The following article presents preliminary reflections on a processual theory of health and disease. It does this by steering the discussion more toward an ontology of organisms rather than conceptual analysis of the semantic content of the terms “health” and “disease.” In the first section, four meta-theoretical assumptions of the traditional debate are identified and alternative approaches to the problems are presented. Afterwards, the view that health and disease are constituted by a dynamic relation between demands imposed on an organism (...) and individual presuppositions for adequate response is developed. In the last section, the paper takes stock of three possible objections to and clarifies some implications of this approach to the notions of health and disease. (shrink)

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)

Following Hannah Arendt’s insights into the affinities between Marxism and the philosophy of life, this article reconstructs a theoretical position that we propose to call ‘vitalist Marxism’. This position conceives of life not only as an essential foundation of the production process, but also as a critical resource for resistance to the capitalist logic of exploitation. We highlight the role Georges Canguilhem (1904–95) played in developing this position, in particular by depicting tools and machines as ‘organs of life’. Drawing on (...) Canguilhem’s early writings as well as unpublished manuscripts, we show that this ‘organological’ understanding of technology was rooted in the increasingly anti-fascist reception of Marx in France during the 1930s. Against the background of today’s protests against climate destruction, racism, and anti-feminist violence, all of which invoke the defense of basic living conditions, we argue that the critical position of vitalist Marxism acquires remarkable topicality. (shrink)

Personalised nutrition (PN) has emerged over the past twenty years as a promising area of research in the postgenomic era and has been popularized as the new big thing out of molecular biology. Advocates of PN claim that previous approaches to nutrition sought general and universal guidance that applied to all people. In contrast, they contend that PN operates with the principle that “one size does not fit all” when it comes to dietary guidance. While the molecular mechanisms studied within (...) PN are new, the notion of a personal dietary regime guided by medical advice has a much longer history that can be traced back to Galen’s “On Food and Diet” or Ibn Sina’s (westernized as Avicenna) “Canon of Medicine”. Yet this history is either wholly ignored or misleadingly appropriated by PN proponents. This (mis)use of history, we argue helps to sustain the hype of the novelty of the proposed field and potential commodification of molecular advice that undermines longer histories of food management in premodern and non-Western cultures. Moreover, it elides how the longer history of nutritional advice always happened in a heavily moralized, gendered, and racialized context deeply entwined with collective technologies of power, not just individual advice. This article aims at offering a wider appreciation of this longer history to nuance the hype and exceptionalism surrounding contemporary claims. (shrink)

The article aims at elaborating a non-speculative concept of social pathology. In the first section, various conceptualizations (e.g. Habermas, Honneth) are critically revaluated. It is argued that (a) applying the originally medical concept of ‘pathology’ on social entities has untenable connotations (due to the lacking social equivalent of death); (b) grounding social pathology on the level of ‘social suffering’ is not in accordance with the actors’ horizon shaped by biomedical- and psy-discourses. To avoid these dead-ends, social pathologies are reinterpreted as (...) structural distortions causing diseases or mental disorders. To refine this initial definition, in the second section, Merleau-Ponty’s concept of chiasm is used as an ontological framework translating between medical and social diagnoses. The proposed concept of social pathology refers to those patterns of disrupted pre-intentional, intentional and mediated intertwining, which manifest as ill or psychopathological chiasm. In the third section, two case studies are elaborated: the intersubjective structures of depressed and asthmatic chiasm. Finally, the implications for critical theory and praxis are overviewed. (shrink)

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) uses the conceptualization of psychopathology to make psychiatric diagnoses operational. The use of explicit operational criteria appears to be based on an implicit neo-positivist epistemology. Operationalism involves an excessive focus on quantitative descriptions of behavior manifestations, contesting that psychopathology is understood as a deviation from the normal or the average in a given population. Consequently, the normal and the psychopathological become homogeneous. Our analysis investigates if this neo-positivist epistemology narrows (...) psychopathology conceptualization and endanger integration with the hybrid biopsychosocial model of psychiatry. Based on Georges Canguilhem’s theorization of a qualitative approach to the individual organism who is in a state of morbidity, we show that the (psychiatric) pathology also contains differences in quality. Moreover, that humans are norm-producing organisms that actively respond to changes in their internal and external environment. In this regard, the operationalization of mental disorders could include the normativity in humans, i.e., the ability to produce norms. We argue this will mitigate the one-sided psychopathology conceptualization and strengthen the relationship between psychiatric nosology and psychiatry’s hybrid biopsychosocial model. (shrink)

