This paper is focused on the concept of finality in the bio-philosophical study of life and organisms. After some methodological remarks, the definition of biological finality is addressed. There are, in fact, wide variations regarding the concept of finality in biology, alt-hough the notions of finality as function or terminus are the most widespread. Given the vast and independent literature on functions, this paper mainly focuses on finality as a terminus, that is, a state or condition a biological entity reaches, (...) or has the possibility of reaching. For what concerns the content of this concept, biologists have stressed above all the importance of self-maintenance and reproduction. Then, various types of finality are classified. Finally, as to the ontological and epistemological value of the concept, it seems that in general biology there is a slight tendency in favour of its use. (shrink)

Biology seems to present local and transitory regularities rather than immutable laws. To account for these historically constituted regularities and to distinguish them from mathematical invariants, Montévil and Mossio (Journal of Theoretical Biology 372:179–191, 2015) have proposed to speak of constraints. In this article we analyse the causal power of these constraints in the evolution of biodiversity, i.e., their positivity, but also the modality of their action on the directions taken by evolution. We argue that to fully account for the (...) causal power of these constraints on evolution, they must be thought of in terms of normativity. In this way, we want to highlight two characteristics of the evolutionary constraints. The first, already emphasised as reported by Gould (The structure of evolutionary theory, Harvard University Press, 2002), is that these constraints are both produced by and producing biological evolution and that this circular causation creates true novelties. The second is that this specific causality, which generates unpredictability in evolution, stems not only from the historicity of biological constraints, but also from their internalisation through the practices of living beings. (shrink)

Many states recognize a legal right to bodily integrity, understood as a right against significant, nonconsensual interference with one’s body. Recently, some have called for the recognition of an analogous legal right to mental integrity: a right against significant, nonconsensual interference with one’s mind. In this chapter, we describe and distinguish three different rationales for recognizing such a right. The first appeals to case-based intuitions to establish a distinctive duty not to interfere with others’ minds; the second holds that, if (...) we accept a legal right to bodily integrity, then we must, on pain of philosophical inconsistency, accept a case for an analogous right over the mind; and the third holds that recent technological developments create a need for a legal right to mental integrity. (shrink)

Parsons’ sick role concept has become problematic in the face of the increased significance of chronic illnesses and the growing emphasis on lifestylecentred health promotion. Both developments de-limit the medical system so that it extends into the world of health, fundamentally changing the doctor-patient relationship. But as the sick role is firmly based on the reciprocities of a resiliently capitalist achievement society it still informs normative expectations in the field of health and illness. The precarious social position of chronic patients (...) between being governed by and being consumers of medicine, I will argue, can only be adequately understood if one involves, as Parsons did, the moral economy surrounding health and illness. (shrink)

The movements and protests of 1968 worldwide criticized the traditional idea of normality. From the 1970s onwards, psychiatry and antipsychiatry became an ideological battleground centered on the boundaries between normality and madness. In this scenario, characterized by a deep cultural and political transformation within the Left, the traditional concept of rationality and its very connection with irrationality was called into question. As a consequence, the very ideal of reason was questioned. This paper will explore the debate on rationality, irrationality and (...) irrationalism within the so-called anti-institutional psychiatry and its reception in the Italian New Left during the second half of the 1970s. (shrink)

This dissertation focuses on teleology and functions in biology. More precisely, it focuses on the scientific legitimacy of teleofunctional attributions and explanations in biology. It belongs to a multi-faceted debate that can be traced back to at least the 1970s. One aspect of the debate concerns the naturalization of functions. Most authors try to reduce, translate or explain functions and teleology in terms of efficient causes so that they find their place in the framework of the natural sciences. Our approach (...) here is radically different, as we question the premise that teleological explanations are disguised causal explanations. On the contrary, we defend that they are acceptable in natural sciences and in biology in particular. We challenge the idea that teleological explanations are immature causal explanations, as well as the idea that teleology and functions are some sort of intentional explanations. We therefore reject the accusations of anthropomorphism, vitalism and finalism. On the contrary, we defend that teleology, causality and intentionality correspond to different, autonomous and complementary modes of representation of the outside world. -/- ———[FRANÇAIS]——— -/- Ce travail de thèse porte sur la téléologie et les fonctions en biologie. Plus précisément, il porte sur la légitimité scientifique des attributions et des explications téléofonctionnelles en biologie. Il s’inscrit dans le cadre d’un débat à plusieurs facettes que l’on peut faire remonter au moins jusqu’aux années 1970 et qui est encore très actif aujourd’hui. L’un des aspects du débat porte sur la naturalisation des fonctions, c’est-à-dire sur la manière de les réduire, de les traduire ou de les expliciter en termes de causes efficientes de sorte qu’elles trouvent leur place dans le cadre des sciences de la nature. Notre approche ici est radicalement différente, car nous remettons en question la prémisse selon laquelle les explications téléologiques seraient des explications causales déguisées. Nous défendons au contraire qu’elles sont acceptables en tant que telles aussi bien de façon générale que dans le domaine scientifique et en particulier en biologie. De façon générale, nous remettons en question l’idée selon laquelle la pensée téléologique serait une pensée causale immature, ainsi que sa dépendance présumée vis-à-vis de la psychologie, c’est-à-dire de l’intentionnalité. Nous rejetons donc les accusations d’anthropomorphisme, de vitalisme et de finalisme formulées contre elle. Nous défendons au contraire que la téléologie, la causalité et l’intentionnalité correspondent à des modes différents, autonomes et complémentaires de représentation du monde extérieur. (shrink)

