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In the last chapter we discussed Mill's methods and their limitations. Here are
some further issues to consider about causation. In many situations, causes are
correlated with their effects. An event C is said to be positively correlated with
E when the presence of C increases the probability that E will also occur. C is

said to be negatively correlated with E when C decreases the probability of E.

If C has no effect on the probability of E, then C is not correlated with E, or C
is independent of E. So for example, the appearance of lightning is positively
correlated with thunder, negatively correlated with a clear sky, and presumably
not at all correlated with the day of the week.
Correlation is about how often two things are associated with each other, so
1 and there

it is a matter of degree. Lightning is inevitably followed by thunder,

is no thunder without lightning. This is 100% or a perfect correlation. Smoking

is positively correlated with lung cancer, but obviously not all smokers will get
cancer. Indeed, a low correlation between two types of events does not rule out
causation in particular instances. A hunter might fail to shoot his prey most of
the time, but when he succeeds his shot will be the cause of the animal's death.
1 Although you

might be too far away to hear it.




Similarly, most people are fine after taking aspirin, and there is only a low positive
correlation between aspirin and allergic reactions. But aspirin does cause allergic
reactions in about 1% of the population.
If a low correlation does not preclude causation, then is a high correlation suf
ficient for causation? Not at all! Confusing positive correlation with causation is
a common mistake in causal reasoning. Even if C does not cause E, there can be
many reasons why C is positive correlated with E. Here are the main possibilities:

The correlation between C and E is purely an accident.

E causes C and not the other way round.

C does not cause E but they are the effects of a common cause.

The main cause of E is some side effect of C rather than C itself directly.

This is not to say that data about correlation are irrelevant to causation. As a
matter of fact correlation is often a guide to causation. But we need to rule out the
alternative possibilities listed above if we want to infer causation on the basis of
positive correlation. Let us discuss these cases further.



Accidental correlation

Sometimes high correlation is the result of not having enough data. Suppose I
have been in only one car accident my whole life, and that was the only time I ever
wore red trousers. There is a perfect correlation between the color of my trousers
and my being involved in a car accident, but this is just a coincidence. Correlation
data are more useful when they involve a large range of cases.
But still we need to be careful. It has been suggested that the sea level in Venice
and the cost of bread in Britain have both been generally on the rise in the past two
centuries (Sober,

1988). But it is rather implausible to think that the correlation is

due to some underlying causal connection between the two cases. The correlation
is presumably an accident due to the fact that both have been steadily increasing
for a long time for very different reasons.
There is also a kind of accidental correlation known as spurious correlation (or
Simpson's paradox) that has to do with the aggregation of statistical data. It is
a rather interesting but somewhat technical topic. If you are interested you can
read more about it on our companion website.


The causal direction is reversed

Sometimes C is correlated with E not because C causes E, but because E causes

C. Drug users are more likely to suffer from psychiatric problems. This might

be because drug use is the cause, but perhaps preexisting psychiatric problems
cause people to turn to drugs. Correlation by itself does not tell us which of these



two stories (if any) is correct.2 It is important to bear this in mind when reading
newspaper accounts of scientific research. Scientific research might tell us only
that drug use is positively correlated with psychiatric problems, but reporters who
should know better might instead write, "drugs make you depressed and crazy."
The word make suggests causation but this might not actually be supported by
the data.
When two causal factors or variables reinforce each other, we have a causal

loop. For example, there is a correlation between health and GDP growth in many
countries. This is because on one hand, healthy citizens work longer and better,
contributing to economic growth. On the other hand, higher GDP brings about
better living conditions and medical care, improving health as a result. So health
and GDP growth are mutually reinforcing. It is possible that one variable has
a more significant effect on the other. However, it would require sophisticated
statistical techniques to determine which is which.
A vicious circle happens when a causal loop makes a bad situation even worse.
Take stage fright for example. Becoming nervous and stressful when you are per
forming can make you perform less well, and this might in turn make you even
more nervous, affecting your performance further. Catastrophe ensures if the vi
cious circle is not broken.