This paper presents a new interpretation of Michel Foucault’s critical project. It is well known that Foucault’s genealogical critique does not focus on issues of justification, but instead tackles “aspectival captivity,” that is, apparently inevitable limits of thought that constrain the agent’s freedom but that, in fact, can be transformed. However, it has not been recognized that, according to Foucault, critique can proceed along two distinct paths. In a key passage of “What Is Critique?,” Foucault states that critique is tasked (...) with questioning truth about its effects of power and with questioning power about its discourses of truth. We show that this “double movement” organizes Foucault’s critical project as a whole, giving it a significantly wider scope and a more complex structure than has been previously acknowledged. At the heart of the above-mentioned bifurcation lies an apparent tension between two contrastive roles Foucault assigns to truth-telling in the context of critique: on the one hand, truth-telling (as avowal) is a target of critique; on the other, truth-telling (as parrhesia) is one of critique’s methods. We argue that combining these two dimensions in a unified account is crucial for understanding and re-evaluating Foucault’s critical project as a whole. By showing that truth-telling remains an essential element of Foucauldian critique, this paper also rectifies some influential misinterpretations according to which Foucault’s critical project seeks to eliminate truth from the picture. (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)

This article offers a novel reconstruction of Foucault’s methodology that emphasises his respect for the natural sciences. Foucault’s work has long been suspected of reducing knowledge to power, and thus collapsing into unconstrained relativism and methodological incoherence. These concerns are predicated on a misunderstanding of Foucault’s overall approach, which takes the form of a historico-critical project rather than a normative epistemology. However, Foucault does sometimes make normative epistemological judgements, especially about the human sciences. Furthermore, there are outstanding questions about what (...) secures the descriptive rigour of the genealogical method. To address these issues, I develop two claims that will significantly enrich our understanding of Foucault’s methodology. The first is that Foucault’s respect for the natural sciences is crucial in making sense of his normative epistemological judgements. The second is that the descriptive rigour of his genealogical method derives from the fact it is modelled on empirical inquiry. (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 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)

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)

ABSTRACTIn Foucault's later works, experience and embodiment become important for explaining the normative constitution of the subject: for norms to be effective, discourses are insufficient – they must be experienced and embodied. Practices of “discipline” inscribe power constellations and discourses into subjective experience and bodies. In his lectures on the Hermeneutics of the Subject, he turns this “violent” form of normative embodiment into an ethical perspective by referring to the Stoic tradition. Even though Foucault never developed a notion of experience (...) and embodiment himself, his ideas can be re-read and complemented from a phenomenological perspective.The article tries to investigate the role of bodily experience and practice in Foucault's Genealogy and to bring it into dialogue with Husserl and Merleau-Ponty's conceptions of the lived body. It will attempt to show that concepts like sedimentation and habituality can help to explain how cultural norms not only influence the way we think abou.. (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)

This paper is an ethnographic endeavour in mapping the Deleuzian concept of Becoming-Animal in a sport called Jallikattu, which involves humans and bulls. Initially, I map the legal and social discourses surrounding this sport to argue the necessity to understand the immanent patterns of molecular forces, activating the human–bull relationships, embedded in this sport. Ethnographic data collected from the domain of Jallikattu bull selection and grooming and from the players of this sport are analysed to materially ground the dynamic ontology (...) of becoming-animal, specifically the conceptions of the pack and the anomalous. I explain how the formation of the Jallikattu assemblage, comprising both the humans and the bulls, compels us to grasp the specific encounters of selectors, groomers and players with the bull in establishing an affective relationship. The act of hugging the bull in this sport and the local conception of action-characteristics help in tracing the nodes of deterritorialisation and rhizomatic connections in the apparatus of Jallikattu. I argue that the richness of becomings embedded in this sport needs to be taken into account, amidst the quantitative surge in legal and social discourses. (shrink)

