Over the years, phenomenology has provided illuminating descriptions of discrimination, with its mechanisms and effects being thematised at the most basic levels of embodiment, (dis)orientation, selfhood, and belonging. What remains somewhat understudied is the lived experience of the discriminator. In this paper I draw on Husserl's phenomenological account of normality to reflect on the ways in which we discriminate at the prereflective levels of perceptual experience and bodily being. By critically reflecting on the intentional structures undergirding discriminatory practices, I argue (...) that discrimination is characteristic of a naïve normalising attitude which is habitually interested in securing a familiar experience of a static normality. I first demonstrate how this attitude problematically tends to reproduce, enforce, and further sediment discriminatory and exclusionary norms. Further, I provide an internal critique which problematises discrimination—without recourse to external normative standards—on three fronts: as epistemically unproductive, experientially obscuring, and normatively non-instantiating. In discriminatory acts we see an abnormal refusal to enrich, revise, and genetically establish new normative commitments, new ways of seeing, and a new normality. (shrink)

Biological individuality is a notoriously thorny topic for biologists and philosophers of biology. In this paper we argue that biological individuality presents multiple, interconnected questions for biologists and philosophers that together form a problem agenda. Using a case study of an interdisciplinary research group in ecology, behavioral and evolutionary biology, we claim that a debate on biological individuality that seeks to account for diverse practices in the biological sciences should be broadened to include and give prominence to questions about uniqueness (...) and temporality. We show that broadening the problem agenda of biological individuality draws attention to underrecognized philosophical issues and discussions and thereby organizes and enriches the existing debate. (shrink)

Developments in biomedical science continue to transform our understanding of concepts such as health and disease. The creation of this expertise has also had a substantive role in changing the veterinary approach to animal diseases. Traditionally, companion animal veterinarians modelled their practices on developments in the diagnosis and treatment of human patients. As science and technology have realigned the boundaries between normalcy, intra-species variation and pathology in particular domains of expertise such as orthopaedic surgery, these patterns of knowledge translation have (...) changed. Not so long ago, treatments for the rupture of the cruciate ligament in human and canine patients were based on pathoanatomical comparison and designed to reestablish the stability of the joint by the functional restoration of ligament anatomy. Recently, a radically different characterization of the canine injury—with a corresponding alternative intervention—has been proposed within the field of veterinary orthopaedics. It views the normal anatomy of the canine knee as being in some way inherently pathogenic and proposes the surgical creation of an idealized structure as a remedy to dysfunction and disease. The veterinary focus on an ideal of patient performance, rather than a specific pathology, is now influencing how orthopaedists choose to approach analogous human injuries. In this article, I chart the history of canine ‘cruciate disease’ therapies as a means to map some of the epistemic assumptions, interplays of idealized and analogical reasoning and patterns of knowledge translation central to the biomedicalization of the science and practice of orthopaedic surgery. (shrink)

The aim of this paper is to make a comparison and build up a dialogue between two different philosophical approaches to values in evolutionary biology. First, I present the approach proposed by Alexander Rosenberg and Daniel McShea in their contribution to the contemporary debate on organic progress. i.e. the idea that there has been some kind of improvement concerning organisms over the history of life. Discussing organic progress raises the question of what “better” exactly means. This requires an explicit clarification (...) on what legitimately means to speak about “good” in evolutionary biology, thus to speak about values. Second, I move on to present an approach to values that has been proposed by Georges Canguilhem in the context of a different philosophical tradition. Canguilhem’s original theses are conceived in a Darwinian framework and clearly relate to the question of values in evolutionary biology. I shall then propose a comparison between these two heterogeneous perspectives on values by critically evaluating their common points and main differences. I will argue that both perspectives agree that the question of values in evolutionary biology takes on its full meaning with respect to the relationship between the organism and the environment. However, the framework for conceptualizing values in evolutionary biology provided by Rosenberg and McShea neglects a significant point highlighted by Canguilhem, i.e. the active role that the organism can play in evaluating the environment. In line with recent developments of biology, this point can be easily integrated into Rosenberg and McShea’s framework. Finally, I will point out some main differences between the two perspectives relative to the specificity of Canguilhem’s biological philosophy. (shrink)

In current phenomenology of medicine, health is often understood as a state of transparency in which our body refrains from being an object of explicit attention. In this paper, I argue that such an understanding of health unnecessarily presupposes an overly harmonious alignment between subjective and objective body, resulting in the idea that our health remains phenomenologically inaccessible. Alternatively, I suggest that there are many occasions in which one’s body in health does become an object of attention, and that technologies (...) mediate how a relation with one’s body is formed. First, I show prominent accounts in current phenomenology of medicine understand health in terms of a harmonious alignment between objective and subjective body. Second, I argue that there are many occasions in which there is a disharmony between objective and subjective body, and suggest that also in health, we cannot escape being an object that we often relate to. Then, I draw on postphenomenology to show how technologies such as digital self-tracking applications and digital twins can be understood as mediating the relationship with one’s own body in a specific way. In conclusion, I argue that both technologies make present the objective body as a site for hermeneutic inquiry such that it can be interacted with in terms of health parameters. Furthermore, I point to some relevant differences in how different technologies make aspects of our own body phenomenologically present. (shrink)

