Turner Andrew
Digital Ethics Lab, Oxford Internet Institute, 41 St Giles, Oxford, OX1 3JS, UK.
Theor Med Bioeth. 2017 Aug;38(4):335-352. doi: 10.1007/s11017-017-9415-y.
In 2009, the UK House of Commons Science and Technology Committee (STC) conducted an 'evidence check' on homeopathy to evaluate evidence for its effectiveness. In common with the wider literature critical of homeopathy, the STC report seems to endorse many of the strong claims that are made about its implausibility. In contrast with the critical literature, however, the STC report explicitly does not place any weight on implausibility in its evaluation. I use the contrasting positions of the STC and the wider critical literature to examine the 'implausibility arguments' against homeopathy and the place of such arguments within evidence-based medicine (EBM). I argue that the STC report undervalues its strong claims about the mechanistic plausibility of homeopathy because it relies on a misunderstanding about the role of mechanistic evidence within EBM. This is not a conclusion for a revision of the role mechanistic evidence plays within EBM, however. It is a conclusion about the inconsistency of the STC report's position towards implausibility arguments, given the evidential claims they endorse and the atypical situation that homeopathy presents. It provides a further example of the general point that mechanistic reasoning should not be seen as providing categorically lower quality evidence.
2009年，英国下议院科学技术委员会（STC）对顺势疗法进行了一次“证据核查”，以评估其有效性的证据。与更广泛的批评顺势疗法的文献一样，STC的报告似乎认可了许多关于顺势疗法不可信的有力观点。然而，与批评性文献不同的是，STC的报告在评估中明确没有考虑不可信这一点。我利用STC和更广泛的批评性文献的不同立场，来审视反对顺势疗法的“不可信论点”以及这些论点在循证医学（EBM）中的地位。我认为，STC的报告低估了其关于顺势疗法机制合理性的有力观点，因为它依赖于对EBM中机制性证据作用的误解。然而，这并不是要对机制性证据在EBM中所起的作用进行修订的结论。这是关于STC报告对不可信论点的立场不一致的结论，鉴于他们认可的证据主张以及顺势疗法所呈现的非典型情况。它进一步说明了一个普遍观点，即机制性推理不应被视为提供绝对低质量的证据。