In this article, I argue that the history and philosophy of autism need to account for two kinds of autism. Contemporary autism research and practice is structured, directed and connected by an ‘ontological understanding of disease’. This implies that autism is understood as a disease like any other medical disease, existing independently of its particular manifestations in individual patients. In contrast, autism in the 1950s and 1960s was structured by a psychoanalytical framework and an ‘individual understanding of disease’. This implied (...) that autism was not a distinct disease but an idiosyncratic and meaningful response of the child to a disturbed development of the ego. These two kinds of autism are embedded in and reveal two very different ‘styles of psychiatric thought’. (shrink)

Autism research is facing profound difficulties. The lack of clinically valuable translations from the biomedical and neurosciences, the variability and heterogeneity of the diagnostic category, and the lack of control over the ‘autism epidemic,’ are among the most urgent problems facing autism today. Instead of encouraging the prevailing tendency to intensify neurobiological research on the nature of autism, I argue for an exploration of alternative disease concepts. One conceivable alternative framework for understanding disease and those we have come to call (...) autistic, can be found in the work of neurologist Kurt Goldstein. His person-centered approach provides radically new ways to investigate and intervene with the behavior we are accustomed to explain by the elusive entity called autism. (shrink)

Metaphors abound in both the arts and in science. Due to the traditional division between these enterprises as one concerned with aesthetic values and the other with epistemic values there has unfortunately been very little work on the relation between metaphors in the arts and sciences. In this paper, we aim to remedy this omission by defending a continuity thesis regarding the function of metaphor across both domains, that is, metaphors fulfill any of the same functions in science as they (...) do in the arts. Importantly, this involves the claim that metaphors in arts as well as science have both epistemic and aesthetic functions. (shrink)

As a result of the world-wide COVID-19 epidemic, an internal tension in the goals of medicine has come to the forefront of public debate. Medical professionals are continuously faced with a tug of...

The goal of this programmatic paper is to highlight a close connection between the core problem in the philosophy of medicine, i.e. the concept of health, and the core problem of the philosophy of mind, i.e. the concept of consciousness. I show when we look at these phenomena together, taking the evolutionary perspective of modern state-based behavioural and life-history theory used as the teleonomic tool to Darwinize the agent- and subject-side of organisms, we will be in a better position to (...) make sense of them both as natural phenomena. (shrink)

Since Boorse [Philos Sci 44(4):542–573, 1977] published his paper “Health as a theoretical concept” one of the most lively debates within philosophy of medicine has been on the question of whether health and disease are in some sense ‘objective’ and ‘value-free’ or ‘subjective’ and ‘value-laden’. Due to the apparent ‘failure’ of pure naturalist, constructivist, or normativist accounts, much in the recent literature has appealed to more conciliatory approaches or so-called ‘hybrid accounts’ of health and disease. A recent paper by Matthewson (...) and Griffiths [J Med Philos 42(4):447–466, 2017], however, may bear the seeds for the revival of purely naturalist approach to health and disease. In this paper, I defend their idea of Biological Normativity against recent criticism by Schwartz [J Med Philos Forum Bioethics Philos Med 42(4):485–502, 2017] and hope to help it flower into a revival of naturalist approaches in the philosophy of medicine. (shrink)

In the introduction to hisAllgemeine Psychopathologie, published in 1913, Karl Jaspers stated that psychology has little value for the psychopathologist because it focuses on all kinds of interesting matters, but not on normal psychic life. In this article we argue that today, in the year 2013, little has changed in this respect. During the past century, normal psychic life has rarely been a topic of research. Clinical psychology has focused primarily on studying three other topics: the mind-body problem, the methodological (...) debate and the psychotherapy debate. Due to this focus, our knowledge in the above-mentioned areas has increased significantly, but the issue raised by Karl Jaspers about normal psychic life has still not been addressed. In this article, we propose that normal psychic life should indeed become the new focus of clinical psychology. We illustrate the importance of this new focus with three examples from clinical psychology: the Global Assessment of Functioning scale, empathy and the emergence of positive psychology during the past decade. We then explore the efficacy of phenomenology for studying this normal psychic life, thereby discovering a useful epistemological basis in Husserl’s systematic phenomenology. Various phenomenological research methods are evaluated in the light of this systematic phenomenology. (shrink)

