2007/07/29 by John Worrall · 7 citations
Economics, Econometrics and Finance · Arts and Humanities · Mathematics · #Health Systems, Economic Evaluations, Quality of Life #Philosophy and History of Science #Advanced Causal Inference Techniques
paper · doi:10.1093/bjps/axm024
openalex publication_date 2007/07/29 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/30
The evidence from randomized controlled trials (RCTs) is widely regarded as supplying the ‘gold standard’ in medicine—we may sometimes have to settle for other forms of evidence, but this is always epistemically second-best. But how well justified is the epistemic claim about the superiority of RCTs? This paper adds to my earlier (predominantly negative) analyses of the claims produced in favour of the idea that randomization plays a uniquely privileged epistemic role, by closely inspecting three related arguments from leading contributors to the burgeoning field of probabilistic causality—Papineau, Cartwright and Pearl. It concludes that none of these further arguments supplies any practical reason for thinking of randomization as having unique epistemic power. 1. Introduction2. Why the issue is of great practical importance—the ECMO case3. Papineau on the ‘virtues of randomization’4. Cartwright on causality and the ‘ideal’ randomized experiment5. Pearl on randomization, nets and causes6. Conclusion