In the face of increasing intervention in childbirth, ‘normal birth’ is currently being promoted by the World Health Organization, national governments, professional bodies and other organisations throughout the world. This paper takes a postmodernist stance and explores the idea of the ‘normal’ before going on to analyse normal childbirth, referring to concepts of the normal and the natural. It refers to historical developments in childbearing and lay organisations along with research relating to women’s views of childbirth, to question the appropriateness (...) of using ‘normal’ to describe the very individual experiences of childbirth. It laments the way in which women have been treated and arguably continue to be ‘cared for’ in maternity/obstetric services. It adds to the current discussion by recalling psychoanalytical theory and philosophical analysis to conclude with a call for future consideration of the ‘good‐enough’ birth instead of concentrating on promoting normal birth which is very difficult, if not impossible to define in retrospect, or to prospectively promote. (shrink)

Today, capitalism functions as a very complex tool of colonisation capturing our desires, dreams, and putting life itself at risk. Its effects lead us all to times of extreme anxiety increasing the number of people with mental health problems. This paper is concerned with the question of ‘critique’ within this context. How can critical legal scholarship engage with a theoretical mode that allows us to confront the politics of law with today’s capitalism? This analysis shows that contemporary capitalism, which operates (...) as an immanent desiring-machine, is investing in our unconscious. In this sense, we aim to rethink the idea of ‘critique’ as an opportunity to make it creative and effective. As such, this paper argues that the Deleuzian concept Critical and Clinical is particularly useful, as it opens new roots for the critical movement. Taking the literary strategy of Masochism and the experience of the Institutional Psychotherapy movement in France, the clinical–critical practice contributes to push and expand critical scholarship into new terrains of thought and practice. (shrink)

Drawing upon ethnographic data, this article analyses 'vocabularies of motive' amongst individuals who work out at a private health club in the Greater Manchester area (UK). The article draws a distinction between motives for starting at a gym and motives for continuing, and analyses each separately. It also seeks to draw out, in the latter case, the many motives which conflict with a stereotypical view of 'working out' found in some academic accounts. Working out is not only an instrumental means (...) of cultivating valued bodily attributes, it is argued, nor are its attractions necessarily all 'bodily' (at least narrowly defined) in nature. (shrink)

The technique of nuclear transplantation – popularly known as cloning – has been integrated into several different histories of twentieth century biology. Historians and science scholars have situated nuclear transplantation within narratives of scientific practice, biotechnology, bioethics, biomedicine, and changing views of life. However, nuclear transplantation has never been the focus of analysis. In this article, I examine the development of nuclear transplantation techniques, focusing on the people, motivations, and institutions associated with the first successful nuclear transfer in metazoans in (...) 1952. The conflict between embryologists and geneticists over the mechanisms of differentiation motivated Robert Briggs to pursue nuclear transplantation experiments as a way to resolve the debate. Briggs worked at the Lankenau Hospital Research Institute, a research facility devoted to the study of cancer. The goal of understanding cancer would play a role in the development of the technique, and the story of nuclear transplantation sheds light on the role that biomedical contexts play in biological research in the second half of the twentieth century. (shrink)

It is a matter of some irony that psychiatry's most trenchant critic for over four decades is himself a psychiatrist. I refer to Thomas S. Szasz. Szasz's core thesis may be succinctly rendered: mental illness is a “myth”, a “metaphor” which serves only to obscure the social and ethical “problems in living” we face as human beings. This paper reconsiders the conceptual bases of Szasz's assault on psychiatry and assesses recent counter-arguments of his critical interlocutors. It presents a defence of (...) the Szaszian conception and emphasises the continuing relevance of his earliest work. Additionally, the paper discusses Szasz's thesis in light of the work of the influential French philosopher of medicine, Georges Canguilhem. (shrink)

What is now familiarly referred to as the ‘embryonic stem (ES) cell’ is a recent biological category whose origins lie in research into benign and malignant teratomas carried out in the 1950s, 60s and 70s. In these studies, the question of the normal or pathological character of the ES cell was a matter of considerable debate and indeed the term ES cell was often used interchangeably with that of the embryonal carcinoma (EC) cell. This article argues that the indecisiveness of (...) the entity known as the ES cell—its refusal to commit to established demarcations between the normal and the pathological—continues to haunt the field of stem cell science. Exploring the prehistory of research into ES cells, early theories of cancer (in particular the embryonal theory expounded by Julius Cohnheim) and recent theoretical critiques of the somatic mutation theory, the article not only points to a shift in understandings of the normal and the pathological but asks under what conditions such shifts are able to take place. (shrink)