The remarkable increase in diagnoses of autism has paralleled an increase in scientific research and turned the syndrome into a kind of a new ‘trend’ within psychiatric and developmental conditions of childhood. At the same time, discursive technologies, such as DSM-IV, autobiographies, movies, fiction, etc., together with ‘educational’ interventions, such as TEACCH, PECS, Makaton, etc., seem to anticipate a form of an apparatus built around the condition named autism. Starting from this premise, the article proposes a new approach within autism (...) studies, which treats the condition in Foucauldian terms and focuses on the emergence of the autistic subjectivity following Foucault’s methodology of archaeology, genealogy, and modes of subjectification. (shrink)

This article is a plea for a realist view of deliberative bodies against a nominalist view. They cannot be reduced to the changing collection of the individuals who compose it. The deliberative bodies are real collective entities insofar as we are able to precise their criteria of identity. These are the differentiation between an interior and an exterior linked by functions or ends; thus these collective entities are adaptive systems. There are three kinds of such adaptive systems: technical systems, organisms (...) and human organizations. The specificity of human organizations is related to the nature of the relations between parties, which are normative, and to the way their ends are determined. Deliberative bodies are organizations of which the specific characteristics have been listed. The mode of being of these collective entities is adverbial. This means that the existence of a deliberative body is subordinated to the nature of the activity of its members and to the manner they are oriented toward its instituted ends. (shrink)

Through a re-articulation of Derridean différance, Bernard Stiegler claims that the human is defined by an originary default that displaces all psychic and social life onto technical supplements. His philosophy of technics re-articulates the logic of the supplement as concerning both human reflexivity and its supports, and the history of the différance of life itself. This has been criticised for reducing Derrida's work to a metaphysics of presence, and for instituting a humanism of the relation to the inorganic. By refuting (...) these claims, this article will show that Stiegler's doubling of différance enables him to articulate the human as constituted by both the individuation characteristic of ‘life’, and that of a technical, psychic, and collective individuation. Putting forward a reading of the logic of the trace in life, and emphasising the aspects of Leroi-Gourhan, Simondon, and Canguilhem that Stiegler uses in his reading of Derrida, I will demonstrate that the political stakes of adaption and adoption in his Noopolitics require this re-articulation of différance. Technics shapes the human future, arising from this differential mutation; marking the invention of the human as the site of the political. (shrink)

One of the orienting claims in Yuk Hui’s The Question Concerning Technology in China is that an adequate accounting for the pluralism of technicity remains forthcoming. Hui brings this to our atten...

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)

Despite the growing interest and supporting evidence for person-centered care, there is still a fundamental disagreement about what makes healthcare person-centered. In this article, we define PCC as operating with three fundamental conditions: personal, participatory and holistic. To further understand these concepts, we develop a framework based on the theory of affordances, which we apply to the healthcare case of rehabilitation and a concrete experiment on social interactions between persons with cerebral palsy and physio- and occupational therapists. Based on the (...) application of the theory, we argue that in order for healthcare to be considered as PCC, professionals need to adopt a personalistic attitude in their care, defined in terms of mutual affordances: how the professional and the person of care acknowledges each other as a person in an interaction. In opposition, we define the functionalistic attitude in terms of object affordances, those related to a concrete goal. We show that PCC requires a balance of personalistic and functionalistic attitudes, since this contributes to a participatory and holistic conception of, and interaction with, the person of care. (shrink)

Education is important in shaping professional identity, including how one approaches norms and normalisation. In the analysis presented in this study, nursing students' own constructions of norms and normality from the outlook of their education are highlighted and problematised. To deepen the understanding of these matters, the aim of this study was to explore constructions of norms and normality among students in nursing education. Students studying in a nursing department at a Swedish university college were approached and asked to consider (...) open survey questions targeting their views on norms and normality; 154 of them replied. After a discourse analytic approach to the data, we could see how the students constructed norms and normality as (a) instrumental instructions, consisting of easy‐to‐digest statements grounded in the profession's obvious moral and ethical values, (b) limiting and frustrating obstacles for personal freedom that were important to challenge, (c) rules to be obeyed for the stability of society and (d) a matter of reflection, with each individual being responsible for understanding differences in norms, perspectives and opinions. We conclude that nursing education would benefit from norm‐critical perspectives, problematising students' own positions to norms, power and privilege. (shrink)

