The paper discusses two recent approaches to schizophrenia, a phenomenological and a neuroscientific approach, illustrating how new directions in philosophy and cognitive science can elaborate accounts of psychopathologies of the self. It is argued that the notion of the minimal and bodily self underlying these approaches is still limited since it downplays the relevance of social interactions and relations for the formation of a coherent sense of self. These approaches also illustrate that we still lack an account of how 1st (...) and 3rd person observations can fruitfully go together in an embodied account of disorders of the self. Two concepts from enactive cognitive science are introduced, the notions of autonomy and sense-making. Based on these, a new proposal for an enactive approach to psychopathologies of the self is outlined that integrates 1st and 3rd person perspectives, while strongly emphasising the role of social interactions in the formation of self. It is shown how the enactive framework might serve as a basis for an alternative understanding of disorders of the self such as schizophrenia, as a particular form of socially constituted self-organisation. (shrink)

This article explores contemporary biopolitics in the light of Michel Foucault's oft quoted suggestion that contemporary politics calls `life itself' into question. It suggests that recent developments in the life sciences, biomedicine and biotechnology can usefully be analysed along three dimensions. The first concerns logics of control - for contemporary biopolitics is risk politics. The second concerns the regime of truth in the life sciences - for contemporary biopolitics is molecular politics. The third concerns technologies of the self - for (...) contemporary biopolitics is ethopolitics. The article suggests that, in these events, human beings have become `somatic individuals': personhood is increasingly being defined in terms of corporeality, and new and direct relations are established between our biology and our conduct. At the same time, this somatic and corporeal individuality has become opened up to choice, prudence and responsibility, to experimentation, to contestation and so to a politics of `life itself'. (shrink)

What clinicians, biomedical scientists, and other health care professionals know as individuals or as groups and how they come to know and use knowledge are central concerns of medical epistemology. Activities associated with knowledge production and use are called epistemic practices. Such practices are considered in biomedical and clinical literatures, social sciences of medicine, philosophy of science and philosophy of medicine, and also in other nonmedical literatures. A host of different kinds of knowledge claims have been identified, each with different (...) uses and logics of justification. A general framework is needed to situate these diverse contributions in medical epistemology, so we can see how they fit together. But developing such a framework turns out to be quite tricky. In this survey, three possible frameworks are considered along with the difficulties associated with each of them. The essay concludes with a fourth framework, which considers any epistemology as part of a practice that is oriented toward overcoming errors that emerge in antecedently given practices where knowledge is developed and used. As medicine indirectly advances health by directly mitigating disease, so epistemology indirectly advances knowledge by directly mitigating error. (shrink)

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

This article offers the critical concept misfit in an effort to further think through the lived identity and experience of disability as it is situated in place and time. The idea of a misfit and the situation of misfitting that I offer here elaborate a materialist feminist understanding of disability by extending a consideration of how the particularities of embodiment interact with the environment in its broadest sense, to include both its spatial and temporal aspects. The interrelated dynamics of fitting (...) and misfitting constitute a particular aspect of world-making involved in material-discursive becoming. The essay makes three arguments: the concept of misfit emphasizes the particularity of varying lived embodiments and avoids a theoretical generic disabled body; the concept of misfit clarifies the current feminist critical conversation about universal vulnerability and dependence; the concept of misfitting as a shifting spatial and perpetually temporal relationship confers agency and value on disabled subjects. (shrink)

Continental philosophies of science tend to exemplify holistic themes connecting order and contingency, questions and answers, writers and readers, speakers and hearers. Such philosophies of science also tend to feature a fundamental emphasis on the historical and cultural situatedness of discourse as significant; relevance of mutual attunement of speaker and hearer; necessity of pre-linguistic cognition based in human engagement with a common socio-cultural historical world; role of narrative and metaphor as explanatory; sustained emphasis on understanding questioning; truth seen as horizonal, (...) aletheic, or perspectival; and a tolerance for paradoxical and complex forms of expression. Continental philosophy of science is thus more comprehensive than philosophy of science in the analytic tradition, including (and as analytic philosophy of science does not tend to include) perspectives on the history of science as well as the social and practical dimensions of scientific discovery. Where analytic philosophy is about reducing or, indeed, eliminating the perennial problems of philosophy, Continental philosophy is all about thinking and that will mean, as both Heidegger and Nietzsche emphasize, making such problems more not less problematic. (shrink)