The purpose of this paper is to explore the role played by the psychoanalytical model of intervention in Althusser’s reflections on the function of the philosophical practice initiated by Marx. In doing so, we will see how Althusser conceptualized Freud’s discovery of the unconscious and Marx’s critique of ideology and used these theoretical revolutions as a paradigm to understand the modalities of philosophical intervention on ideology. While the centrality of consciousness, subjectivity and knowledge will appear subordinated in both psychoanalytical and (...) ideological processes, the primacy of structural, non-subjective and practical experience as a precondition for any critical and emancipatory theory will be highlighted. (shrink)

Članek razvija tezo, da nudi Bachelardova epistemologija teoretske nastavke, ki presegajo dualizem "razumevanje" v s. "razlaga", s katerim sta tako pozitivizem kot različne variante antipozitivizma držala znanstveno aktivnost v odvisnosti od filozofskega spoznanja. Takšno zastavitev epistemologije vidi članek v njenem konceptu "notranje meje" znanstvenega spoznanja. Različni momenti, ki so v tradicionalnem samorazumevanju delovali kot neposredovana zunanjost bistvenega notranjega sistema znanstvenih stavkov, so zdaj prav v svoji nezvedljivi zunanjosti vpotegnjeni v notranjost znanstvenega sistema. S tem zadobi znanstveno spoznanje strukturo samo-refleksije, znanost (...) postane sposobna, da sama upravičuje svojo prakso. V nadaljevanju skuša članek na primeru althusserjanske obravna« ve zgodovine znanosti orisati nekatere spremembe, ki jih postavka o delovanju samorefleksivnih mehanizmov v objektivnem spoznanju sproža na področju marksistične filozofije. (shrink)

In this paper we examine aspects of Canguilhem’s philosophy of biology, concerning the knowledge of life and its consequences on science and vitalism. His concept of life stems from the idea of a living individual, endowed with creative subjectivity and norms, a Kantian view which “disconcerts logic”. In contrast, two different approaches ground naturalistic perspectives to explore the logic of life and the logic of the living individual in the 1970s. Although Canguilhem is closer to the second, there are divergences; (...) for example, unlike them, he does not dismiss vitalism, often referring to it in his work and even at times describing himself as a vitalist. The reason may lie in their different views of science. (shrink)

In this paper, we offer a criticism, inspired by Wittgenstein’s rule-following considerations, of the enactivist account of perception and action. We start by setting up a non-descriptivist naturalism regarding the mind and continue by defining enactivism and exploring its more attractive theoretical features. We then proceed to analyse its proposal to understand normativity non-socially. We argue that such a thesis is ultimately committed to the problematic idea that normative practices can be understood as private and factual. Finally, we offer a (...) characterization of normativity as an essentially social phenomenon and apply our criticisms to other approaches that share commitments with enactivism. (shrink)

A biological function is supposed to be performed adequately, and hence may fail to do so: this is dysfunction. This raises two questions. One is how to make explicit the way in which function can be discriminated from dysfunction without confusing dysfunction with non-function. The second question is how what is “right” and “wrong” can be legitimated by natural regulatory norms. A function can be viewed as a quality to which at least one variable with a definite set of values (...) is associated. Accordingly, function and dysfunction are the same quality of the same trait, but differ in the values associated to this variable. Dysfunction occurs when the associated set of values does not match this normal state. Biological systems have the epistemic singularity that their existence is the consequence of two distinct causal regimes, the so-called “proximate” and “ultimate” causes, whose convergence defines a system’s prescriptive normality. Each cause imposes restrictive rules that limit the possible ways these systems can putatively exist. When a system is insensitive to ultimate cause, it is determined by proximate causation alone, and hence escapes its own prescriptive norms. In conclusion: The normality of a biological system is defined by the convergence of proximate and ultimate causes. A function is a variable-associated quality whose values are defined relative to the norms of the system. Dysfunction occurs when the set of values of the same variable does not match the normality of the system, which can occur when the system is insensitive to ultimate causation. (shrink)

