The CauseHealth Series: Chapter 4 - When a Cause Cannot be Found with Dr Rani Lill Anjum and Dr Elena Rocca

Welcome to another episode of The Words Matter Podcast.

So we are up to Chapter 4 of the CauseHealth Series, and I hope you’ve enjoyed the previous episodes.

In this episode I talk again with two of the editors of the CauseHealth book (download here), Dr Rani Lill Anjum and Dr Elena Rocca about Chapter 4 which they co-wrote titled ‘When a Cause Cannot be Found’ (read Chapter 4 here).

In this episode we talk about:

• Medically unexplained symptoms (or MUS) and how such health conditions, which defy a clear biomedical explanation, offered a practical and clinical challenge for CauseHealth to take on (see paper here by Rani, Roger Kerry and others).
• We talk about how the mere accumulation of more biomedical knowledge and scientific discoveries won’t necessarily lead to a satisfactory explanation of MUS in individual patients, and how and why a dispositionalist view of causation offers a deeper and person-focused understanding to the complexity associated with MUS.
• We discuss the Problem of Uniqueness –and outline the challenge this poses both practically (i.e. clinically and methodologically), and also the broader and more fundamental philosophical challenge of medically unexplained symptoms.
• We talk about how methodological and evidential pluralism and inclusivism can help provide this deeper contextual understanding, which is not captured by RCTs and other quantitative methods alone.
• Finally, we talk about how other forms of evidence such as patient narratives, case studies and qualitative research, which don’t traditionally get involved with causation, that when taking a dispositionalist view, do in fact have lots to say and contribute to in regards to causation in healthcare

This episode really made me reflect on the role and contribution of qualitative research towards causal explanations in healthcare whether it be recovery or the onset of pain and illness.

The dispositionalist view opens up space for qualitative methodologies and methods to sit at the table of causation and offers researchers from these disciplines a theoretical framework to allow rich, detailed and sometimes abstract qualitative evidence, constructed from multiple individual perspectives and experiences to add to a causative understanding of individual patients.

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