Greenhalgh Trisha
Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK.
Interface Focus. 2021 Oct 12;11(6):20210017. doi: 10.1098/rsfs.2021.0017. eCollection 2021 Dec 6.
When the history of the COVID-19 pandemic is written, it is likely to show that the mental models held by scientists sometimes facilitated their thinking, thereby leading to lives saved, and at other times constrained their thinking, thereby leading to lives lost. This paper explores some competing mental models of how infectious diseases spread and shows how these models influenced the scientific process and the kinds of facts that were generated, legitimized and used to support policy. A central theme in the paper is the relative weight given by dominant scientific voices to probabilistic arguments based on experimental measurements versus mechanistic arguments based on theory. Two examples are explored: the cholera epidemic in nineteenth century London-in which the story of John Snow and the Broad Street pump is retold-and the unfolding of the COVID-19 pandemic in 2020 and early 2021-in which the evidence-based medicine movement and its hierarchy of evidence features prominently. In each case, it is shown that prevailing mental models-which were assumed by some to transcend theory but were actually heavily theory-laden-powerfully shaped both science and policy, with fatal consequences for some.
当书写新冠疫情的历史时，很可能会表明科学家所持的心智模型有时促进了他们的思考，从而拯救了生命，而在其他时候则限制了他们的思考，从而导致了生命的丧失。本文探讨了关于传染病传播方式的一些相互竞争的心智模型，并展示了这些模型如何影响科学进程以及所产生、合法化并用于支持政策的各类事实。本文的一个核心主题是，主流科学观点对基于实验测量的概率性论据与基于理论的机制性论据的相对重视程度。探讨了两个例子：19世纪伦敦的霍乱疫情——其中重述了约翰·斯诺和宽街水泵的故事——以及2020年和2021年初新冠疫情的发展——其中循证医学运动及其证据等级制度显著凸显。在每种情况下，都表明了当时盛行的心智模型——一些人认为它超越了理论，但实际上却充满了理论色彩——对科学和政策都产生了强大的影响，给一些人带来了致命后果。
