Sarah Wieten, Thinking about guidelines:
I was glad to participate in the CauseHealth conference planning meeting October 24th 2016 in London. In the aftermath of the meeting, I was happy to share these brief notes with Sam.
I noticed that the group as a whole seemed very interested in discussing the nature of truth. I was somewhat surprised by this because it can be very abstract work. This is the sort of topic which might be very strictly in the purview of philosophers, and I worry none of us there were the right people to deliver on that topic. If that is what will help the general project of producing better and more useful guidelines, and is a component that others expect we (as philosophers) will be able to talk about, perhaps we should be sure to invite some philosophers that do in fact study that to the conference.
Wrapped up with the hope that philosophers might be able to sort out what truth was the hope that we could say what exactly is bias. There seemed to be uncertainty about how much intentions might matter for whether something was biased or not. It was noted that bias was different than ignorance and that one could be biased without meaning to or without committing fraud, but there was still a bit of a puzzle about why bias was chosen to be the category with which we talked about these various epistemic failures.
I also was excited about a point brought up in the discussion of guidelines, questioning if being “easy to use” was in fact a virtue, as is generally assumed. I wondered if this might fruitfully be linked to the literature in the philosophy of science which questions “simplicity” as an obvious epistemic virtue.
Another question which was raised and I think merits future consideration was, “Is it possible to write guidelines for personalized medicine?” The idea here seems to be that there is something incompatible between insisting that all interventions be indexed to particular individuals and the goal of guidelines, which is to produce widely generalizable population-level advice. However, I wonder how much of this seeming incompatibility might fall away if it becomes clear that the intense personalization promised by personalized medicine is mostly public relations-the best that can be done is to get data from more specific populations and deliver interventions to those specific populations.
Generally it was a vibrant and enjoyable meeting with many important current controversies discussed from a variety of perspectives. I look forward to the upcoming conference.