, I will discuss two prominent views on the relevance and irrelevance of ontological investigations for the social sciences, namely, ontological foundationalism and anti-ontological pragmatism. I will argue that both views are unsatisfactory. The subsequent part of the article will introduce an alternative role for ontological projects in the philosophy of the social sciences that fares better in this respect by paying attention to the ontological assumptions of actual social scientific theories, models, and related explanatory practices. I will illustrate and support this alternative through discussion of three concrete cases. © The Author(s) 2016.

Zusammenfassung Der Artikel diskutiert Niklas Luhmanns Konzeption von Kommunikation als emergentem Phänomen. Erstens soll gezeigt werden, dass sich Luhmann, entgegen jüngster Einwände, in der Tat als sozialer Emergentist rekonstruieren und als solcher in die aktuelle Debatte um Reduktion und Emergenz des Sozialen einordnen lässt. Zweitens soll dadurch Licht auf die generellen Probleme und Voraussetzungen einer emergentistischen Soziologie geworfen werden. Um diese Ziele zu erreichen, wird zunächst geklärt, welche Positionen sich in der Soziologie grundsätzlich gegenüber stehen und auf welcher Grundlage Luhmann als Emergentist einzuordnen ist. Anschließend soll die Emergenz der Kommunikation als eigenständiges soziales Phänomen erläutert und ins Verhältnis zum Individuum gesetzt werden. Schließlich wird Luhmanns Konzeption mit Hilfe einiger Adäquatheitsbedingungen aus der allgemeinen Wissenschaftsphilosophie als unzureichend kritisiert. Ziel ist dabei auch die Klärung der Bedingungen für eine plausible Emergenztheorie innerhalb der Soziologie. Nach einer abschließenden Zusammenfassung der wesentlichen Ergebnisse soll ein Ausblick auf eine aussichtsreiche soziologische Emergenzkonzeption geboten werden.

This article is a revision of the previous edition article by P. Hoyningen-Huene, volume 12, pp. 8171–8176, © 2001, Elsevier Ltd.