Hidden common causes

Sometimes C and E are correlated not because one causes the other but because
there is a hidden condition X that causes both C and E. For example, children
who wear bigger shoes tend to have better reading skills. Do shoes somehow pro
mote brain growth? Presumably not. The more mundane explanation is that older
children read better, and they have bigger feet. So growth is the hidden common
cause that leads to both bigger shoes and better reading skills. Or suppose the
drinking of bottled water instead of tap water is correlated with healthier children.
Is this because bottled water is cleaner, and ordinary tap water contains harmful
impurities? Not necessarily. Perhaps this is just because wealthier parents can af
ford higher-quality care and food for their children, and being more cautious, they
choose to buy bottled water even if tap water is just as good.


Causation due to side effect

In some cases where C correlates with E because C occurs together with some
other condition or side effect that actually causes E. The causal contribution from
C to E might be nonexistent or of lesser importance. The placebo effect is a good

example of causation due to side effect. It refers to the real or felt improvement
in a patient's condition that is due to beliefs about the treatment rather than the
medical efficacy of the treatment itself. It is suggested that when patients believe
that they have taken medicine, this is enough to make many of them feel better or
2 Most

likely there is causation in both directions.



suffer from less pain, even when the treatment being given (such as a cornstarch
pill) has no medical benefit. In fact, it has been reported that a larger pill has
a more pronounced placebo effect, and colored pills are better than white ones,
and that injections are even better!
The extent and mechanism of the placebo effect is still under study, but this is
one reason why it is necessary to include a control group in testing a drug. Sub
jects in the control group would be given an inert pill without being told that this
is the case, and the difference in response in the normal and control groups can
then provide a more reliable estimate as to the effectiveness of the drug.3

Placebo Surgery
It is surprising that the placebo effect applies not just to drugs but to
surgery as well. In Moseley et al.

(2002), over 100 patients suffering from

a knee problem (osteoarthritis) were given either real surgery or fake

surgery (in which the knee received only a superficial cut) . The patients
were not told whether they were given a real surgery or not. But in the
following two-year period, both groups reported the same amount of
pain and improvement in function. In another study, researchers stud
ied whether transplanting human embryonic cells into the brain would
improve Parkinson's disease (McRae et al.,

2004). All the patients had

small holes drilled into their skulls. Half of them were given the trans
plant, but the patients did not know whether they had it or not. Yet a
year later, those who believed that they had the real transplant reported
a better quality of life, whether or not they actually had the surgery! This
is a powerful demonstration of the placebo effect, and a good reminder
of the importance of double-blind studies. It also raises a difficult ethical
question: Should doctors exploit placebo effects more often in medical
treatments? But is it ethical to lie to patients about the nature of their

In scientific research, it is important to investigate side effects to ensure that

experimental results are reliable. For example, studying captive animals might
not give a true picture of the behavior of wild animals because putting animals in
a confined environment might change their habits, which is a form of side effect.
In other situations, experimental procedures can introduce contamination or ar
tifacts that affect the results. The following are other cases of side effect causation
relating to human beings:

even better version of this approach is to adopt a

double-blind study in which neither the patient

nor the doctor know whether the real pill or the fake one has being given. This is to avoid the doctor
leaking relevant information to bias the expectation of the patient.



An example in social science and industrial psychology is the Hawthorne

effect. This refers to the fact that people tend to change their behavior when
they know they are being studied. In particular, they might work harder or
perform better in an experimental setting.

People react to new things differently, and this produces a novelty effect.
Once the novelty wears off, their behavior might return to normal. For ex
ample, some schools claim that students behave better and learn better
when they switch their drab school uniforms to colorful Hawaiian shirts. Al
though there might have been a real correlation between the colorful shirts
and the better performance, this might just be due to the novelty of the new
arrangement. To show that wearing Hawaiian shirts can somehow really
improve learning and behavior, we would check whether the improvement
still remains after the novelty is gone.

The pygmalion effect originated from a study where teachers were told that
some of their students were above average even though they were randomly
selected with the same average abilities. But the subjective expectation of
the teachers somehow led to better performance by these students later on.
The result has been replicated in other contexts, and this has important im
plications for education and management.



We have looked at many reasons why correlation might not amount to causation.
To establish causation then, it is important to eliminate these alternative hypothe
ses. But what kind of positive evidence can we obtain to support causation?