Background Biomedicine, i.e. the application of basic sciences to medicine, has become the cornerstone for the study of etiopathogenesis and treatment of diseases. Biomedicine has enormously contributed to the progress of medicine and healthcare and has become the preferred approach to medical problems in the West. The developments in statistical inference and machine learning techniques have provided the foundation for personalised medicine where clinical management can be fully informed by biomedicine. The deployment of precision medicine may impact the autonomy and (...) self-normativity of the patients. Understanding the relationship between biomedicine and medical practice can help navigate the benefits and challenges offered by precision medicine. Methods Conventional content analysis was applied to “Le Normal and le Pathologique” (Canguilhem G. The Normal and the Pathological. Princeton: Princeton University Press; 1991) and further investigated with respect to its relationship with techne and precision medicine using PubMed and Google Scholar and the Standford Encyclopedia of Philosophy to search for the following keywords singularly or in combination: “Canguilhem”, “techne”, “episteme”, “precision medicine”, “machine learning AND medicine”. Results The Hippocratic concept of techne accounts for many characteristics of medical knowledge and practice. The advances of biomedicine, experimental medicine and, more recently, machine learning offer, in contrast, the model of a medicine based purely on episteme. I argue that Canguilhem medical epistemology establishes a framework where episteme and data-driven medicine is compatible with the promotion of patient’s autonomy and self-normativity. Conclusions Canguilhem’s medical epistemology orders the relationship of applied medicine with experimental sciences, ethics and social sciences. It provides guidance to define the scope of medicine and the boundaries of medicalization of healthy life. Finally, it sets an agenda for a safe implementation of machine learning in medicine. (shrink)

In this article I assess Georges Canguilhem's historical epistemology with both theoretical and historical questions in mind. From a theoretical point of view, I am concerned with the relation between history and philosophy, and in particular with the philosophical assumptions and external norms that are involved in history writing. Moreover, I am concerned with the role that history can play in the understanding and evaluation of philosophical concepts. From a historical point of view, I regard historical epistemology, as developed by (...) Gaston Bachelard and Georges Canguilhem, as a conception and practice which came out of the project, elaborated in France from the 1920s to the 1940s, of combining history of science and philosophy. I analyse in particular Canguilhem's epistemology in his theory and practice of history of science. What he called 'normative history' is the focus of my analysis. I evaluate the question of the nature and provenience of the norm employed in normative history, and I compare it with the norm as discussed by Canguilhem in Le normal et le pathologique. While I am critical of Canguilhem's treatment of history, I conclude that his philosophical suggestion to analyse the formation of scientific concepts 'from below' represents a useful model for history and philosophy of science, and that it can be very profitably extended to philosophical concepts. (shrink)

Naturalistic theories of disease appeal to concepts of biological function, and use the notion of dysfunction as the basis of their definitions. Debates in the philosophy of biology demonstrate how attributing functions in organisms and establishing the function-dysfunction distinction is by no means straightforward. This problematization of functional ascription has undermined naturalistic theories and led some authors to abandon the concept of dysfunction, favoring instead definitions based in normative criteria or phenomenological approaches. Although this work has enhanced our understanding of (...) disease and illness, we need not necessarily abandon naturalistic concepts of function and dysfunction in the disease debate. This article attempts to move towards a new naturalistic theory of disease that overcomes the limitations of previous definitions and offers advantages in the clinical setting. Our approach involves a re-evaluation of concepts of biological function employed by naturalistic theories. Drawing on recent insights from the philosophy of biology, we develop a contextual and evaluative account of function that is better suited to clinical medicine and remains consistent with contemporary naturalism. We also show how an updated naturalistic view shares important affinities with normativist and phenomenological positions, suggesting a possibility for consilience in the disease debate. (shrink)

In the late 1960s, Georges Canguilhem introduced the concept of ‘scientific ideology’. This concept had not played any role in his previous work, so why introduce it at all? This is the central question of my paper. Although it may seem a rather modest question, its answer in fact uncovers hidden tensions in the tradition of historical epistemology, in particular between its normative and descriptive aspects. The term ideology suggests the influence of Althusser’s and Foucault’s philosophies. However, I show the (...) differences between Canguilhem’s concept of scientific ideology and Althusser’s and Foucault’s respective concepts of ideology. I argue that Canguilhem was in fact attempting to solve long-standing problems in the tradition of historical epistemology, rather than following the lead of his younger colleagues. I argue that Canguilhem’s ‘refurbishment without rejection’ of Bachelard’s epistemology, which the concept of scientific ideology was aimed to implement, was necessary to justify the historical narratives that Canguilhem had constructed in his own work as a historian of concepts. A strict acceptance of Bachelard’s epistemology would have made it impossible to justify them. Canguilhem’s concept of scientific ideology therefore served as a theoretical justification of his practice as a historian. I maintain that the concept of scientific ideology was needed to reconcile Bachelard’s normative epistemology with Canguilhem’s view of the history of science and its aims, which differed from Bachelard’s more than it is generally acknowledged. (shrink)

