Philosophy of Medicine Roundtable 2025 (part one)

The Philosophy of Medicine Roundtable was held at King's College London on 2nd and 3rd June 2025. Here is a brief account of some of the talks and posters presented on the first day of the event.

Bush House in London, conference venue

The first talk was by John Ioannidis, "Research results: the false, the fake, the useless, and the untouchables". The presentation started with the statement that "Science is the best thing that can happen to humans". Yet, Ioannidis argued that most scientific research has used non-reproducible and sub-optimal research practices.

Results can be:

• False = due to random error or bias
• Fake = not real, crafted, fabricated
• Useless = not having a meaningful purpose
• Untouchable = impossible to access or use.

John Ioannidis

Problems:

• Megajournals publish too many papers and have high acceptance rates (25-60%). Review is fast and authors pay to publish.
• Predatory journals publish poor science and have an acceptance rate of 100%.
• Extreme publishing behaviour is another threat (researchers publish 60 research articles every year) and get high citation rates in problematic ways.
• Many fake papers are generated through AI and only a few are detected and retracted.

In the rest of the presentation, Ioannidis analysed in more detail the challenges of doing science in a way that produces results that are not fake, not useless, and accessible; and suggested some ways we can improve scientific practices.

In the first break of the conference, participants were invited to look at the research posters. One of these posters was by EPIC postdoctoral researcher Jodie Russell. Russell's work is on intersectional invisibility. You can download her poster here.

Jodie Russell on intersectionality

In the afternoon,  Maria Cristina Amoretti presented a paper about the distinction between values and biases in medicine, co-authored with Elisabetta Lalumera. While values guide research priorities and clinical decision-making, biases are typically seen as distortions to be eliminated. However, this view is too simplistic: both values and biases can promote or hinder medical knowledge and patient care. 

Cristina Amoretti and... Pimpa!

Amoretti and Lalumera proposed a functional distinction: values are explicit, discussable, and justifiable judgments shaping medical aims, whereas biases are implicit tendencies influencing reasoning in ways not explicitly articulable. Values are not always beneficial, and biases are not always harmful. Instead, their roles in medical research and clinical practice need further examination.

In another talk, Elena Popa and Jay Zameska discussed the relationship between social determinants of health and various conceptions of causation. The empirical evidence linking wide social issues such as inequality or poverty to health outcomes justifies the search for interventions on these high-level phenomena. This can be a more efficient way of improving the health of a population in contrast with targeting individuals suffering from downstream health effects. 

Elena Popa presenting

But it is difficult to fit insights from population health science with biomedical approaches which focus on downstream causes and which have been preponderantly used in public health. For Pola and Zameska, overcoming the dominance of narrow biomedical models requires considering a wider range of causal concepts, particularly mechanistic and dispositional ones. The suitability of these concepts can then be assessed by analyzing the interventions resulting from them through the lens of priorities in public health

ethics.

Another break in the conference meant another look at the posters! Themistoklis Pantazakos prepared a poster on the role of biomarkers in debates about pathologization.

Themistoklis Pantazakos on biomarkers

Rebecca Brione presented on the importance of philosophy of language for doctor-patient interactions. In particular, Brione focused on failed refusals of medical treatment. Should the patient have the right to refuse treatment, and if so, under what circumstances? Little attention has been paid to the speech act of refusal itself. 

Brione argued that philosophy of language offers the resources we need to develop a more sophisticated understanding of medical refusal (and similar speech acts), in isolation and in context. These resources enable us both to conceptualise refusal as a normative act, and to understand what is required for a patient to succeed in their attempt to refuse treatment. 

Rebecca Brione on medical refusal

Brione presented a novel account of refusal as an assertion which attempts to add both a direct proposition and presupposed content about the normative landscape to the communicative common ground (the shared beliefs, knowledge and information that form the background for an assumed-collaborative conversation).

The first day of the Roundtable was very rich and thought-provoking, showcasing the variety of issues that can be tackled by philosophers of medicine.