It is an imperative within health care, medicine, and public health to restore, preserve, and enhance health. Therefore, it is important to determine what kinds of enhancement are increases in health and what kinds are not. Taking as its point of departure two conceptions of health, namely, “manifest health” and “fundamental health,” the paper discusses various means used to enhance ability and well-being, and if those means, such as wheelchairs, implants, medicines, stimulants, or narcotics, enhance health. The fact that some (...) means that enhance ability or well-being are not usually considered health enhancing, for example, narcotics, constitutes a problem. The paper ends with a discussion of some suggestions about how to distinguish between those enhancements that are health related and those that are not. One plausible idea holds that an enhancement is health related when the substance, or aid, increases ability or well-being, is integrated into the body, and does not harm the individual’s fundamental health. (shrink)

There is still a question about what it means to say that Georges Canguilhem was a philosopher of error. This paper, unlike other work on the topic, investigates archival sources and early texts, up to and including the publication of theEssay on Some Problems Concerning the Normal and the Pathologicalin 1943, in order to reveal Canguilhem’s early thoughts on error and to formulate the basic philosophical problem therein, as he understood it. This work reveals a partial transformation of his thinking (...) as he seeks to develop this question through the study of concrete human problems.La question demeure de savoir en quel sens Georges Canguilhem peut être considéré comme un penseur de l’erreur. Cet article, par contraste avec d’autres textes sur le même sujet, s’intéresse aux documents d’archives et à des écrits de jeunesse, jusqu’à l’Essai sur quelques problèmes concernant le normal et le pathologiquede 1943, en vue de mieux comprendre la première pensée de Canguilhem sur l’erreur et de formuler le problème philosophique fondamental auquel elle est associée. Ce travail montre qu’il y a eu une transformation partielle de sa pensée alors qu’il entreprend de répondre à cette question par le biais d’une étude des problèmes humains concrets. (shrink)

The last years’ achievements in neuroscience are key for a philosophical analysis focused on the mind-body problem, such as the phenomenological approach.The digital evolution, on the one hand, faces us with the interaction between the world of reality and the world of possibility. This means more than a mere coexistence between these two dimensions. Rather, a concrete feedback occurs among them, and this brings out unprecedented and unavoidable issues with regard to perceptual processes. On the other hand, the digital evolution (...) allows for analyzing data and monitoring environmental systems, thus reasoning in a predictive way, anticipating problems, and checking ex ante their evolution and outcomes.Neuroscience, for its part, with the experiments of Libet and their subsequent interpretations, has highlighted a consciousness of the unconscious made of ballistic and automatic processes, which constitutes the starting phase of our decisions and actions. This further confirmed that sequential and linear thinking is unable to address the brain-environment relationship that is key in understanding any cognitive process.This analysis confirms the relevance of different aspects of Husserl’s phenomenology. There is, however, a “but,” which significantly reduces the extent of adherence to his point of view. Husserl assumed that an implicit horizon precedes or accompanies the acts of conscience. This is the material, impressional, passive, receptive, and, in some way, tacit dimension, strictly connected to the issue of genesis, i.e. the process of constitution of the analyzed entities. Thus, he drew a clear dividing line between this dimension and the phases of the self-controlling, vigilant conscience and its activity. In fact, his approach to the phenomenological problem is mainly oriented toward these phases. (shrink)

In this paper I present and compare the ideas behind naturalistic theories of health on the one hand and phenomenological theories of health on the other. The basic difference between the two sets of theories is no doubt that whereas naturalistic theories claim to rest on value neutral concepts, such as normal biological function, the phenomenological suggestions for theories of health take their starting point in what is often named intentionality: meaningful stances taken by the embodied person in experiencing and (...) understanding her situation and taking action in the world.Although naturalism and phenomenology are fundamentally different in their approach to health, they are not necessarily opposed when it comes to understanding the predicament of ill persons. The starting point of medical investigations is what the patient feels and says about her illness and the phenomenological investigation should include the way diagnoses of different diseases are interpreted by the person experiencing the diseases as an embodied being. Furthermore, the two theories display similarities in their emphasis of embodiment as the central element of health theory and in their stress on the alien nature of the body displayed in illness. Theories of biology and phenomenology are, indeed, compatible and in many cases also mutually supportive in the realm of health and illness. (shrink)

