Abstract Twentieth century innovations in reasoning about health and medicine (randomized clinical trials, systematic reviews, and a growing list of other inventions) have dramatically changed what counts as good argumentation within this domain. Though these new forms are often highly specialized and highly technical, they are gradually becoming “norms of public argumentation” (Zenker, et al., 2024), spreading from esoteric discussion among medical scientists into other discourses (including interpersonal exchanges between doctors and patients). This pattern is not limited to health and medicine but affects so many domains that it has become ubiquitous in contemporary argumentative discourse. But innovations aimed at improving reasonableness, when successful, can disrupt preexisting normative frameworks. They can undermine and supplant prior bases for inference, abruptly change standards for argument criticism, and require adoption of different rules for argumentative engagement. The study reported here concerns the volatility that surrounds these innovations in a case study of debate over a controversial treatment for a controversial disease. Close examination of the debate from a normative pragmatic perspective shows much greater normative complexity than has been acknowledged within contemporary argumentation theory, including unexpected volatility in norms that arguers themselves must somehow manage.

Abstract Argumentation occurring in public controversies (large, long-lasting, and complex disagreements) deserve more attention from argumentation theorists than they have yet received, primarily because they offer plentiful opportunity to discover new facts about the contemporary practice of argumentation. Drawing on the polylogue framework (Lewiński and Aakhus 2023) and the cartography of controversy (Venturini and Munk 2022), nine suggestions are offered for how to build new theoretical knowledge through observational research that combines classic techniques in qualitative social science with emerging computational techniques: (1) aim for observationally grounded theory; (2) anchor analysis in argumentative texts; (3) practice constant comparison; (4) build outward from individual texts to networks; (5) investigate the places where texts are produced; (6) pay attention to the literatures where texts accumulate; (7) leverage computational techniques for natural language processing of large bodies of text; (8) reserve judgment on matters of disagreement within the controversy; and (9) try team science. Recent argument-centered studies of controversies demonstrate aspects of this approach and show its promise for discovering interesting and novel phenomena.

Contemporary reasoning about health is infused with the work products of experts, and expert reasoning about health itself is an active site for invention and design. Building on Toulmin’s largely undeveloped ideas on field-dependence, we argue that expert fields can develop new inference rules that, together with the backing they require, become accepted ways of drawing and defending conclusions. The new inference rules themselves function as warrants, and we introduce the term “warranting device” to refer to an assembly of the rule plus whatever material, procedural, and institutional resources are required to assure its dependability. We present a case study on the Cochrane Review, a new method for synthesizing evidence across large numbers of scientific studies. After reviewing the evolution and current structure of the device, we discuss the distinctive kinds of critical questions that may be raised around Cochrane Reviews, both within the expert field and beyond. Although Toulmin’s theory of field-dependence is often criticized for its relativism, we find that, as a matter of practical fact, field-specific warrants do not enjoy immunity from external critique. On the contrary, they can be opened to evaluation and critique from any interested perspective.