The way we experience, investigate and interact with reality changes drastically in the course of history. Do such changes occur gradually, or can we pinpoint radical turns, besides periods of relative stability? Building on Oswald Spengler, we zoom in on three styles in particular, namely Apollonian, Magian and Faustian thinking, guided by grounding ideas which can be summarised as follows: “Act in accordance with nature”, “Prepare yourself for the imminent dawn and “Existence equals will to power”. Finally, we reach the (...) present. How to characterise the new era we entered round the year 2000? (shrink)

Precision Medicine has become a common label for data-intensive and patient-driven biomedical research. Its intended future is reflected in endeavours such as the Precision Medicine Initiative in the USA. This article addresses the question whether it is possible to discern a new ‘medical cosmology’ in Precision Medicine, a concept that was developed by Nicholas Jewson to describe comprehensive transformations involving various dimensions of biomedical knowledge and practice, such as vocabularies, the roles of patients and physicians and the conceptualisation of disease. (...) Subsequently, I will elaborate my assessment of the features of Precision Medicine with the help of Michel Foucault, by exploring how precision medicine involves a transformation along three axes: the axis of biomedical knowledge, of biomedical power and of the patient as a self. Patients are encouraged to become the managers of their own health status, while the medical domain is reframed as a data-sharing community, characterised by changing power relationships between providers and patients, producers and consumers. While the emerging Precision Medicine cosmology may surpass existing knowledge frameworks; it obscures previous traditions and reduces research-subjects to mere data. This in turn, means that the individual is both subjected to the neoliberal demand to share personal information, and at the same time has acquired the positive ‘right’ to become a member of the data-sharing community. The subject has to constantly negotiate the meaning of his or her data, which can either enable self-expression, or function as a commanding Superego. (shrink)

This article discusses various ethical and philosophical aspects of heroin addiction. It arose as a result of the plan by the Amsterdam city council to supply free heroin to drug addicts. The objective of treatment of heroin addicts is ambivalent because what is in fact a socio-cultural problem is transformed into a medical problem. The characteristics of this treatment are made explicit through a philosophical analysis which sees the medical intervention as part of a strategy aimed at achieving social normalisation. (...) The reason why such a social control function is practised by physicians is discussed, as well as the reason why heroin users in particular are the object of such a process. In this paper, heroin addiction is considered primarily as a cultural problem. The consequences of this for treatment and ethics form the conclusion. (shrink)

In order to understand the lived experiences of physicians in clinical practice, we interviewed eleven expert, respected clinicians using a phenomenological interpretative methodology. We identified the essence of clinical practice as engagement. Engagement accounts for the daily routine of clinical work, as well as the necessity for the clinician to sometimes trespass common boundaries or limits. Personally engaged in the clinical situation, the clinician is able to create a space/time bubble within which the clinical encounter can unfold. Engagement provides an (...) account of clinical practice as a unitary lived experience. This stands in stark contrast to the prevailing notion, referred to as a dual discourse, that describes medicine as the addition of humanism to science. Drawing on Aristotle’s notion of phronesis and Sartre’s definition of the situation, we illustrate how this novel perspective entwines clinical practice, the person of the clinician, and the clinician’s situation. (shrink)

During the last decades, medical historiography has undergone considerable changes. This review attempts an outline of the developments since 1945. The first section sketches the institutional background of the discipline focusing on the characteristic features which emerged in different national traditions. The following sections—essentially restricted to the German speaking context—describe the development of the fields in research and teaching, ranging from the history of ideas to the social history of medicine, from philogical and editorial work to the philosophy and sociology (...) of medical knowledge. (shrink)

Este artículo propone una exégesis de dos de los hitos conceptuales fundamentales con los que Foucault llevó adelante su investigación sobre la medicina como campo de producción de lo “humano” en la modernidad: por un lado, el delineamiento del individuo en el nacimiento de la clínica moderna y, por el otro, el surgimiento de la figura de lo “humano” a partir del proceso de medicalización como correlato de lo que el filósofo denomina la bio-historia. A tal fin, en primer lugar, (...) se analiza la producción de lo “humano” bajo la noción de “individuo” como consecuencia de la “mirada médica”, en Nacimiento de la clínica. Luego, se relaciona esa noción con la de “hombre”, que aparece como su corolario en Las palabras y las cosas, donde esta última figura cobra toda su significación como resultante de la positividad de las ciencias que se producen en tono de él. Finalmente, se realiza un examen de la producción de lo “humano” en las conferencias que Foucault pronuncia en la Universidad del Estado de Río de Janeiro, en 1974, donde la producción de lo “humano” va a aparecer ligada al paradigma de la biopolítica y, específicamente, en el caso de la medicina, de la “bio-historia”, que complementan y precisan los desarrollos previos. (shrink)