In this paper I explore health and illness through the lens of enactivism, which is understood and developed as a bodily-based worldly-engaged phenomenology. Various health theories – biomedical, ability-based, biopsychosocial – are introduced and scrutinized from the point of view of enactivism and phenomenology. Health is ultimately argued to consist in a central world-disclosing aspect of what is called existential feelings, experienced by way of transparency and ease in carrying out important life projects. Health, in such a phenomenologically enacted understanding, (...) is an important and in many cases necessary part of leading a good life. Illness, on the other hand, by such a phenomenological view, consist in finding oneself at mercy of unhomelike existential feelings, such as bodily pains, nausea, extreme unmotivated tiredness, depression, chronic anxiety and delusion, which make it harder and, in some cases, impossible to flourish. In illness suffering the lived body hurts, resists, or, in other ways, alienates the activities of the ill person. (shrink)

A large slice of contemporary phenomenology of medicine has been devoted to developing an account of health and illness that proceeds from the first-person perspective when attempting to understand the ill person in contrast and connection to the third-person perspective on his/her diseased body. A proof that this phenomenological account of health and illness, represented by philosophers, such as Drew Leder, Kay Toombs, Havi Carel, Hans-Georg Gadamer, Kevin Aho, and Fredrik Svenaeus, is becoming increasingly influential in philosophy of medicine and (...) medical ethics is the criticism of it that has been voiced in some recent studies. In this article, two such critical contributions, proceeding from radically different premises and backgrounds, are discussed: Jonathan Sholl’s naturalistic critique and Talia Welsh’s Nietzschean critique. The aim is to defend the phenomenological account and clear up misunderstandings about what it amounts to and what we should be able to expect from it. (shrink)

1st Gent.: Our deeds are fetters that we forge ourselves. 2d Gent.: Ay, truly: but I think it is the world that brings the iron. R. L. Scott once explained that the “environment is experienced as being rhetorical,” meaning anything within the milieu can participate in addressivity, that who or what addresses what and whom is variable and multiple. He stressed that human valuing determined participation, but he nonetheless anticipated a more robust, posthuman ecological view when he contended that “one (...) must not think of rhetorical attributes as exclusively the property of speakers, writers, or other message-senders”. Scott claimed an “enlarged concept of rhetoric” was necessary... (shrink)

Today’s question concerning technology involves asking about both the post-pandemic world and the post-data-economy world, in a situation where resentments and scapegoats are easily generated. We c...

This article suggests a new approach to understanding the self-formation of subjectivity in the work of Michel Foucault that emphasizes the influence of his mentor, the philosopher and historian of science Georges Canguilhem. I argue that Foucault adapts Canguilhem’s biological–epistemological notion of ‘error’ in order to achieve two things: to provide a notion of subjective self-formation compatible with the claims of his ‘archaeology of knowledge’ and ‘genealogy of power’, and to provide an alternative to the phenomenological theory of the subject. (...) The notion of ‘error’ accomplishes these goals because it posits that experience is the result of knowledge, not vice versa. To illustrate the notion of ‘erroneous’ subjectivity, I turn to two volumes edited by Foucault: I, Pierre Rivière, having slaughtered my mother, my sister and my brother… and Herculine Barbin; Being the Recently Discovered Memoirs of a Nineteenth- Century French Hermaphrodite. Both juxtapose ‘subjective’ accounts of ‘abnormal’ individuals with ‘objective’ documents written by judges, psychiatrists and medical professionals in order to show how ‘erroneous subjectivities’ may transgress epistemological limits and form new concepts. (shrink)

In the two volumes which make up Capitalism and Schizophrenia, Deleuze and Guattari propose new concepts of “machine” and “organism.” The problem of the relationship between machines and organisms has a long philosophical history, and this essay treats their work as a contribution to this debate. It is argued that their solution to this problem is found in their difficult concept of the “body without organs,” a concept that is given some much-needed clarification in the essay. The first section details (...) Deleuze and Guattari’s concept of the machine, examining the ways in which it differs from the traditional concept as described by Canguilhem: their machines do not have predictable movements, but instead produce events; they do not have a purpose; they are able to reproduce themselves. The second section details their conception of the organism through their account of Geoffroy Saint-Hilaire: organisms are bodies which normalize and which create hierarchies; they also do not have a purpose; they have a “unity of composition.” The final section argues that their concept of the “body without organs” shows us how to understand the relation between the two transformed concepts, and defines the body without organs as the becoming-machine of the organism. (shrink)

This study brings together socio-theoretical and ethnographic approaches to psychiatry, demonstrating the role of the clinic as a major consolidator of ideologies as well as the site where personal miseries are registered as markers of social failure. It focuses on innovation in psychiatric taxonomies, changes in the figurative language of the emotions, changes in conceptualizations of the self and how all of these relate to changing socio-economic events and circumstances.