I have been breathless for a long time. I lagged behind others when walking uphill. I became breathless when dancing. I couldn’t play tennis. But I somehow convinced myself that this was normal. I was getting older—perhaps in one’s mid-30s fitness drops like this, I thought? Perhaps I have “small lungs,” my husband speculated. But we were both physically active, and as we were living in Australia at the time, we enjoyed bush-walking, bike riding, and the sunshine that permeates outdoor (...) life down under. So I masked my breathlessness as best I could, and never went to see a doctor, despite my clear and increasing respiratory difficulties.Two years went by. We returned to live in the United Kingdom—in hilly Bristol.. (shrink)

This article examines the philosophical role of illness. It briefly surveys the philosophical role accorded to illness in the history of philosophy and explains why illness merits such a role. It suggests that illness modifies, and thus sheds light on, normal experience, revealing its ordinary and therefore overlooked structure. Illness also provides an opportunity for reflection by performing a kind of suspension (epoché) of previously held beliefs, including tacit beliefs. The article argues that these characteristics warrant a philosophical role for (...) illness. While the performance of most philosophical procedures is volitional and theoretical, however, illness is uninvited and threatening, throwing the ill person into anxiety and uncertainty. As such it can be viewed as a radical philosophical motivation that can profoundly alter our outlook. The article suggests that illness can change the ways in which we philosophise: it may shape philosophical methods and concerns and change one's sense of salience and conception of philosophy. (shrink)

The phenomenological method has been fruitfully used to study the experience of illness in recent years. However, the role of illness is not merely that of a passive object for phenomenological scrutiny. I propose that illness, and pathology more generally, can be developed into a phenomenological method in their own right. I claim that studying cases of pathology, breakdown, and illness offer illumination not only of these experiences, but also of normal function and the tacit background that underpins it. In (...) particular, I claim that the study of embodiment can be greatly enhanced, and indeed would be incomplete, without attending to bodily breakdown and what I term bodily doubt. I offer an analogy between illness and Husserl’s epoché, suggesting that both are a source of distancing, and therefore motivate a reflective stance. (shrink)

Medical discourse in the contemporary United States is rife with military metaphors. These metaphors have come under vigorous criticism over the last few decades but to no avail; the militaristic tendency has proven tenacious. This essay suggests that its tenacity stems, at least in part, from a dualistic understanding of medicine unaddressed by prior criticisms. For an alternative, this essay turns to Augustine of Hippo, balancing close readings of works that deal explicitly with medical themes—The Catholic Way of Life and (...) the Manichean Way of Life (De moribus) and The Nature of the Good (De natura boni)—with a constructive approach. By adapting Augustine's privative account of evil, we can understand disease as a condition of loss and treatment as a task of restoration. This reconfiguration shifts the focus of our interpretive discourses from malicious invaders to a fuller affirmation of the lived experiences of those who are ill. (shrink)

Judith Butler's (2006) account of vulnerability, resonant with other accounts offered by feminist theorists of embodiment (such as Margrit Shildrick [2000] and Rosalyn Diprose [2002]), underscores a "conception of the human . . . in which we are, from the start, given over to the other, one in which we are, from the start, even prior to individuation itself and, by virtue of bodily requirements, given over to some set of primary others" (31). She is concerned with how this state (...) of being—"not only constituted by our relations but also dispossessed by them as well" (24)—becomes recognized, or not, in the political production and recognition of vulnerability, and the suffering that occurs in the violent .. (shrink)

This article charts the history of mental testing in the context of the rise and fall of Russian child science between the 1890s and the 1930s. Tracing the genealogy of testing in scientific experimentation, scholastic assessment, medical diagnostics and bureaucratic accounting, it follows the displacements of this technology along and across the boundaries of the child science movement. The article focuses on three domains of expertise – psychology, pedagogy and psychiatry, examining the key guises that mental testing assumed in them (...) – namely, the experiment, the exam and the diagnosis. It then analyses the failed state-bureaucratic harnessing of mental testing in early Soviet attempts to manage mass education, discussing the peculiar dynamics of the legitimation of testing, as it swung between black-boxing and instrumentalization, on the one hand, and scandal and controversy, on the other. The article argues that mental testing thrived in Russia as a strategically ambiguous and flexibly interpreted ‘boundary object’, which interconnected a highly heterogeneous field, enabling the coexistence and cooperation of diverse occupational agendas and normative regimes. (shrink)

One of the difficulties facing the philosopher of science today is the divide between historical epistemology and analytic philosophy of science. For over half a century these two traditions have followed independent and divergent paths. Historical epistemology, which originated in France in the early twentieth century, has recently been reformulated by a number of scholars such as Lorraine Daston, Ian Hacking, and Hans-Jörg Rheinberger. Elaborating novel historical methods, they seek to provide answers to major questions in the field. In the (...) light of this situation, my article examines the cultural barrier that explains the uneasy relationship between the two traditions. This barrier hinges on a number of factors—institutional, political and social—that are bound up with the philosophical issues in question. By resorting both to historical study and logical analysis, the new historical epistemology incites us to move beyond a rather sterile antagonism. (shrink)