Viewed in the light of the discussions ofscientificlecturing in eighteenth-century London contained in this issue, the case of medicine may be said to be both more of the same but also something different.

On several occasions Michel Foucault advocated a methodological turn towards what he called a ‘happy positivism’. Foucault’s emphasis on the surface does not deny the importance of structures of hiding, but understands it as a game in which the structures of hiding are viewed as contingently given. In this paper, I will analyse the conflict between the hacker movement and the field of corporate interests. I argue that the introduction of graphical user interfaces and the maintaining of copyright interests are (...) the contingent background of the ongoing conflict. By bracketing the analyses of hidden intentional structures, the happy positivist is thus able to facilitate deeper understandings of the prevailing structures of hiding. (shrink)

Ian Hacking has defined himself as a philosopher in the analytic tradition. However, he has also recognized the profound influence that Michel Foucault had on much of his work. In this article I analyse the specific imprint of certain works by Foucault—in particular Les mots et les choses—in two of Hacking’s early works: Why Does Language Matter to Philosophy? and The Emergence of Probability. I propose that these texts not only share a debt of Foucauldian thought, but also are part (...) of what I believe is Hacking’s central project: the analysis of the historical and situated conditions of possibility for the emergence of concepts and of objects, inspired also by the French philosopher’s thought. (shrink)

Taking as our starting point Plato'smetaphor of the doctor as philosopher we reflect on some aspects of the epistemological status of medicine. The framework to this paper is the hermeneutics of Hans-Georg Gadamer which shows the paradoxical nature of Western medicine in choosing the body-object as its investigative starting point, while in actual fact dealing with subjects. Gadamer proposes a model of medicine as the art of understanding and dialogue, which is capable of bringing together its various constituent parts, i.e. (...) knowledge, knowing how to do and knowing how to be, in medical practice and in the physician'straining. The paper concludes with a brief discussion of the dyadic figure of the physician as Platonic master of the living totality and wounded healer, capable of activating the patient'sself-healing capacity. (shrink)

The author of the present paper argues that while trying to explain the institutional success of the science and its broad social impact, it is worth throwing aside the arguments concerning the universal traits of human nature, changes in the human mentality, or transformation of the culture and civilization, such as the development of capitalism or bureaucratic power. In the 16th century no new man emerged, and no mutants with overgrown brains work in modern laboratories. So one must also reject (...) the Great Divide between the cultures of the scientific and pre-scientific and replace it with multiple, uncertain and unexpected ‘not-so-great divides’, which can be described in meticulous anthropological studies. Although the achievements of science are certainly spectacular, and the gap between scientific practice and other areas of activity is so obvious, this does not mean that one must look for the \"great\" reasons behind this situation. One should rather focus on quite down-to-earth practices and tools used by scientists. A significant part of their activities can be described by referring to the craft of writing, reading and transforming of various types of inscriptions (records), and broadly understood visualization – their combining, performing, interpreting, confronting, comparing, shifting, shuffling etc. The important role of these tools and methods is especially visible in situations of scientific controversy. It is so because scientific controversies are won by the one able to muster on the spot the largest number of well aligned and faithful allies, and the technology of writing, printing and visualizing play a special role in mobilizing them. These are necessary to ensure that certain factors can be mobile – easy to move from place to place, and yet, immutable – not undergoing deformation as a result of the movement. This way, scientists are able to not only diffuse different types of factors relevant to the dispute and the process of constituting science, but also concentrate them in the centers of calculation, where, through accumulation, one can take actions not available elsewhere. (shrink)

