In The Biopsychosocial Model of Health and Disease, Derek Bolton and Grant Gillett argue that a defensible updated version of the biopsychosocial model requires a metaphysically adequate account of disease causation that can accommodate biological, psychological, and social factors. This present paper offers a philosophical critique of their account of biopsychosocial causation. I argue that their account relies on claims about the normativity and the semantic content of biological information that are metaphysically contentious. Moreover, I suggest that these claims are (...) unnecessary for a defence of biopsychosocial causation, as the roles of multiple and diverse factors in disease causation can be readily accommodated by a more widely accepted and less metaphysically contentious account of causation. I then raise the more general concern that they are misdiagnosing the problem with the traditional version of the biopsychosocial model. The challenge when developing an explanatorily valuable version of the biopsychosocial model, I argue, is not so much providing an adequate account of biopsychosocial causation, but providing an adequate account of causal selection. Finally, I consider how this problem may be solved to arrive at a more explanatorily valuable and clinically useful version of the biopsychosocial model. (shrink)

In this talk I present the main results from Anta (2021), namely, that the theoretical division between Boltzmannian and Gibbsian statistical mechanics should be understood as a separation in the epistemic capabilities of this physical discipline. In particular, while from the Boltzmannian framework one can generate powerful explanations of thermal processes by appealing to their microdynamics, from the Gibbsian framework one can predict observable values in a computationally effective way. Finally, I argue that this statistical mechanical schism contradicts the Hempelian (...) (1958) thesis that the predictive power of a scientific theory is directly proportional to its explanatory potential, and vice versa. (shrink)

Over the past 25 years, several new “medicines” have come screeching onto health care’s various platforms, including narrative medicine, personalized medicine, precision medicine and person-centred medicine. Philosopher Miriam Solomon calls the first three of these movements different “ways of knowing” or “methods,” and argues that they are each a response to shortcomings of methods that came before them. They should also be understood as reactions to the current dominant model of medicine. In this article, I will describe our dominant model, (...) which I call “the new medical model.” I will argue that several towering problems in modern medicine can be traced to its philosophical foundations, which calls for philosophical analysis. (shrink)

L'importance que les défenseurs du Research Domain Criteria (RDoC) accordent aux circuits du cerveau dans la compréhension des désordres mentaux a conduit certains chercheurs à suspecter qu'on avait affaire à un programme de recherche foncièrement réductionniste. Puisque le RDoC devrait éventuellement affecter la psychiatrie clinique, on a craint qu'elle ne se transforme en une science neuro-comportementale appliquée sans tenir compte de l'esprit (mindless). Cet article montre en quoi le projet du RDoC s'éloigne du réductionnisme classique et comment il en évite (...) les écueils. Pour cette raison, du moins en principe, le RDoC pourrait enrichir plutôt qu'appauvrir la psychiatrie clinique. Pour conclure, les effets néfastes produits par le réductionnisme de façade des défenseurs du RDoC seront soulignés. (shrink)

Chronobiologists argue that their scientific findings have implications for prevention of sleep problems. They claim that some sleep problems are caused by the fact that people live against their individual body clock rather than adjusted to it. They also claim that by taking the findings of chronobiology seriously in policy-making some sleep problems can be prevented. I investigate applications of chronobiology in two social areas—school schedules and shift work—and show that in order for these applications to be justified certain implicit (...) presumptions have to be justified. The first presumption is explanatory, namely that a chronobiological explanation is an adequate explanation of the sleep problems at hand. In addition I analyse three ethical presumptions. The first ethical presumption is that sleep is of vital value. The second is that sleep is not an exclusively private issue. The third ethical presumption is that the preventive measures to be undertaken are ethically acceptable. My main point is that it is not possible to simply “read off” policy measures from the empirical findings of chronobiology. (shrink)

Instances of explanatory reduction are often advocated on metaphysical grounds; given that the only real things in the world are subatomic particles and their interaction, we have to try to explain everything in terms of the laws of physics. In this paper, we show that explanatory reduction cannot be defended on metaphysical grounds. Nevertheless, indispensability arguments for reductive explanations can be developed, taking into account actual scientific practice and the role of epistemic interests. Reductive explanations might be indispensable to address (...) some epistemic interest answering a specific explanation-seeking question in the most accurate, adequate and efficient way. Just like explanatory pluralists often advocate the indispensability of higher levels of explanation pointing at the pragmatic value of the explanatory information obtained on these higher levels, we argue that explanatory reduction—traditionally understood as the contender of pluralism—can be defended in a similar way. The pragmatic value reductionist, lower level explanations might have in the biomedical sciences and the social sciences is illustrated by some case studies. (shrink)

Medical classification systems aim to provide a manageable taxonomy for sorting diagnoses into their proper classes. The question, this paper wants to critically examine, is how to correctly systematise diseases within classification systems that are applied in a variety of different settings. ICD and DSM , the two major classification systems in medicine and psychiatry, will be the main subjects of this paper; however, the arguments are not restricted to these classification systems but point out general methodological and epistemological challenges (...) of classifying diseases for differing purposes. Deciding what qualifies as a disease to be included into a classification system as well as choosing a specific validator for correctly systematising diseases is complicated because the broad applicability of medical classification systems simultaneously appears as aim and challenge. Drawing upon the case study of classifying Alzheimer’s disease, this paper will address three dilemmas in designing ‘good’ medical classification systems. They are due to general epistemological problems of medicine, such as the relationship between individual manifestations of diseases and the necessity of building groups in order to scientifically elucidate causes of diseases. Moreover, they involve pragmatic issues of designing usable classifications that allow for easily discriminating between classes of diseases, restricting, however, the completeness of disease representations. This paper wants to trace how the choice of certain validators is unavoidably value-laden and deeply intertwined with epistemological assumptions of how different uses relate to each other, resulting either in a prioritisation of (constrained) coherence or of (vague) pluralistic connectibility. (shrink)

Instances of explanatory reduction are often advocated on metaphysical grounds; given that the only real things in the world are subatomic particles and their interaction, we have to try to explain everything in terms of the laws of physics. In this paper, we show that explanatory reduction cannot be defended on metaphysical grounds. Nevertheless, indispensability arguments for reductive explanations can be developed, taking into account actual scientific practice and the role of epistemic interests. Reductive explanations might be indispensable to address (...) some epistemic interest answering a specific explanation-seeking question in the most accurate, adequate and efficient way. Just like explanatory pluralists often advocate the indispensability of higher levels of explanation pointing at the pragmatic value of the explanatory information obtained on these higher levels, we argue that explanatory reduction—traditionally understood as the contender of pluralism—can be defended in a similar way. The pragmatic value reductionist, lower level explanations might have in the biomedical sciences and the social sciences is illustrated by some case studies. (shrink)

A well-known problem in the health sciences is the distorted research agenda: the agenda features too little research that is tailored to the health problems of the poor, and it features too little research that supports the development of other solutions to health problems than medicines . This article analyzes these two sub-problems in more detail, and assesses several strategies to deal with them, resulting in some specific recommendations that indicate what governments should do to make the research agenda in (...) the health sciences less distorted. (shrink)