First of

Look for covariation and manipulability

all, data about covariation are particularly useful. Recall Mill's method of

concomitant variations. If changes in one event correspond to changes in another

event, then this makes it more probable (though not conclusive) that one causes
the other. When we suspect smoking causes lung cancer, the fact that cigarette
smokers have a higher cancer rate than nonsmokers is only one piece of evidence.
It becomes even more convincing when it is discovered that the death rate from
lung cancer increases linearly with the number of cigarettes smoked per day.
Covariation is even stronger evidence when it can be directly manipulated and
not just being passively observed-we vary some aspects of the cause and see how
it affects the effect. For example, hitting the key of a piano causes a sound to be
made. We can be sure of the causal connection because we can change the timing
and the loudness of the sound by controlling when and how we hit the piano key.
This makes it extremely unlikely that the correlation is accidental or due to some
other explanation. In reality, manipulating correlation can sometimes be difficult
or even unethical to do. To study how smoking leads to lung cancer, it would be



immoral to request some subjects to smoke more cigarettes and see if they are
more likely to get cancer!


Look for a reliable model of causal mechanism

A causal mechanism is a series of objects, processes, or events that explain how

a cause leads to its effects. Using the piano as an example again, hitting the key
causes a felt-covered hammer to strike a steel string. This causes the string to vi
brate, and the vibration in turn causes air molecules to move, which is the sound
we hear. This causal process explains how the keys can create music, and a break
down in any step of the causal process might result in no sound being produced.
Nearly all instances of causation involve underlying causal mechanisms. A
causal mechanism explains why there is causation and helps us make predictions
about what would happen when the system changes. For example, the story about
the causal mechanism in a piano explains why a louder sound is heard when we
hit the key harder, because this means the string would vibrate with a larger am
plitude, making a louder sound.
This is why the search for causation is often tied to the search for causal mech
anisms. One way to show that C causes E is to offer a theory of causal mechanism
that leads from C to E, and try to provide evidence to support this theory. This
way of establishing causation is particularly important when we are dealing with
events that are difficult or impossible to repeat.
Of course, it is possible to obtain strong evidence for causation even when we
lack detailed knowledge of the underlying mechanism. For example, we now know
that infection by HIV is the cause of AIDS, but this discovery took place before de
tailed knowledge of how it is that the virus causes AIDS through interfering with
the immune system, and even up till now there are still gaps in our understanding
of the exact causal mechanism. Similarly, it has long been known that there is a
correlation between smoking and lung cancer, but it took nearly 50 years to iden
tify the causal mechanisms whereby the chemical compounds in cigarette smoke
trigger the cellular changes that result in lung cancer.



We have discussed a lot about searching for the cause of an effect. However, the
world is a complicated place and events can interact with each other, often mak
ing it difficult if not impossible to find the one true cause. Here are some useful
terms for making more fine-grained distinctions between causes:

Nearly all, because there might be exceptions when it comes to causation in quantum mechanics

involving action-at-a-distance, where remote particles seem to be able to affect each other without
any apparent causal mechanism. There is also the philosophical question of whether there is a most
basic level of causal mechanism.



Causal relevance: Suppose a student failed a course. She might have been
lazy or having personal problems. Or perhaps she was ill on the day of the
exam. All these factors could have contributed to her failure. They were all
causally relevant, each being a cause of her failure but none being the cause.
The most important one is the primary or central cause.

Causally necessary and sufficient conditions: X is causally necessary for

Y when Y would not happen without X, and X is causally sufficient for Y

when X by itself is enough for Y. Water is causally necessary but not suf
ficient for our survival, and moving electric charges are sufficient but not
necessary for the presence of a magnetic field.5 But X can be causally rele
vant to Y even if X is neither causally necessary nor sufficient for Y.

Triggers: A triggering cause (or trigger) is a cause that starts off a chain of
events leading to an effect. Whereas a structural cause (or standing con
dition) is a background condition that is causally relevant to the effect but
which on its own is not sufficient for it. For example, an electric spark in
a kitchen with a gas leak can result in an explosion. Here, the spark is the
trigger, and the flammable gas is the standing condition.

Proximity: A proximate cause happened at a time near the occurrence of

the effect, whereas a distal cause happened much earlier.

Randomness and causal determination: A random event is one that is not

causally determined by what happened earlier. To say that an event is de
termined is to say that it must occur given what has happened earlier and
the physical laws of our universe.


simple magnet can produce a magnetic field without electricity.