This paper considers the theoretical circumstances that urged Michel Foucault to analyse modern societies in terms of biopower. Georges Canguilhem’s account of the relations between science and the living forms an essential starting point for Foucault’s own later explorations, though the challenges posed by the molecular revolution in biology and François Jacob’s history of it allowed Foucault to extend and transform Canguilhem’s philosophy of error. Using archival research into his 1955–1956 course on “Science and Error,” I show that, for Canguilhem, (...) it is inauthentic to treat a living being as an error, even if living things are capable of making errors in the domain of knowledge. The emergent molecular biology in the 1960s posed a grave challenge, however, since it suggested that individuals could indeed be errors of genetic reproduction. The paper discusses how Canguilhem and Foucault each responded to this by examining, among other texts, their respective reviews of Jacob’s The Logic of the Living. For Canguilhem this was an opportunity to reaffirm the creativity of life in the living individual, which is not a thing to be evaluated, but the source of values. For Foucault, drawing on Jacob’s work, this was the opportunity to develop a transformed account of valuation by posing biopower as the DNA of society. Despite their disagreements, the paper examines these three authors as different iterations of a historical epistemology attuned to errancy, error, and experimentation. (shrink)

Canguilhem is known to have regretted, with some pathos, that Life no longer serves as an orienting question in our scientific activity. He also frequently insisted on a kind of uniqueness of organisms and/or living bodies – their inherent normativity, their value-production and overall their inherent difference from mere machines. In addition, Canguilhem acknowledged a major debt to the German neurologist-theoretician Kurt Goldstein, author most famously of The Structure of the Organism in 1934; along with Merleau-Ponty, Canguilhem was the main (...) figure who introduced the work of Goldstein and his ‘phenomenology of embodiment’ into France. In this paper I inquire if we should view Canguilhem and Goldstein as ‘biochauvinists’, that is, as thinkers who consider that there is something inherently unique about biological entities as such, and if so, of what sort. (shrink)

Is the boundary between the normal and the pathological real or fiction? Are health and disease just a matter of fact or are they value-laden? Here we present some examples of how alleged diseases can be invented and propagated by the industry (disease mongering) or by the methodology of medical science itself. We show that the boundary between health and disease is blurred and depends on individual and social representations, culture relative ways of categorising things and people, and by the (...) society’s degree of medicalisation. However, we do not mean that it is not real, rather that it is more complex than expected, as the subjectivity of social constructions and individual experiences makes them no less real. Finally, we conclude that health and disease belong to both objective and subjective kinds of reality, so the fictional can be real. (shrink)

The state subvention and distribution of health care not only jeopardize the financial sustainability of the state, but also restrict without a conclusive rational basis the freedom of patients to decide how much health care and of what quality is worth what price. The dominant biopolitics of European health care supports a healthcare monopoly in the hands of the state and the medical profession, which health care should be opened to the patient’s authority to deal directly for better basic health (...) care. In a world where it is impossible for all to receive equal access to the best of basic health care, one must critically examine the plausible scope of the authority of the state to limit access to better basic health care. Classical distributive justice affords a basis for re-examining the current European ideology of equality, human dignity, and solidarity that supports healthcare systems with unsustainable egalitarian concerns. (shrink)

In this contribution, I comment on Raffaella Campaner’s defense of explanatory pluralism in psychiatry (in this volume). In her paper, Campaner focuses primarily on explanatory pluralism in contrast to explanatory reductionism. Furthermore, she distinguishes between pluralists who consider pluralism to be a temporary state on the one hand and pluralists who consider it to be a persisting state on the other hand. I suggest that it would be helpful to distinguish more than those two versions of pluralism – different understandings (...) of explanatory pluralism both within philosophy of science and psychiatry – namely moderate/temporary pluralism, anything goes pluralism, isolationist pluralism, integrative pluralism and interactive pluralism. Next, I discuss the pros and cons of these different understandings of explanatory pluralism. Finally, I raise the question of how to implement or operationalize explanatory pluralism in scientific practice; how to structure the “genuine dialogue” or shape “the pluralistic attitude” Campaner is referring to. As tentative answers, I explore a question-based framework for explanatory pluralism as well as social-epistemological procedures for interaction among competing approaches and explanations. (shrink)