Michel Foucault’s famous book on madness first appeared in 1961 as Folie et Déraison. When it was reissued in 1972, ‘Déraison’ had dropped from the title, but it remained dense in the text, often capitalized or italicized. No two texts, abridgements, or translations of the madness book are identical with respect to the word. It is translated as ‘unreason’, but what does it mean? How did Foucault use it? Why did he come to downplay it? The relationships between déraison and (...) painting and writing are explored. It is noted that the idea of ‘archaeology of knowledge’ is introduced in connection with a discussion of folie and déraison as displayed in Racine’s Andromaque. (shrink)

El pluralismo cultural y la diversidad social atraviesan diferentes contextos sociales en el mundo contemporaneo, ejerciendo diferentes impactos sobre las instituciones oficiales. En el contexto de los servicios de salud de una ciudad cosmopolita como Montreal, la realización de nuevos proyectos de investigación y de intervención se hace necesaria, con el fin de evaluar la manera como los diversos grupos poblacionales entran en relación con dichos servicios. A nivel investigativo, se hace indispensable la creación de colaboraciones interdisciplinarias con las cuales (...) poder examinar las situaciones clínicas, a la luz de los diferentes elementos que la componen: sociales, culturales y étnicos. En este artículo, expongo algunas reflexiones que se derivan de una investigación interdiscip-linaria entre antropólogos y médicos, cuyo tema central giro en torno de los desórdenes funcionales del intestino dentro de la población infantil. Este trabajo en antropología médica permitió documentar y analizar los discursos de las familias y de los niños alrededor de la percepción de dicho problema de salud, así como de las prácticas y soluciones que estos ponen en marcha y con las cuales buscan aliviar el dolor y lograr un estado de bienestar. Las reflexiones que comparto en este artículo tienen como centro de interés los principales referentes teóricos y metodológicos utilizados desde la disciplina antropológica, los cuales seran ilustrados con la ayuda de algunos extractos de entrevistas realizadas. Mas allá de simplemente enumerar los resultados de la investigación, muestro un ejemplo de colabora-ción fructífera entre la antropología y la pediatría, la cual abre perspectivas de investigación y de aplicación futuras en lo que atañe a las relaciones entre las familias, las comunidades y los servicios institucionales. (shrink)

This article provides a reading and analysis of Foucault’s 1973-4 lecture course Le pouvoir psychiatrique. It begins by situating the course within the wider context of Foucault’s work, notably in relation to Histoire de la folie and the move of the early 1970s to the conceptual tools of power and genealogy. It is argued that Le pouvoir psychiatrique is a rewriting of the last part of Histoire de la folie from the perspective of these new conceptual tools. Analysis then moves (...) to more thematic concerns, showing how this course enriches our understanding of Foucault’s work on the sources of power, the individual and the family, and the spaces of the disciplinary society. Particular focus is given to the role of the army, public health, the hospital, children, women and hospital architecture. The article concludes by showing how the themes of this course, while not worked up for publication themselves, point the way to concerns in Foucault’s later work, notably The History of Sexuality and collaborative work on urban medicine and habitat. (shrink)

An examination of late Rorty shows that he does not abandon belief in an external world about which we can, and indeed must, acquire knowledge. His disapproval of the correspondence theory of truth does not involve the idea that anything other than local weather, for example, could falsify remarks about local weather. It is just that once we get done looking out the window or, if we are outside, feeling the right kind of drops make contact with our skin, there (...) is nothing else we can do, nothing better, to make ourselves more certain, more cognitively secure. One can see this in the detailed work that enables scientific progress. Science improves itself by doing more of the same. G. E. Moore's famous open question stays open only as a reminder that our fallibility never disappears and that our cognitive security is never better than pro tem. Rorty, as a faithful pragmatist and undogmatic meliorist, thinks this is perfectly O.K. (shrink)

The year 2013 marked the 50th anniversary of the publication of a classic of the historiography of sciences, Michel Foucault’s The birth of the clinic: An archaeology of medical gaze. In different parts of the world, events were organized to reflect on this important work. The article argues that if one cannot draw a direct line linking the work of the leading historians-philosophers of the twentieth-century sciences in France to Michel Foucault’s archaeological study of the clinic, we must recognize that (...) the author of The Birth of the Clinic has taken up from these historians-philosophers the methodological and conceptual tools that made it possible to study the history of science and knowledge in a new way. (shrink)