This paper seeks to characterize how the study of nutrition processes contributed to revisit the problem of vital organization in the late eighteenth century. It argues that focusing on nutrition leads to reformulate the problem of the relation between life and organization in terms of processes, rather than static or given structures. This nutrition-centered approach to life amounts to acknowledge the specific strategic role nutrition played in the development of a materialist approach to the generation of vital organization. The paper (...) proposes a clarification of the multiple meanings of the concept of organization in the context of Enlightenment physiology and nascent biology, before focusing on the century long analogy between nutrition and generation. It shows how, by contrasting different uses of this analogy, nutrition was employed as a key vital phenomenon in the development of epigenetic theories of generation, i.e. how a nutritive modeling of generation was used in the undermining of preformationism. To this purpose I contrast two seemingly opposite theories of generation, Buffon’s and Bonnet’s, and show that despite the obvious metaphysical discontent, their views of generation share a common mechanical conceptual frame in which nutrition is conflated with growth and repair. I then turn to the role nutrition played in the epigenetic conception of generation in C. F. Wolff’s embryology and analyze this rival understanding of nutrition as an organizing process. (shrink)

The objective of this article is to analyse the value-ladenness of technology in the context of medicine. To address this issue several characteristics of technology are investigated: i) its interventive capacity, ii) its expansiveness and iii) its influence on the concept of disease, iv) its generalising character, v) its independence of the subjective experience of the patient. By this analysis I hope to unveil the double face of technology: Technology has a Janus-face in modern medicine, and the opposite of its (...) factual face is evaluative. (shrink)

In this paper, I argue for two claims. The first is that all social and political thinking lies along a continuum and that the structure of each thought along the continuum is that of a basic desire for self-determination. Self-determination, I argued, occurs in a variety of ways including, importantly, at a variety of levels of intention. On the one hand, there are the relatively unreflective ways of understanding oneself as autonomous. I attributed this way of thinking of the Neo-Aristotelian (...) conception of practical reason which is characteristic of conservatism. On the other side of the continuum, there is a rigoristic version of Kantian moral philosophy in which, to be autonomous, one must act exclusively from duty or from purely economic motivation. The second claims is that populism can be understood as a clash between different practical conceptions of autonomy which are brought into conflict as a result of the process of modern rationalization. This clash can, I argued, be clarified and also alleviated by appreciating that what the values which stand opposed in the “us vs. them” of populism and liberalism are based on a fundamentally similar conception of the value of autonomy but have come into conflict by sometime contingent historical processes which can be undone or steered in a different direction. (shrink)

This article theorizes the biopolitical production of embodiment through a consideration of biopolitical metaphor. It is argued that much recent theoretical work on biopower fails to provide an adequate account of embodiment, and particularly the question of the habitualization of bodily experience. However, read through the lens of biopolitical metaphor, and drawing on the works of George Lakoff and Mark Johnson, a dynamic account of the biopolitical shaping of bodily memory and embodied habit becomes possible. Moreover, it is argued that (...) a theory of biopolitical metaphor provides provocative openings for thinking together the recent discursively oriented work on biopower and other approaches associated with the affective turn, specifically around the problems of mimesis and supplement. New research directions are proposed, centered on common experiences of biopolitical domination among marginalized groups drawn from shared experiences of habit and embodiment. (shrink)

Since the emergence of in-vitro fertilization, a specific set of technologies has been developed to address the problem of the ‘biological clock’. The medical extension of fertility time is accompanied by promissory narratives to help women synchronize conflicting biological and social temporalities. This possibility also has a transgressive potential by blurring one of the biological landmarks – the menopause – by which reproductive lives are organized and governed. These new ways of managing, measuring and controlling reproductive time have renewed debates (...) on the age limits of motherhood and the moral legitimacy of medical intervention into age-related fertility decline. Building on Amir’s feminist concept of biotemporality, this paper questions what happens when the ontological foundations of age-limited motherhood are disrupted by technologies which allow fertility to be extended. It discusses the reconfigurations of the ontological boundaries of the facts of life in the light of literature on reproductive technologies and temporality. Through the Swiss experience, the paper shows how medical experts are drawn into negotiating the ontological boundaries of age-limited motherhood along the binaries of the normal/pathological and the biological/social. Questioning the purpose of medical interventions in what are seen as facts of life, they produce different configurations of moral reasoning where what is natural undergoes shifts which both reinforce the normative order and subvert it. (shrink)

At a time when the practice of medicine is subject to technical and biopolitical imperatives that give rise to defensive bioethics, it is essential to revitalize the ethical dimensions of care at the very heart of the clinic, in order to give new meaning to the moral responsibility that inhabits it. This contribution seeks to meet this challenge by drawing on the ethical resources of the work of Emmanuel Levinas. In Levinas’ view, ethical responsibility is the response to the injunction, (...) the interpellation, of the other’s face, and humaneness is conceived entangled in the other’s face. Against this background, I suggest that Levinas’ philosophical insight constitutes a turning point from a traditional to a new conception of responsibility that may bear great significance to a renewed understanding of an hermeneutics and an ethics of care. By drawing on this aspect of Levinas’ thought, I would like to reveal the ethical core of an ethics of clinical care that shapes a new insight on medical judgment. (shrink)