ArgumentEighteenth-century Montpellerian vitalism and contemporaneous French “vitalist” materialism, exemplified by the medical and biological materialism of La Mettrie and Diderot, differ in some essential aspects from some later forms of vitalism that tended to postulate immaterial vital principles or forces. This article examines the arguments defending the existence of vital properties in living organisms presented in the context of eighteenth-century French materialism. These arguments had recourse to technological metaphors and analogies, mainly clockworks, in order to claim that just as machines (...) can have functional properties which its parts do not possess, so living organisms can, as material entities, also have organic or vital properties which its material parts do not possess. Such arguments, with the help of a healthy dose of epistemological scepticism, tend to strike a balance between two positions concerning the ontology of life which we now tend to label “vitalism” and “emergentism.” Although there is nothing inconsistent in viewing vital properties as emergent, some ambiguity results if one does not draw a clear distinction between properties and functions. The philosophical problems related to these ambiguities are revealed in Diderot's apparent hesitation concerning sentience as “a general property of matter or the product of organization.”. (shrink)

Finality, design and purpose have started to be excluded from the language of the natural sciences since the XVIIth century. Darwin succeeded in excluding them from his theory of evolution appealing to a blind and mechanical natural selection. Today, the most usual definitions for the concept of biological function take for granted that functions: 1) are not dependent on a goal; 2) are not dependent on observers, but only on nature; 3) are explicable in causal terms, either with reference to (...) the causal history of the organ (etiological definition), or with reference to its present structure and causal capabilities (dispositional definition). However, we shall see that such presuppositions cannot take into account the normative character of the concept of biological function. We show that a generalization of the concept of scientific objectivity lets us affirm that functions: 1’) are dependent on a goal; 2’) are dependent on both observers and nature; 3’) cannot be reduced to causality, nor break the laws of physics; and yet, 4) are truly objective. (shrink)

The aim of this article is (1) to investigate the ‘neurosciences’ as an object of study for historical and genealogical approaches and (2) to characterize what we identify as a particular ‘style of thought’ that consolidated with the birth of this new thought community and that we term the ‘neuromolecular gaze’. This article argues that while there is a long history of research on the brain, the neurosciences formed in the 1960s, in a socio-historical context characterized by political change, faith (...) in scientific and technological progress, and the rise of a molecular gaze in the life sciences. They flourished in part because these epistemological and technological developments were accompanied by multiple projects of institution-building. An array of stakeholders was mobilized around the belief that breakthroughs in understanding the brain were not only crucial, they were possible by means of collaborative efforts, cross-disciplinary approaches and the use of a predominantly reductionist neuromolecular method. The first part of the article considers some of the different approaches that have been adopted to writing the history of the brain sciences. After a brief outline of our own approach, the second part of the article uses this in a preliminary exploration of the birth of the neurosciences in three contexts. We conclude by arguing that the 1960s constitute an important ‘break’ in the long path of the history of the brain sciences that needs further analysis. We believe this epistemological shift we term the ‘neuromolecular gaze’ will shape the future intellectual development and social role of the neurosciences. (shrink)

The Linda paradox is a key topic in current debates on the rationality of human reasoning and its limitations. We present a novel analysis of this paradox, based on the notion of verisimilitude as studied in the philosophy of science. The comparison with an alternative analysis based on probabilistic confirmation suggests how to overcome some problems of our account by introducing an adequately defined notion of verisimilitudinarian confirmation.

This article presents a conceptual discussion on the phenomenon of incorporation of tools and other objects in the light of Maine de Biran’s philosophy of the relation between the body and the motor will. Drawing on Maine de Biran’s view of the body as that portion of the material world which directly obeys one’s motor will, as well as on his view (supported by studies in contemporary cognitive science) of active touch as the perceptual modality that is sensitive to objects (...) as fields of forces resisting the perceiver’s movements, we discuss the phenomena of motor incorporation and haptic incorporation, as well as the relation between them. Motor incorporation occurs when something is integrated into the motor system, i.e. when practice enables one to animate an object as directly, effortlessly and fluently as one is able to animate one’s own body. The subject then has the experience of acting there, where the object is located, not at the body–object interface. In order to better understand the phenomenon of motor incorporation, we highlight the phenomenological difference between directly and indirectly moving something. Haptic incorporation occurs when something is integrated into the haptic system, i.e. when an object is used as an instrument for the haptic perception of other objects. Finally, we seek to shed light on the phenomenon of transparency, understanding the transparency acquired by the incorporated object as both a relational property and a matter of degrees. (shrink)

