The article presents the advantages and limitations of adaptive clinical trials for assessing the effectiveness of medical interventions and specifies the conditions that contributed to their development and implementation in clinical practice. I advance two arguments by discussing different cases of adaptive trials. The normative argument is that responsible adaptation should be taken seriously as a new way of doing clinical research insofar as a valid justification, sufficient understanding, and adequate operational conditions are provided. The second argument is historical. The (...) development of adaptive trials can be related to lessons learned from research in cases of urgency and to the decades-long efforts to end the productivity crisis of pharmaceutical research, which led to the emergence of translational, personalized, and, recently, precision medicine movements. (shrink)

This dissertation explores the influence of time constraints on different research practices. The first two parts present case studies, which serve as a basis for discussing the epistemological and ethical implications of temporal limitations in scientific research. Part I is a case study on gravitational wave research, conducted by the LIGO Scientific Collaboration. This exemplifies fundamental research – without immediate societal applications, open-ended in terms of timeline and in terms of research goals. It is based, in part, on qualitative interviews (...) conducted with gravitational wave physicists. I show that considerations about time and speed play a role in every stage of research: goal setting, method design, and the evaluation and communication of results. Part II provides a case study on translational medicine, an approach explicitly dedicated to accelerating research in order to develop and implement new therapies. This epitomizes applied research with high social stakes, motivated by non-epistemic goals. Here, epistemic trade-offs between speed and reliability intersect with ethical trade-offs between different types of harms. In Part III, the insights from both of these case studies are used as the basis for a more general discussion concerning the pragmatic aspects of epistemic practices, especially in relation to current debates centered on the role of values in science. A particular focus is on the value of speed and the ability to generate reliable results, either via choice of methods, or via decisions about which goals to set, as well as decisions about when to stop further testing. The primary thesis of the dissertation is that pragmatic considerations stemming from limitations of resources are a necessary feature of the pursuit of epistemic aims, and that the epistemic is thus inherently pragmatic. (shrink)

I examine the role of time-sensitivity in science by drawing on a discussion between Kevin Elliott and Daniel McKaughan and Daniel Steel, on the role of non-epistemic values in theory assessment and the epistemic status of speed of inference. I argue that: 1) speed supervenes on ease of use in the cases they discuss, 2) speed is an epistemic value, and 3) Steel’s account of values doesn’t successfully distinguish extrinsically epistemic from non-epistemic values. Finally, I propose an account of time-sensitivity.

Practical reasoning is a domain of concerns that deal with our most intimate views on what should be done, every day, in facing the world. Unlike theoretical reasoning which forms only beliefs, practical reasoning forms intensions and sets ground for actions. It deals mostly with the notion of reason, broadly understood as a term that acquires both rationality and motivation for our actions. Bernard Williams in “Internal and external reasons” introduced a strong and influential distinction, the distinction between internal and (...) external reasons. Williams explicitly argues in favour of internalism, excluding the existence of external reasons and placing the burden of proof on the externalists. In this paper I will reconsider his views drawing on John Skorupski’s insights on Williams in “Internal Reasons and the Scope of Blame” and Skorupski’s cognitive internalism. I will criticise both of their internalistic accounts and argue for an Aristotelian framing of their main arguments which I believe is a fairer deal in their contribution to the practical reasoning issues. (shrink)