This study brings together socio-theoretical and ethnographic approaches to psychiatry, demonstrating the role of the clinic as a major consolidator of ideologies as well as the site where personal miseries are registered as markers of social failure. It focuses on innovation in psychiatric taxonomies, changes in the figurative language of the emotions, changes in conceptualizations of the self and how all of these relate to changing socio-economic events and circumstances.

Medicalization appears to be an issue that is both ubiquitous and unquestionably problematic as it seems to signal at once a social and existential threat. This perception of medicalization, however, is nothing new. Since the first main writings in the 1960s and 1970s, it has consistently been used to describe inappropriate or abusive instances of medical authority. Yet, while this standard approach claims that medicalization is a growing problem, it assumes that there is simply one “medical model” and that the (...) expanding realm of “the medical” can be more or less clearly delineated. Moreover, while intended to establish the reality of this growing threat, this research often requires making arbitrary or unjustified distinctions between different practices. To better clarify the concept of medicalization, I will focus more on capturing the variety of medical practices than on the sociological aspects of medical discourse. In doing so, I will explore the distinction between medicalization and pathologization, a distinction that is often overlooked and that brings with it many conceptual and practical implications. After defining these terms, I will use some examples to show that while pathologizing is closely tied to medicalizing, both can occur independently. I will then further develop this distinction in terms of the different individual and social effects of these practices. (shrink)

Several philosophers have recently argued that phenomenology is well-suited to help understand the concepts of health, disease, and illness. The general claim is that by better analysing how illness appears to or is experienced by ill individuals—incorporating the first-person perspective—some limitations of what is seen as the currently dominant third-person or ‘naturalistic’ approaches to understand health and disease can be overcome. In this article, after discussing some of the main insights and benefits of the phenomenological approach, I develop three general (...) critiques of it. First, I show that what is often referred to as naturalism tends to be misunderstood and/or misrepresented, resulting in straw-man arguments. Second, the concept of normality is often problematically employed such that some aspects of naturalism are actually presupposed by many phenomenologists of medicine. Third, several of the key phenomenological insights and concepts, e.g. having vs. being a body, the alienation of illness, the epistemic role of the first-person perspective, and the idea of health within illness, each bring with them new problems that limit their utility. While acknowledging the possible contributions of phenomenology, these criticisms point to some severe limitations of bringing phenomenological insights to bear on the problems facing philosophy of medicine that should be addressed if phenomenology is to add anything substantially new to its debates. (shrink)

Many historical studies tend to underline two central Kantian themes frequently emerging in Georges Canguilhem’s works: (1) a conception of activity, primarily stemming from the Critique of Pure Reason, as a mental and abstract synthesis of judgment; and (2) a notion of organism, inspired by the Critique of Judgment, as an integral totality of parts. Canguilhem was particularly faithful to the first theme from the 1920s to the first half of the 1930s, whereas the second theme became important in the (...) early 1940s. With this article, I will attempt to show that a third important theme of technique arose in the second half of the 30s also in the wake of Kant’s philosophy, especially Sect. 43 of the Critique of Judgment. This section, which states that technical ability is distinguished from a theoretical faculty, led Canguilhem to a more concrete and practical conception of activity. I will then suggest that it was by considering technique that the concept of normativity, which characterizes Georges Canguilhem’s philosophy of life, also took shape. (shrink)

Medicine increasingly envisions health promotion in terms of reducing risk as determined by quantitative risk factors, such as blood pressure, blood lipids, or genetic variants. This essay argues that this vision of health care as risk reduction is dangerous for Christian bioethics, since risk can be infinitely reduced leading to a self-defeating spiral of iatrogenic effects. Moreover, it endangers character because this vision of health is connected to a reductionist vision of the body and an understanding of individual risk that (...) undermines the more communal virtue of solidarity. The essay concludes by discussing how recent Thomistic analyses in favor of physical enhancements illustrate some of the problems that envisioning health care in terms of risk reduction holds for Christian bioethics. (shrink)