I distinguish between ‘substantival’ and ‘functional’ forms of vitalism in the eighteenth century. Substantival vitalism presupposes the existence of a (substantive) vital force which either plays a causal role in the natural world as studied scientifically, or remains an immaterial, extra-causal entity. Functional vitalism tends to operate ‘post facto’, from the existence of living bodies to the search for explanatory models that will account for their uniquely ‘vital’ properties better than fully mechanistic models can. I discuss representative figures of the (...) Montpellier school (Bordeu, Ménuret, Fouquet) as functional rather than substantival vitalists, and suggest an additional point regarding the reprisal of vitalism(s) in the 20th century, from Driesch to Canguilhem: that in addition to the substantival and functional varieties, we encounter a third species of vitalism, which I term ‘attitudinal’, as it argues for vitalism as a kind of attitude. (shrink)

This paper does not intend to provide an exhaustive account of Canguilhem's thinking. It will focus on his philosophical approach to the biological sciences.

This article summarizes some of the results of the BIOMED II project “Basic Ethical Principles in European Bioethics and Biolaw” connected to a research project of the Danish Research Councils “Bioethics and Law”. The BIOMED project was based on cooperation between 22 partners in most EU countries. The aim of the project was to identify the ethical principles of respect for autonomy, dignity, integrity and vulnerability as four important ideas or values for a European bioethics and biolaw. The research concluded (...) that the basic ethical principles cannot be understood as universal everlasting ideas or transcendental truths but they rather function reflective guidelines and important values in European culture. The method of the research was conceptual, philosophical analysis of the cultural background of the four values or normative ideas that people use and find important in their existence. Moreover, this was combined with analysis of empirical legal material and policy documents. Also, a number of qualitative interviews with relevant experts were carried out. Another important result of the BIOMED project was the partner's Policy Proposals to the European Commission, the Barcelona Declaration, unique as a philosophical and political agreement between experts in bioethics and biolaw from many different countries. The Policy Proposals are reprinted here at the end of the article. (shrink)

In 1998, the US Supreme Court first held that asymptomatic HIV infection constituted a disability when it ruled on the case of Bragdon v. Abbott. The use of yet another label to identify women living with HIV has been rarely questioned. While we do value the use of this label as an anti-discriminatory strategy, we believe that there is a need to examine how language and more specifically, the use of words such as disability, limitation, and impairment may create new (...) forms of identities for women living with HIV. Using this legal case as a starting point, the goal of this paper is to critically examine the 'fabrication' of asymptomatic HIV infection as a disability. Grounded in a feminist poststructuralist perspective, this paper exposes the relationship between language, social institutions, subjectivity, and power in the construction of difference. By doing so, it addresses the identification of women living with HIV/AIDS as disabled and the self-differentiation process that they must go through in order to live as normally as possible. (shrink)

Este artigo aborda o tratamento que Canguilhem e Foucault oferecem da medicina. Passando pelas distintas análises da clínica, da medicina em sua história e de seu aspecto social e político, observaremos desdobramentos irredutíveis em torno de uma problemática compartilhada.

“Deleuze and the Inversion of Kantism”. In this paper we aim to look into French philosopher Gilles Deleuze’s work in order to see whether there is such a thing as a ‘reversal of Kantianism’, parallel to his more well-known reversal of Platonism. To this end, we will propose, firstly, to read in the key of reversal the movements made by Deleuze regarding intensity and extension, on the one hand, and the paradox of inner sense, on the other. Then, we will (...) analyze why Kant had already accomplished two great reversals, regarding the classical conception of both time and law, and consequently, we will develop the Deleuzean conception of Nietzschean eternal return as a simultaneous reversal of both aspects. Finally, we will inquire about the tropos of the aforementioned reversal, calling on the concepts of humor and irony. (shrink)