This article analyses the biochemical object of tnf inhibitors from the perspective of living with an autoimmune disease. The author tries to tease out how the concept of immune inhibition is used in tandem with the biochemical object of tnf inhibitors to dominate in defining and narrating what health and disease, normal and pathological, cure and healing can mean in the context of autoimmune bodies. Specifically, and within the ‘pathological’ framework of autoimmune diseases, the pharmacological treatment of tnf inhibition is (...) designed to suppress the ‘overly’ active immune system, thus acting as a negative or suppressing biochemical agent aimed at putting the ‘malfunctioning’ immune system back in balance. As can be seen in the current conjuncture, tnf inhibitors officially —and governmentally— place those taking them in a risk group, as they 'lower' their overall bodily immunity and make them more vulnerable to infectious diseases, while stabilizing their patho-logical, ‘over’-immune uninhibited condition. Part personal narrative of being diagnosed with an autoimmune condition, part speculative autoimmune theory inspired by such a diagnosis, the article ultimately calls for a different form of embodiment that is neither negative nor affirmative, and yet is resistant even to itself. (shrink)

Western culture has a few traditions of representing the human body – among them mortuary art (gisants), the freak show, the culture of the relics, renaissance art and pre-modern and modern anatomy. A historical analysis in the spirit of Norbert Elias is offered with regard to body – person relationship in anatomy. Modern anatomy is characterized by separating the story of the person from the story of the body, a strategy that is incompatible with the bio-psycho-social paradigm of clinical medicine. (...) The paper discusses different aspects of the above traditions and how they might bear on this conflict and on contemporary bioethics and bedside practice. (shrink)

Gilbert Simondon has recently attracted the interest of political philosophers and theorists, despite the fact that he is renowned as a philosopher of technics – author of Of the Mode of Existence of Technical Objects – who also elaborated a general theory of complex systems in Individuation in the Light of the Notions of Form and Information. A group of scholars has developed Gilles Deleuze’s early suggestion that Simondon’s social ontology might offer the basis for a re-theorisation of radical democracy. (...) Others, following Herbert Marcuse, have instead focused on Simondon’s analysis of the relationship between technology and society. However, only a joint study of Simondon’s two major works can reveal their implicit political stakes. As I will argue, Simondon’s anti-Aristotelianism and his anti-Heideggerian understanding of the Greek origins of philosophy, allow us to conceive philosophical thought as a ‘tradition of invention’, that is, a pedagogical technē endowed with the political task of maintaining the openness of the social system and allowing normative invention to emerge from within. (shrink)

There is no lack of criticisms frequently levelled against the international pharmaceutical industry (Big Pharma): excessive profits, dubious or even dishonest practices, exploiting the sick and selective use of research data. Neither is there a shortage of examples used to support such opinions. A recent book by Brody (Hooked: Ethics, the Medical Profession and the Pharmaceutical Industry, 2008) provides a précis of the main areas of criticism, adopting a twofold strategy: (1) An assumption that the special nature and human need (...) for pharmaceutical medicines requires that such products should not be treated like other commodities and (2) A multilevel descriptive approach that facilitates an ethical analysis of relationships and practices. At the same time, Brody is fully aware of the nature of the fundamental dilemma: the apparent addiction to (and denial of) the widespread availability of gifts and financial support for conferences etc., but recognises that ‘Remove the industry and its products, and a considerable portion of scientific medicine’s power to help the patient vanishes’ (Brody 2008, p. 5). The paper explores some of the relevant issues, and argues that despite the identified shortcomings and a need for rigorous and perhaps enhanced regulation, and realistic price control, the commercially competitive pharmaceutical industry remains the best option for developing safer and more effective medicinal treatments. At the same time, adoption of a broader ethical basis for the industry’s activities, such as a triple bottom line policy, would register an important move in the right direction and go some way toward answering critics. (shrink)

This article argues that the limited influence of Ludwik Fleck's ideas on philosophy of science is due not only to their indirect dissemination by way of Thomas Kuhn, but also to an incommensurability between the standard conceptual framework of history and philosophy of science and Fleck's own more integratedly historico-social and praxis-oriented approach to understanding the evolution of scientific discovery. What Kuhn named "paradigm" offers a periphrastic rendering or oblique translation of Fleck's Denkstil/Denkkollektiv , a derivation that may also account (...) for the lability of the term "paradigm". This was due not to Kuhn's unwillingness to credit Fleck but rather to the cold war political circumstances surrounding the writing of The Structure of Scientific Revolutions . Following a discussion of Fleck's anatomical allusions, I include a brief discussion of Aristotle (on menstruation and darkened mirrors) and conclude with a reference to the productivity of error in Mach and Nietzsche. (shrink)

Volume 20, Issue 8, August 2020, Page 32-36.

