Jacob Stegenga – författare

The philosophy of medicine has become a vibrant and complex intellectual landscape, and Care and Cure is the first extended attempt to map it. In pursuing the interdependent aims of caring and curing, medicine relies on concepts, theories, inferences, and policies that are often complicated and controversial. Bringing much-needed clarity to the interplay of these diverse problems, Jacob Stegenga describes the core philosophical controversies underlying medicine in this unrivaled introduction to the field.The fourteen chapters in Care and Cure present and discuss conceptual, metaphysical, epistemological, and political questions that arise in medicine, buttressed with lively illustrative examples ranging from debates over the true nature of disease to the effectiveness of medical interventions and homeopathy. Poised to be the standard sourcebook for anyone seeking a comprehensive overview of the canonical concepts, current state, and cutting edge of this vital field, this concise introduction will be an indispensable resource for students and scholars of medicine and philosophy.

This book argues that if we consider the ubiquity of small effect sizes in medicine, the extent of misleading evidence in medical research, the thin theoretical basis of many interventions, and the malleability of empirical methods, and if we employ our best inductive framework, then our confidence in medical interventions ought to be low.

Medical nihilism is the view that we should have little confidence in the effectiveness of medical interventions. This volume argues that medical nihilism is a compelling view of modern medicine. If we consider the frequency of failed medical interventions, the extent of misleading evidence in medical research, the thin theoretical basis of many interventions, and the malleability of empirical methods in medicine, and if we employ our best inductive framework, then our confidence in the effectiveness of medical interventions ought to be low. Part I articulates theoretical and conceptual groundwork, in which Jacob Stegenga offers a defence of a hybrid theory of disease, which forms the basis of a novel account of effectiveness, and applies this to pharmacological science and to issues such as medicalization. Part II critically examines details of medical research. Even the very best methods in medical research, such as randomized trials and meta-analyses, are malleable and suffer from various biases. Methods of measuring the effectiveness of medical interventions systematically overestimate benefits and underestimate harms. Part III summarizes the arguments for medical nihilism and what this position entails for medical research and practice. To evaluate medical nihilism with care, Stegenga states the argument in formal terms. Medical nihilism suggests that medical research must be modified, that clinical practice should be less aggressive in its therapeutic approaches, and that regulatory standards should be enhanced.

A novel epistemology of science contends that good science need not attain its aims, but it must justify its claims.  In Heart of Science, philosopher Jacob Stegenga breaks with the most dominant epistemologies of science to argue that in judging scientific activity, we should focus on its justification, not the achievement of truth or knowledge. Yet, Stegenga argues, the aim of science goes far beyond justification and is, instead, a special kind of truth—common knowledge, a broadly shared and mutually justified scientific finding.  Drawing on both historical examples and recent events like the COVID-19 pandemic, Stegenga outlines his approach before delving into its implications for scientific evaluation, testimony, values, progress, and credit, as well as the nature of science during times of crisis. Truth, he shows, may not be easily identified in the short term. However, an evaluation of scientific justification, grounded in shared standards, is possible. This framework helps us appraise—and appreciate—historical theories that ultimately weren’t accurate and offers fresh insights about appropriate science communication and public trust in scientific research. Justification and scientific rigor are not just means to an end, Stegenga writes, but the very heart of good science.  Ambitious, authoritative, and accessible, Heart of Science offers a new vision for the philosophy of science.