In 2003, the Food and Drug Administration approved the use of growth hormone treatment for idiopathic short stature children, i.e. children shorter than average due to an unknown medical cause. Given the absence of any pathological conditions, this decision has been contested as a case of medicalisation. The aim of this paper is to broaden the debate over the reasons for and against the treatment, to include considerations of the sociocultural phenomenon of the medicalisation of short stature, by means of (...) a critical understanding of the concept of medicalisation. After defining my understanding of medicalisation and describing both the treatment and the condition of idiopathic short stature, I will problematise two fundamental issues: the medical/non-medical distinction and the debate about the goals of medicine. I will analyse them, combining perspectives of bioethics, medical sociology, philosophy of medicine and medical literature, and I will suggest that there are different levels of normativity of medicalisation. Ultimately, this study shows that: the definition of idiopathic short stature, focusing only on actual height measurement, does not provide enough information to assess the need for treatment or not; the analysis of the goals of medicine should be broadened to include justifications for the treatment; the use of growth hormone for idiopathic short stature involves strong interests from different stakeholders. While the treatment might be beneficial for some children, it is necessary to be vigilant about possible misconduct at different levels of medicalisation. (shrink)

Phenomenology in medicine’s main contribution is to present a first-person narrative of illness, in an effort to aid medicine in reaching an accurate disease diagnosis and establishing a personal relationship with patients whose lived experience changes dramatically when severe disease and disabling condition is confirmed. Once disease is diagnosed, the lived experience of illness is reconstructed into a living-with-disease narrative that medicine’s biological approach has widely neglected. Key concepts like health, sickness, illness, disease and the clinical encounter are being diversely (...) and ambiguously used, leading to distortions in socio-medical practices such as medicalization, pharmaceuticalization, emphasis on surveillance medicine. Current definitions of these concepts as employed in phenomenology of medicine are revised, concluding that more stringent semantics ought to reinforce an empirical phenomenological or postphenomenological approach. (shrink)

In the 1940s, Georges Canguilhem has established the concept of biological normativity on the level of the organism in his key work on “ The Normal and the Pathological ”. We would like to present a contemporary analysis of Canguilhem’s work, set it in context with more recent results from the field of complexity and immunology, and evaluate the problematic whether normativity is a genuine capacity of the organism. Based on Canguilhem’s conditions of the definition of biological normativity, we show (...) that the immune system as one of the complex systems of the living equally shares the capacity to be normative. We will then conclude that normativity can also be conceptually independently displayed on the level of complex systems of the living. (shrink)

Psychiatry is becoming a cognitive neuroscience. This new paradigm not only aims to give new ways for explaining mental diseases by naturalizing them, but also to have an influence on different levels of psychiatric norms. We tried here to verify whether a biological paradigm is able to fulfill this normative goal. We analyzed three main normative assumptions that is to say the will of giving psychiatry a valid nosology, a rigorous definition of what is a mental disease, and new tools (...) for destigmatizing mentally ill patients. Although these different kinds of normativity are very heterogeneous, we must conclude that, in all these cases, biological psychiatry is a failure, in part because of a lack of epistemological conceptualization. (shrink)

The concept of human ecology was introduced into Catholic pastoral documents by John Paul II, in his 1991 encyclical Centesimus annus. As an exquisitely interdisciplinary field of enquiry, human ecology involves a great many scientific, ethical and religious questions. Thus, it can be chosen as an appropriate case study in the dialogue between faith and science. After a review of the ways in which the relationships between faith and science have been addressed, an original model for their interaction is proposed. (...) Then, this new model is tested in the specific case of human ecology, as well as in that of the relationship between the God of the universe and the laws of nature. (shrink)

What makes insurance special among risk technologies is the particular way in which it links solidarity and technical rationality. On one hand, within insurance practices ‘risk’ is always defined in technical terms. It is related to monetary measurement of value and to statistical probability calculated for a limited population. On the other hand, and at the same time, insurance has an inherent connection to solidarity. When taking out an insurance, one participates in the risk pool within which each member is (...) reciprocally responsible for others’ risks. The combination of technical controllability and solidarity has made insurance a successful tool for governing welfare societies during the twentieth century. From the point of view of business ethics, it is interesting that, as we argue in this article, the connection between insurance and solidarity is not limited to social welfare assemblages, but is evident in relation to private insurance as well. At the same time, however, it is important to understand that insurance does not advance all forms of solidarity. Hence, this theoretical article analyzes the specific conceptions of solidarity that the different forms of insurance practice produce. Particular emphasis is put on the distinction between ‘chance solidarity’ and ‘subsidizing solidarity’. The main questions of the article are: What kinds of conceptions of solidarity are built in the insurance technology? And how are the limits of solidarity defined and justified in different forms of insurance? (shrink)