For many years, biology was largely descriptive (natural history), but with its emergence as a scientific discipline in its own right, a reductionist approach began, which has failed to be matched by adequate understanding of function of cells, organisms and species as whole entities. Every effort was made to explain biological phenomena in physico-chemical terms.It is argued that there is and always has been a clear distinction between life sciences and physical sciences, explicit in the use of the word biology. (...) If this distinction is real, it implies that biological phenomena can never be entirely satisfactorily explained in terms of extant physicochemical laws. One notable manifestation of this is that living organisms appear to -- actually do -- behave in purposeful ways, and the inanimate universe does not. While this fundamental difference continues to be suppressed, the purposiveness (or teleology) which pervades biology remains anathema to almost all scientists (including most biologists) even to the present day. We argue here that it can, however, become a perfectly tenable position when the Theory of Natural Selection is accepted as the main foundation, the essential tenet, of biology that distinguishes it from the realm of physical sciences. In accepting this position, it remains quite legitimate to expect that in many but not all circumstances, extant physical laws (and presumably others still to be discovered) are in no way breached by biological systems, which cannot be otherwise since all organisms are composed of physical material. (shrink)

The emerging crealectic frame posits that there are three complementary and effectual domains of intelligence, namely analytic, dialectic, and crealectic, being alternatively or complementarily used in human interactions with the world. The focus of crealectic intelligence is the relative possibilization and local realization of absolute possibility, the becoming real, biological, and social of creation. This multimodal externalization and asymptotic unification of a cosmological flux expresses itself via three realms of possibilization: physical, psychological, and philosophical. But the philosophical possible is not (...) merely abstract; it originates a generative process of exteriorizations, interiorizations, dissolutions, and unifications transforming the possible into realities. The term “crealectics,” coined by philosopher and author Luis de Miranda, is a compound of “Creal” and of two possible suffixes: “logos” or “ektos”. The ontological core of crealectics, the Creal, is the immanent process of creation understood as a ubiquitous stream of absolute possibility exteriorizing itself. For a crealectician, philosophy is not the mere logical analysis of truth conditions, but the self-questioning enterprise of thought regarding its own possibilizing and world-making power. (shrink)

After describing the disorder of psychopathy, I examine the theories and the evidence concerning the psychopaths’ deficient moral capacities. I first examine whether or not psychopaths can pass tests of moral knowledge. Most of the evidence suggests that they can. If there is a lack of moral understanding, then it has to be due to an incapacity that affects not their declarative knowledge of moral norms, but their deeper understanding of them. I then examine two suggestions: it is their deficient (...) practical reason or their stunted emotions that are at fault. The evidence supports both explanations. I conclude with an overview of the debate concerning whether they are morally or legally responsible for their actions. (shrink)

Massimiliano Simons provides the first systematic study of Serres' work in the context of late 20th-century French philosophy of science. By proposing new readings of Serres' philosophy, Simons creates a synthesis between his predecessors, Gaston Bachelard, Georges Canguilhem, and Louis Althusser as well as contemporary Francophone philosophers of science such as Bruno Latour and Isabelle Stengers. Simons situates Serres' unique contribution through his notion of the quasi-object, a concept, he argues, organizes great parts of Serres' work into a promising philosophy (...) of science as well as a challenge to the narrower field of French epistemology, to which it has often been limited. Simons highlights how the concept encompasses Serres' commitment to positive relations between science and culture and his rejection of pleas to purify the scientific self from imaginative and cultural elements. It helps to situate Serres between the distinct traditions of Bachelard and Latour as well as progressing the innovative aspects of Serres' philosophy for current debates in the philosophy, history, and sociology of science. Showing how Serres' philosophy can serve as a normative approach to science and technology, Michel Serres and French Philosophy of Science takes in themes of materiality, religiosity, modernity and ecology to advance a timely alternative to philosophy of science for contemporary life. (shrink)

This study addresses the question of normative analysis of the value‐based aspects of nursing. In our perspective, values in science may be distinguished into (i) epistemic when related to the goals of truth and objectivity and (ii) non‐epistemic when related to social, cultural or political aspects. Furthermore, values can be called constitutive when necessary for a scientific enterprise, or contextual when contingently associated with science. Analysis of the roles of the various forms of values and models of knowledge translation provides (...) the ground to understand the specific role of values in nursing. A conceptual framework has been built to classify some of the classical perspectives on nursing knowledge and to examine the relationships between values and different forms of knowledge in nursing. It follows that adopting a normative perspective in the analysis of nursing knowledge provides key elements to identify its proper dimension. (shrink)

This article isolates ten prepositions, which constitute the undercurrent paradigm of contemporary discourse of health disease and medicine. Discussion of the interrelationship between those prepositions leads to a systematic refutation of this paradigm. An alternative set is being forwarded. The key notions of the existing paradigm are that health is the natural condition of humankind and that disease is a deviance from that nature. Natural things are harmonious and healthy while human made artifacts are coercive interference with natural balance. It (...) is suggested that the current paradigm is influenced by the world of finances and by instrumental reason. The alternative model suggests that human nature cannot be delineated. Humans fashion their own selves and nature by artificial means, medicine among them. The article discusses the implications of the paradigm adapted in various scholarly and popular debates such as the use of sex hormones for contraception, the care of the elderly, holistic medicine and distributive justice in health care. Medicine is not an isolated or a privileged realm. There is no unique entitlement to health care. It is always part of a broader agenda of social values and institutions. A open view of human societies, values and practices as they are situated within concrete material conditions is the platform required for an integrative and creative discourse of health care. (shrink)