A proposal for the biological grounding of intrinsic teleology and sense-making through the theory of autopoiesis is critically evaluated. Autopoiesis provides a systemic language for speaking about intrinsic teleology but its original formulation needs to be elaborated further in order to explain sense-making. This is done by introducing adaptivity, a many-layered property that allows organisms to regulate themselves with respect to their conditions of viability. Adaptivity leads to more articulated concepts of behaviour, agency, sense-construction, health, and temporality than those given (...) so far by autopoiesis and enaction. These and other implications for understanding the organismic generation of values are explored. (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)

This paper explores the relationship between the problem of dis/harmony in Jakob von Uexküll’s Umwelt theory and the inclusion of experiences of disability, disease, or trauma, in said theory. It starts with discussions of dis/harmony and dis/ability in Uexküllian studies, from Uexüll’s very own work on Umwelt theory to the contemporary commentaries and studies of said theory. It first articulates how Uexküll’s focus on harmony provided poor conditions to account for dis/ability, while commenting on points where Uexküll offered direct engagement (...) with or openness to situations of dis/harmony and dis/ability. It then forays into post-Uexküllian research on dis/ease and pathology and suggests that the work of Weizsäcker, Kurt Goldstein and Georges Canguilhem might constitute a useful step aside to allow Umwelt theory better to account for these situations. From then on, the article shows how contemporary investigations into the mutability of Umwelten in the context of the ecological crisis allows for the development of a phenomenology of Umwelt crises and trauma. Finally, the ethological dimension of Umwelt theory is taken up as a way to formulate a philosophy of intra-specific ethological diversity and ethological divergence, and the example of autism is read into the theoretical framework of Umwelt thinking. (shrink)

In 2001, I experienced severe radial neuropathy, leading to permanent dysfunctions in the fingers of my left hand. In this personal account of nerve damage, medical and surgical treatment, and adaptation, I first describe the sequence of neuropathies, then turn to how through serendipity, the brace enabled other connections—nervelines—with individuals and places. The brace is a metonym of a severed nerve with its associated loss of movement and capacity; it is also both a functional orthotic and an affordance. It carries (...) me forward, activating other nervelines and networks to make things happen. I write of literal and metaphoric nerves, evolving connectivities, and fiber lines, thought lines and collaborations. I then extend the idea of nervelines and networks to global connnections; I emphasize how the organization of labor, the distribution of goods and services, and the expectations of workers shape body histories and life outcomes. (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)

In the science and values literature, scholars have shown how science is influenced and shaped by values, often in opposition to the ‘value free’ ideal of science. In this paper, we aim to contribute to the science and values literature by showing that the relation between science and values flows not only from values into scientific practice, but also from (allegedly neutral) science to values themselves. The extant literature in the ‘science and values’ field focuses by and large on reconstructing, (...) post hoc, how values have influenced science; our reconstruction of the case studies, instead, aims to show that scientific concepts and methods _too, because of specific identifiable characteristics,_ can promote some values rather than (or at the expense of) others. We explain this bidirectional relation in analogy to debates on the normativity of technical artifacts and on feminist approaches in science, and we illustrate our claims with cases from the health sciences and machine learning. While our arguments in this paper also draw on post hoc reconstructions, we intend to show where, in the science in the making, we should engage not only with the question whether a practice is value-laden, but also how specific conceptual and methodological choices can influence values down the road. All in all, these considerations expand the ways in which philosophers can contribute to more value-aware scientific practices. (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)