This paper argues that in daycare centres in France, where children are cared for from four months to age three, the competence of female staff members is usually denied and unvalued vis à vis the expert opinions. The paper highlights empirical research on early childhood and gender, providing pragmatic access to children's languages of desire, a language mostly ignored. Incorporating the ideas of Foucault, Deleuze and Guattari, the paper draws upon the conceptualization of Fernand Deligny who took care of autistic (...) children in mapping what he called ‘lines of wandering’, an idea that shows how desire can become accessible. In the present ‘society of control’ which Deleuze analyses and which coexists with Foucault's discipline and biopower, such lines of flight enable the emergence of a new narrative for young children's desire, and for the competence of the female staff members in their departure from the highway of normalization. (shrink)

BackgroundThe evaluation of pain remains one of the most difficult challenges that healthcare practitioners face. Chronic pain appears to affect more than 35% of the population in the West, and indeed, pain is the most common reason patients seek medical care. Despite its ubiquity, studies in the last decades reveal that many patients feel their pain is dismissed by healthcare practitioners and that, as a result, they are denied proper medical care. Buchman, Ho, and Goldberg (J Bioethic Inq 14:31-42, 2017) (...) point to this phenomenon as a form of “epistemic injustice”: an unfair and harmful downgrading of credibility affecting some individuals and groups, which prevents them from receiving appropriate and beneficial medical care.MethodsBy exploring the existing literature on this downgrading of patients’ credibility written by healthcare professionals and scholars in medical humanities, I identify and examine the reasons patients are often not believed about their pain and why healthcare is too-often unhelpful or hurtful to people presenting with chronic pain. I also explore to what extent it is possible to forge an alternative epistemological model.ResultsI suggest that most of the causes of this downgrading of patient’s credibility result from either the difficulty in communicating pain or the widespread belief that pathology is always the result of objective tissue damage. I examine whether pain has to be effectively communicated and have an objective cause in order for it to be deemed credible. In the end, I argue that in the case of pain, both communication and objectivity are highly problematic.ConclusionsI conclude by suggesting that, although alternative epistemological models might be impossible to build, believing patients has both moral and clinical benefits, and this warrants further research. (shrink)

The term “genetic load” first emerged in a paper written in 1950 by the geneticist H. Muller. It is a mathematical model based on biological, social, political and ethical arguments describing the dramatic accumulation of disadvantageous mutations in human populations that will occur in modern societies if eugenic measures are not taken. The model describes how the combined actions of medical and social progress will supposedly impede natural selection and make genes of inferior quality likely to spread across populations – (...) a process which in fine loads their progress. Genetic load is based on optimal fitness and emerges from a “typological view” of evolution. This model of evolution had previously, however, been invalidated by Robert Wright and Theodosius Dobzhansky who, as early as 1946, showed that polymorphism was the rule in natural populations. The blooming and persistence of the concept of genetic load, after its theoretical basis had already expired, are a historical puzzle. This persistence reveals the intricacy of science and policy-making in eugenic matters. The Canguilhemian concept of ‘scientific ideology’ is used along with the concept of ‘immutable mobile’ and compared with the concept of ‘co-production’, to provide complementary perspectives on this complex phenomenon. (shrink)

The article shows the strategic analogies, but also the differences between Bachelard and Canguilhem on the use of the history of science for epistemology. It emphasizes the importance of the ideology for Canguilhem, and the conceptual essence he recognizes in the history of science, which is read in its internal specific differences and in its complex articulations with life and reality. No concept, in fact, comes from nothing. The link between history and epistemology is not however of subjection, but of (...) mutual influence. Canguilhem radicalizes the thought of Bachelard, and recognizes the historicity of every aspect of scientific knowledge, even of its less valued features and above all of errors. All aspects of Science are historical. The object of the history of science is not the object of the sciences, because it is always a discourse. This is why the history of science is inevitably linked to other forms of history. This opens up a pluralist conception of History and of Time, thinking of the sciences in their real body and no longer ideal or legal. Thus Canguilhem opens the way to the researches of Foucault and Serres. (shrink)