What is it to be mentally healthy? In the ongoing movement to promote mental health, to reduce stigma, and to establish parity between mental and physical health, there is a clear enthusiasm about this concept and a recognition of its value in human life. However, it is often unclear what mental health means in all these efforts and whether there is a single concept underlying them. Sometimes, the initiatives for the sake of mental health are aimed just at reducing mental (...) illness, thus implicitly identifying mental health with the absence of diagnosable psychiatric disease. More ambitiously, there are high-profile proposals to adopt a positive definition, identifying mental health with psychic or even overall well-being. We argue against both: a definition of mental health as mere absence of mental illness is too thin, too undemanding, and too closely linked to psychiatric value judgments, while the definition in terms of well-being is too demanding and potentially oppressive. As a compromise, we sketch out a middle position. On this view, mental health is a primary good, that is, the psychological preconditions of pursuing any conception of the good life, including well-being, without being identical to well-being. (shrink)

A satisfactory account of the nature of health is important for a wide range of theoretical and practical reasons. No theory offered in the literature thus far has been able to meet all the desiderata for an adequate theory of health. This article introduces a new theory of health, according to which health is best defined in terms of dispositions at the level of the organism as a whole. After outlining the main features of the account and providing formal definitions (...) of ‘health’, ‘healthy’, and ‘healthier than’, I present the main strengths of the proposed account. I argue that the proposed dispositional theory accounts for all paradigm cases of health and pathology, that it circumvents a number of problems faced by rival theories, and that it makes for a naturalistic theory of health with a rigorous metaphysical underpinning. 1Introduction 2The Dispositional Account 3Further Specification of the Dispositional Account 3.1Reference classes 3.2Comparison classes 3.3Which dispositions? 4Advantages of the Dispositional view 5Three Objections and Replies 5.1Objection 1: Counter-examples 5.2Objection 2: Issues with holism 5.3Objection 3: Expediting medicalization 6Final Remarks. (shrink)

This article analyses research that has explored the potential of a focus on indeterminate bodies for decision making, policy and politics. Drawing on different ways of conceptualising indeterminacy in scientific and policy domains it describes the Loweswater Care Project, a participatory ‘knowledge collective’ that attempted to avoid converting the complexities of vital cyanobacterial bodies into a purely social or managerial set of questions around water quality. Through a commitment to opening out the nature of ‘things’, participants in this collective honed (...) new questions and avenues of inquiry around cyanobacteria and its relations. The Loweswater Care Project was a kind of ‘open’ in Haraway’s sense, where questions and demands are put to bodies, and to the apparatus that allows us to sense them, in ways that do not shy away from the probabilistic character of entities and their relations. The implications of generating indeterminacies in this setting are explored for environmental decision making, policy and politics. (shrink)

Does it work? This question lies at the very heart of the kinds of controversies that have surrounded complementary and alternative medicines (such as herbal medicine) in recent decades. In this article, I argue that medical anthropology has played a pivotal and largely overlooked role in taking the sham out of the placebo effect with important implications for what it means to say a therapy or drug `works'. If pharmacologists and clinicians have corporeally located the concept of efficacy in terms (...) of bio-availability, pharmacodynamics and pharmacokinetics, and herbalists in terms of a herbal revitalizing of the body's own vis medicatrix naturae, from the early 20th century onwards medical anthropologists (especially those who became interested in the `savage mind') have built up an equally rigorous theory of symbolic efficacy in terms of narratives, symbols and a kind of cognitive homeostasis. It was precisely as a mediating link between the somatic and the symbolic that I suggest a decriminalized placebo effect (as opposed to suggestion) could emerge in the middle of the 20th century. Taking the example of St John's Wort, I go on to show how notions of symbolic efficacy, spillover placebo efficacy and bio-efficacy co-circulate in recent attempts by herbalists, clinicians and pharmacologists to address the question of whether or not this herbal remedy `works' in the treatment of depression. (shrink)

This paper represents a philosophical reflection on the nature and value of philosophy itself. Georges Canguilhem somewhat scandalously argued that the fundamental value of philosophy does not lie in truth. He suggests that truth is a typical value of science because truth is what science says and what is said scientifically. Why would a philosopher depreciate his own discipline? And does he really do so? Or is there a different motivation: to help philosophy to become a much more self‐confident voice? (...) And if truth is no longer a value of philosophy, what value fits it better? The article follows Canguilhem in his conception of truth, science, and philosophy. It is against the background of these considerations that the specific revised anthropology of the scientist or philosopher is formed. The main question is what this means for current philosophy and why it could be inspiring for philosophers today. (shrink)