In recent years there have been a variety of university courses,[4][5] journals,[6][7][8][9] books,[10][11][12][13] textbooks[14] and conferences dedicated to the philosophy of medicine.
[17] Metaphysics is the branch of philosophy that examines the fundamental nature of reality including the relationship between mind and matter, substance and attribute, and possibility and actuality.
For example, the defining feature of randomized controlled trials (RCTs) is that they are thought to establish causal relationships, whereas observational studies do not.
[21] In this instance, causation can be considered as something which is counterfactually dependent, i.e. the way RCTs differ from observational studies is that they have a comparison group in which the intervention of interest is not given.
While Cartesian dualism dominates clinical approaches to medical research and treatment, the legitimacy of the split between mind and body has been consistently challenged from a variety of perspectives.
When the human body is exposed to the solid pathogen, it falls ill, giving rise to the notion of a disease entity.
The distinctions at work in these types of definition: between active and inactive or inert, specific and non-specific, and subjective and objective, have been problematized.
[35][36] The problems arising over the definition of placebos and their effects may be said to be the heritage of Cartesian dualism, under which mind and matter are understood as two different substances.
This then means that medical science has difficulty in entertaining even the possibility that placebo effects are real, exist and may be objectively determinable and finding such reports difficult if not impossible to comprehend and/or accept.
Yet such reports which appear to be genuine pose a threat to Cartesian dualism which provides the ontological underpinning for biomedicine especially in its clinical domain.
[22] Evidence-based medicine (EBM) is underpinned by the study of the ways in which knowledge can be gained regarding key clinical questions, such as the effects of medical interventions, the accuracy of diagnostic tests, and the predictive value of prognostic markers.
[40][page needed] Additionally the epistemological virtues of particular aspects of clinical trial methodology have been examined, mostly notably the special place that is given to randomisation,[41][42][43] the notion of a blind experiment and the use of a placebo control.