Interventions are medically necessary when they are vital in achieving the goal of medicine. However, with varying perspectives comes varying views on what interventions are (un)necessary and, thus, what potential treatment options are available for those suffering from the myriad of conditions, pathologies and disorders afflicting humanity. Medical necessity's teleological nature is perhaps best illustrated in cases where there is debate over using contentious medical interventions as a last resort. For example, whether it is appropriate for those suffering from body (...) integrity dysphoria to receive healthy limb amputations. This paper explores how one's perception of medicine's goal underpins whether interventions are necessary or unnecessary, using the controversial topic of therapeutic amputation as an example. By contrasting ‘classical’ amputations with their more contentious counterparts, it highlights how the idea of medical necessity influences and restrains clinical decision-making. The paper starts by giving an account of body integrity dysphoria, focusing on the debate concerning elective amputation's justifiability. It then introduces Georges Canguilhem's vitalist theory of health, paying particular attention to his emphasis on adaptability. Then, this paper uses his theory as a lens through which to evaluate the appropriateness of therapeutic amputation as a medically necessary procedure. Ultimately, the paper highlights how the label of medical necessity is withheld from potential therapeutic interventions because they fail to conform to pre-established ideas of medicine's purpose and that by doing so, potential harm befalls those who are left with no effective treatments and must look for solutions in the non-clinical world. (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)

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)

This review assesses a rare and insightful philosophical examination of the ethics of the medical management of sex-atypical children. In Making Sense of Intersex, Ellen K. Feder crafts an ethics that would shift several common foci of the contemporary debate on her topic: from questions of gender to the ethics of normalization; from individual or parental autonomy to a general corporeal vulnerability; and from parental medical proxy rights to the interdependency of parent-child relations. The review identifies some seemingly unavoidable conundrums (...) that would remain unsolved after such shifts: the continuing role of gender in normalizing medical aims, the utility of an undifferentiated concept of vulnerability in medical decision making, and the place of cosmetic medicine in general. (shrink)

In this article, I argue that scholarship on the cultural impact of neoliberalism provides a vital framework with which to revisit early trans critiques of Butlerian queer feminism. Drawing on this scholarship, I reread the appeals to the real and realness in these critiques through the neoliberal transformation of social difference. I link the early argument that some trans figures were problematically used in queer feminism to represent the fluidity of identity with the more recent argument that the flexibility of (...) identity has become a core part of neoliberal cultures. This context challenges the current dominant view of early trans critiques of Butler as misreadings and instead casts them as resistant to a superficial encouragement of individual flexibility. As a result, revisiting this debate demonstrates the need to rework theoretical frameworks that may continue to inadvertently lead to selective trans inclusion in queer feminism and points the way to trans-queer-feminist theory that is more attuned to shifting models of power. (shrink)

This study clarifies the need for a renewed account of the body in physiotherapy to fill sizable gaps between physiotherapeutical theory and practice. Physiotherapists are trained to approach bodily functioning from an objectivist perspective; however, their therapeutic interactions with patients are not limited to the provision of natural-scientific explanations. Physiotherapists’ practice corresponds well to theorisation of the body as the bearer of original bodily intentionality, as outlined by Merleau-Ponty and elaborated upon by enactivists. We clarify how physiotherapeutical practice corroborates Merleau-Ponty’s (...) critical arguments against objectivist interpretations of the body; particularly, his analyses demonstrate that norms of optimal corporeal functioning are highly individual and variable in time and thus do not directly depend on generic physiological structures. In practice, objectively measurable physical deviations rarely correspond to specific subjective difficulties and, similarly, patients’ reflective insights into their own motor deficiencies do not necessarily produce meaningful motor improvements. Physiotherapeutical procedures can be understood neither as mechanical manipulations of patients’ machine-like bodies by experts nor as a process of such manipulation by way of instructing patients’ explicit conscious awareness. Rather, physiotherapeutical practice and theory can benefit from the philosophical interpretation of motor disorders as modifications of bodily intentionality. Consequently, motor performances addressed in physiotherapy are interpreted as relational features of a living organism coupled with its environment, and motor disorders are approached as failures to optimally manage the motor requirements of a given situation owing to a relative loss of the capacity to structure one’s relation with their environment through motor action. Building on this, we argue that the process of physiotherapy is most effective when understood as a bodily interaction to guide patients towards discovering better ways of grasping a situation as meaningful through bodily postures and movements. (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)

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)

