Epistemic Causality and Evidence-Based Medicine

Causal claims in biomedical contexts are ubiquitous albeit that they are not always made explicit. This paper addresses the question of what causal claims mean in the context of disease. It is argued that in medical contexts causality ought to be interpreted according to the epistemic theory. According to this approach, causal claims tell us about which inferences (e.g., diagnoses and prognoses) are appropriate, rather than about the presence of some physical causal relation analogous to distance or gravitational attraction. It is shown that the epistemic theory has im- portant consequences for medical practice, in particular with regard to the evidence-based causal assessment