There is a conceptual crisis in the biomedical sciences that is particularly salient in psychopathology research. Underlying the crisis is a controversy that pertains to the current medical model of disease that largely draws from causal-mechanistic explanations. The bedrock of this model is the analysis of biological part-dysfunctions that aims at unequivocally defining a pathological condition and demarcating it from its neighboring entities. This endeavor has led to a quest for physiological, biochemical, and genetic signatures. Yet, so far there is (...) little evidence for reliable biomarkers for any mental disorder. The contemporary biomedical paradigm largely ignores historical, dynamic, and system-level aspects—a view that has contributed much to the conceptual disjunction of the patient as a person from his/her disease. Notwithstanding the impressive progress in the biomedical sciences, increasingly more critics question whether the constituting framework is sufficient to convey a comprehensive understanding of illnesses, especially mental illnesses. Thus, the medical model urgently requires an update. But rather than revamping it by methodological advancements, it will be necessary to critically review its philosophical roots. The most problematic issues that require reworking are: the preponderance of the biostatistical theory; the undue decoupling of physiological from evolutionary explanations of function; the clinging to the Modern Synthesis ; and the neglect of dynamic and system-level properties. The proposed overhaul requires the heeding of historical explanations that draw from the Extended Evolutionary Synthesis as well as systems biology approaches for tackling multilevel and dynamic phenomena of complex systems. (shrink)

Since the Enlightenment, critique has played an overarching role in how Western society understands itself and its basic institutions. However, opinions differ widely concerning the understanding and evaluation of critique. To understand such differences and clarify a viable understanding of critique, the article turns to Kant’s critical philosophy, inaugurating the “age of criticism”. While generalizing and making critique unavoidable, Kant coins an unambiguously positive understanding of critique as an affirmative, immanent activity. Not only does this positive conception prevail in the (...) critique of pure and practical reason and the critique of judgment; these modalities of critique set the agenda for three major strands of critique in contemporary thought, culminating in among others Husserl, Popper, Habermas, Honneth, and Foucault. Critique affirms and challenges cognition and its rationality, formulates ethical ideals that regulate social interaction, and further articulates normative guidelines underway in the ongoing experimentations of a post-natural history of human nature. In contradistinction to esoteric Platonic theory, philosophy at the threshold of modernity becomes closely linked to an outward-looking critique that examines and pictures what human forms of life are in the process of making of themselves and challenges them, by reflecting upon what they can and what they should make of themselves. As a very widely diffused practice, however, critique may also become a self-affirming overarching end in itself. (shrink)

If the healthy and the pathological are not merely judgments qualifiers, but real phenomena, it must be possible to define both of them positively, which, in this context, means as factual contraries. On the other hand, only a privative definition, either of the pathological as ‘non-healthy’, or of the healthy as ‘non-pathological’, can rationally circumscribe all possible states of an organism. This fluctuation between two meanings of the ‘healthy’–‘pathological’ opposition, factual vs. rational, characterizes the ordinary usage of these concepts and (...) puts all philosophical definitions in a hopeless situation. Although a scientific definition may conceal this equivocation by adequately setting out the terms of the problem of discriminating between the ‘healthy’ and the ‘pathological’, it could explain some of the difficulties met in determining ‘gold standards’, in the choice of separators, and in the assessment of the diagnostic qualities of tests. (shrink)

In this paper I will briefly discuss flourishing and freedom, relating them to health and disease; discuss the tensions between flourishing and freedom; and exemplify how those discussions are relevant to chronic disease suffering. The concept of freedom has significant connections with the concepts of health, disability and disease. Understanding disease and disability in terms of the loss of aspects of freedom may help our understanding of the suffering that arises from chronic disease. On the other hand, flourishing may require (...) a degree of adversity. Therefore disability and disease may be conducive to flourishing. Flourishing may be understood as subordinated to freedom, as a path to freedom, or as transcending freedom. It is suggested that freedom and flourishing are expressed as mutually enhancing cycles, actualized according to the personal circumstances that will ground their expression. In a distant horizon of innocent spontaneous self-expression, flourishing and freedom may become coincident. Regarding chronic disease as a constraint on ‘species-typical’ abilities to fulfill one’s significant life interests, as well as an unwanted intrusion into the patient’s life, presents chronic disease suffering as a loss of both positive and negative freedom. The conceptual relation between flourishing and freedom will thus organise the possibilities the sufferer sees as open to their self. (shrink)

If the healthy and the pathological are not merely judgments qualifiers, but real phenomena, it must be possible to define both of them positively, which, in this context, means as factual contraries. On the other hand, only a privative definition, either of the pathological as 'non-healthy', or of the healthy as 'non-pathological', can rationally circumscribe all possible states of an organism. This fluctuation between two meanings of the 'healthy'-'pathological' opposition, factual vs. rational, characterizes the ordinary usage of these concepts and (...) puts all philosophical definitions in a hopeless situation. Although a scientific definition may conceal this equivocation by adequately setting out the terms of the problem of discriminating between the 'healthy' and the 'pathological', it could explain some of the difficulties met in determining 'gold standards', in the choice of separators, and in the assessment of the diagnostic qualities of tests. (shrink)