Recovery is a commonly used concept in both professional and everyday contexts. Yet despite its extensive use, it has not drawn much philosophical attention. In this paper, I question the common understanding of recovery, show how the concept is inadequate, and introduce new and much needed terminology. I argue that recovery glosses over important distinctions and even misrepresents the process of moving away from malady as "going back" to a former state of health. It does not invite important nuances needed (...) to distinguish between biomedical, phenomenological, and social perspectives. In addition, I claim that there are many conditions where we are making use of the concept of recovery, although the person recovered from the condition in question, has not regained the same degree of soundness. I show how the concept of recovery leads to conceptual discrepancies that can result in worsening patients' conditions. To gain a fuller understanding, I propose to rethink the direction of the process in question. I define the process of moving away from malady as a move forward towards a new state of soundness. I also suggest three terms, corresponding to different perspectives, to describe this movement forward: 'curing', 'healing', and 'habilitating'. This new terminology provides a more nuanced understanding of the states of both malady and soundness and an attentiveness as to how they differ and relate. (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)

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)

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)

The tendency to idealise artificial intelligence as independent from human manipulators, combined with the growing ontological entanglement of humans and digital machines, has created an “anthrobotic” horizon, in which data analytics, statistics and probabilities throw our agential power into question. How can we avoid the consequences of a reified definition of intelligence as universal operation becoming imposed upon our destinies? It is here argued that the fantasised autonomy of automated intelligence presents a contradistinctive opportunity for philosophical consciousness to understand itself (...) anew as holistic and co-creative, beyond the recent “analytic” moment of the history of philosophy. Here we introduce the concept of “crealectic intelligence”, a meta-analytic and meta-dialectic aspect of consciousness. Intelligent behaviour may consist in distinguishing discrete familiar parts or reproducible functions in the midst of noise via an analytic process of segmentation; intelligence may also manifest itself in the constitution of larger wholes and dynamic unities through a dialectic process of association or assemblage. But, by contrast, crealectic intelligence co-creates realities in the image of an ideal or truth, taking into account the desiring agent imbued with a sense of possibility, in a relationship not only with the Real but also with the creative sublime or “Creal”. (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)

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)

The article explores theoretical convergences between the work of Georges Canguilhem and Lucien Febvre on the theme of science and technique. In comparing the scholarship of both authors from the 1920s through 1940s, we endeavor to show that their critique of mechanistic determinism was rooted in the concept of the genres of life and its creative interaction with the environment.

This paper critically evaluates Foucault’s relation to Bachelard and Canguilhem. It reconsiders the relevance of the concept of “influence” for treating this relation in order to register the more sceptical position Foucault adopts towards knowledge practices than either of these figures from twentieth-century French epistemology.

I develop an interpretation of Maurice Merleau-Ponty's concept of motor intentionality, one that emerges out of a reading of his presentation of a now classic case study in neuropathology—patient Johann Schneider—in Phenomenology of Perception. I begin with Merleau-Ponty's prescriptions for how we should use the pathological as a guide to the normal, a method I call triangulation. I then turn to his presentation of Schneider's unusual case. I argue that we should treat all of Schneider's behaviors as pathological, not only (...) his abstract movements, as is commonly acknowledged in the secondary literature, but also crucially his concrete movements. Using these facts of Schneider's illness, I reconstruct a ‘fundamental function’ of consciousness, as Merleau-Ponty called it, in which there are two kinds of bodily agency: the power of the body to be solicited by a situation and the power of the body to project a situation. I propose that these powers became dissociated in Schneider's case, as evidenced by his abstract and concrete movements, while in the normal case, these powers comprise a dynamic unity, enacted as motor intentionality. I also discuss how my interpretation complements Merleau-Ponty's assertion that motor intentions exist between mind and matter. (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)

We defend a view of the distinction between the normal and the pathological according to which that distinction has an objective, biological component. We accept that there is a normative component to the concept of disease, especially as applied to human beings. Nevertheless, an organism cannot be in a pathological state unless something has gone wrong for that organism from a purely biological point of view. Biology, we argue, recognises two sources of biological normativity, which jointly generate four “ways of (...) going wrong” from a biological perspective. These findings show why previous attempts to provide objective criteria for pathology have fallen short: Biological science recognizes a broader range of ways in which living things can do better or worse than has previously been recognized in the philosophy of medicine. (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)

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)

