This paper explores the nature of causation within the framework of evidence‐based practice (EBP) for health care. The aims of the paper were first to define and evaluate how causation is presently accounted for in EBP; second, to present an alternative causal account by which health care can develop in both its clinical application and its scientific research activity. The paper was premised on the idea that causation underlies medical and health care practices and impacts on the way we understand health science research and daily clinical practice. The question of what causation is should therefore be of utmost relevance for all concerned with the science, philosophy and progress of EBP. We propose that the way causation is thought of in contemporaneous health care is exposed by evidential frameworks, which categorize research methods on their epistemological strengths. It is then suggested that the current account of causation is limited in respect of both the functionality of EBP, and its inherent scientific processes. An alternative ontology of causation is provided, which has its roots in dispositionalism. Here, causes are not seen as regular events necessitating an effect, but rather phenomena that are highly complex, context‐sensitive and that tend towards an effect. We see this as a better account of causation for evidence‐based health care.
Some of the chief goals of science are understanding, explanation, prediction, and application in new technologies. Only if the world has some significant degree of constancy in what follows from what can these activities be conducted with any purpose. But what is the source of such predictability and how does it operate? This is a question that goes beyond science itself and inevitably requires a philosophical approach. It is argued in such terms that causation is the main foundation upon which the possibility of science rests. But what methods should we adopt in order to identify causes in science? The choice of methods will inevitably reflect what one takes causation to be, making an accurate account of causation an even more pressing matter. The enquiry concerns the correct norms for the empirical study of the world. This matters a lot. Some of the greatest challenges that we face will only be solved if we understand what has caused the problem and what, if anything, could then cause its alleviation.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.