ArgumentResearch into the biological markers of pathology has long been a feature of British psychiatry. Such somatic indicators and associated features of mental disorder often intertwine with discourse on psychological and behavioral correlates and causes of mental ill-health. Disorders of sociality – particularly psychopathy and antisocial personality disorder – are important instances where the search for markers of pathology has a long history; research in this area has played an important role in shaping how mental health professionals understand the conditions. (...) Here, I characterize the multiplicity of psychiatric praxis that has sought to define the mark of antisociality as a form of “ontological anarchy.” I regard this as an essential feature of the search for biological and other markers of an unstable referent, positing that uncertainties endure – in part – precisely because of attempts to build consensus regarding the ontology of antisociality through biomedical means. Such an account is suggestive of the co-production of biomarkers, mental disorder, and psychiatric institutions. (shrink)

In The Open, a series of reflections on the historical endeavours to define the essential features of the human figure in relation to the biological existence it shares with animals, Giorgio Agamben offers a detailed reading of Titian’s painting The Nymph and the Shepherd. He argues that the scene depicted enables the contemporary viewer to visualize the advent of radical freedom, the moment when the historical dialectic of nature and culture comes to a ‘stand-still’. In this article, I offer a (...) different reading of The Nymph and the Shepherd, whereby the advent of radical freedom and death become indistinguishable. This different reading, I argue, calls into question Agamben’s understanding of corporeal being. I conclude by suggesting more speculatively and tentatively that ‘bioart’, the field now emerging at the intersection of the creative arts and the bio-medical sciences, may provide a better site of reflection on the questions Agamben ultimately poses about the future of bio-political governmentality. (shrink)

. The time of the real: When disease is ‘actual’. Cultural Values: Vol. 2, No. 2-3, pp. 243-260.

Who is speaking in the history of social thought? The question of the authentic voice of social thought is typically posed in terms that tend to be either ambitiously theoretical or carefully methodological. Thus histories of social thought frequently offer either a résumé of general ideas about society (say from Montesquieu to Parsons) or a survey which gets bogged down in a rather tedious, nit-picking debate about empirical methodology. This paper is something of a preview of a pro jected attempt (...) on the part of the authors to capture the voice of social thought in rather different terms. Our three theses are: (1) that those who speak 'in the name of society' have just as frequently been doctors and bureaucrats as opposed to 'social philosophers' or professional sociologists; correlatively, (2) that the creative voice of social thought has more often been technical, problem-centred and tied up with par ticular rationalities of government as opposed to being either exclu sively theoretical or merely responsive to 'objective problems' in society; and, (3) that if sociology today struggles for a voice in which to speak this may be in some part due to the ways in which the past history of social thought has typically been conceived. (shrink)

Conceptual analysis of health and disease is portrayed as consisting in the confrontation of a set of criteria—a “definition”—with a set of cases, called instances of either “health” or “ disease.” Apart from logical counter-arguments, there is no other way to refute an opponent’s definition than by providing counter-cases. As resorting to intensional stipulation is not forbidden, several contenders can therefore be deemed to have succeeded. This implies that conceptual analysis alone is not likely to decide between naturalism and normativism. (...) An alternative to this approach would be to examine whether the concept of disease can be naturalized. (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)

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)

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)

Few notions are more central than noise to the transformation of modern life. Noise has become synonymous with the complexity of our world and its global digitised information networks, for as the...

Empowerment is a prominent ideal in health promotion. However, the exact meaning of this ideal is often not made explicit. In this paper, we outline an account of empowerment grounded in the human capacity to adapt and adjust to environmental and societal norms without being completely determined by those norms. Our account reveals a tension at the heart of empowerment between (a) the ability of self-governance and (b) the need to adapt and adjust to environmental and societal norms. We address (...) this tension by drawing from the work of Freud, Canguilhem, and Lacan. First, we clarify through a discussion of Freud’s notion of sublimation that it is difficult to assess empowerment independent of any social valuations, but also that it is no less problematic to make it dependent on social valuations alone. Second, we draw from the work of Canguilhem to show how empowerment can be understood in terms of the individual’s capacity to tolerate the aggressions of a multiplicity of environments. Third, using Lacan, we show how empowerment requires incorporation of social and symbolic norms, without necessarily rendering ourselves a mere product of these norms. Finally, we demonstrate how the views of these authors can complement one another, resulting in a more sophisticated understanding of empowerment. (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)