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  1. Does proper function come in degrees?John Matthewson - 2020 - Biology and Philosophy 35 (4):1-18.
    Natural selection comes in degrees. Some biological traits are subjected to stronger selective force than others, selection on particular traits waxes and wanes over time, and some groups can only undergo an attenuated kind of selective process. This has downstream consequences for any notions that are standardly treated as binary but depend on natural selection. For instance, the proper function of a biological structure can be defined as what caused that structure to be retained by natural selection in the past. (...)
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  • The Overdiagnosis of What? On the Relationship Between the Concepts of Overdiagnosis, Disease, and Diagnosis.Bjørn Hofmann - 2017 - Medicine, Health Care and Philosophy 20 (4):453-464.
    Overdiagnosis and disease are related concepts. Widened conceptions of disease increase overdiagnosis and vice versa. This is partly because there is a close and complex relationship between disease and overdiagnosis. In order to address the problems with overdiagnosis, we may benefit from a closer understanding this relationship. Accordingly, the objective of this article is to elucidate the relationship between disease and overdiagnosis. To do so, the article starts with scrutinizing how overdiagnosis can explain the expansion of the concept of disease. (...)
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  • Defining Disease in the Context of Overdiagnosis.Mary Jean Walker & Wendy Rogers - 2017 - Medicine, Health Care and Philosophy 20 (2):269-280.
    Recently, concerns have been raised about the phenomenon of ‘overdiagnosis’, the diagnosis of a condition that is not causing harm, and will not come to cause harm. Along with practical, ethical, and scientific questions, overdiagnosis raises questions about our concept of disease. In this paper, we analyse overdiagnosis as an epistemic problem and show how it challenges many existing accounts of disease. In particular, it raises ques- tions about conceptual links drawn between disease and dysfunction, harm, and risk. We argue (...)
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  • The Concept of Disorder Revisited: Robustly VAlue-Laden Despite Change.I.—Rachel Cooper - 2020 - Aristotelian Society Supplementary Volume 94 (1):141-161.
    Our concept of disorder is changing. This causes problems for projects of descriptive conceptual analysis. Conceptual change means that a criterion that was necessary for a condition to be a disorder at one time may cease to be necessary a relatively short time later. Nevertheless, some conceptually based claims will be fairly robust. In particular, the claim that no adequate account of disorder can appeal only to biological facts can be maintained for the foreseeable future. This is because our current (...)
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  • Is Psychopathy a Harmful Dysfunction?Marko Jurjako - 2019 - Biology and Philosophy 34 (5):1-23.
    In their paper “Is psychopathy a mental disease?”, Thomas Nadelhoffer and Walter Sinnott-Armstrong argue that according to any plausible account of mental disorder, neural and psychological abnormalities correlated with psychopathy should be regarded as signs of a mental disorder. I oppose this conclusion by arguing that at least on a naturalistically grounded account, such as Wakefield’s ‘Harmful Dysfunction’ view, currently available empirical data and evolutionary considerations indicate that psychopathy is not a mental disorder. For an online version of the paper, (...)
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  • Current Dilemmas in Defining the Boundaries of Disease.Jenny Doust, Mary Jean Walker & Wendy A. Rogers - 2017 - Journal of Medicine and Philosophy 42 (4):350-366.
    Boorse’s biostatistical theory states that diseases should be defined in ways that reflect disturbances of biological function and that are objective and value free. We use three examples from contemporary medicine that demonstrate the complex issues that arise when defining the boundaries of disease: polycystic ovary syndrome, chronic kidney disease, and myocardial infarction. We argue that the biostatistical theory fails to provide sufficient guidance on where the boundaries of disease should be drawn, contains ambiguities relating to choice of reference class, (...)
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  • Medical Nihilism.Jacob Stegenga - 2018 - Oxford University Press.
    Medical nihilism is the view that we should have little confidence in the effectiveness of medical interventions. Jacob Stegenga argues persuasively that this is how we should see modern medicine, and suggests that medical research must be modified, clinical practice should be less aggressive, and regulatory standards should be enhanced.
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  • A Critical Overview of Biological Functions.Justin Garson - 2016 - Dordrecht: Springer.
    This book is a critical survey of and guidebook to the literature on biological functions. It ties in with current debates and developments, and at the same time, it looks back on the state of discourse in naturalized teleology prior to the 1970s. It also presents three significant new proposals. First, it describes the generalized selected effects theory, which is one version of the selected effects theory, maintaining that the function of a trait consists in the activity that led to (...)
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  • Institutionalized Intolerance of ADHD: Sources and Consequences.Susan C. C. Hawthorne - 2010 - Hypatia 25 (3):504 - 526.
    Diagnosable individuals, caregivers, and clinicians typically embrace a biological conception of attention-deficit/hyperactivity disorder (ADHD), finding that medical treatment is beneficial. Scientists study ADHD phenomenology, interventions to ease symptoms, and underlying mechanisms, often with an aim of helping diagnosed people. Yet current understanding of ADHD, jointly influenced by science and society, has an unintended downside. Scientific and social influences have embedded negative values in the ADHD concept, and have simultaneously dichotomized ADHD diagnosable from non-diagnosable individuals. In social settings insistent on certain (...)
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  • A Second Rebuttal On Health.Christopher Boorse - 2014 - Journal of Medicine and Philosophy 39 (6):683-724.
    This essay replies to critics since 1995 of my “biostatistical theory” of health. According to the BST, a pathological condition is a state of statistically species-subnormal biological part-functional ability, relative to sex and age. Theoretical health, the total absence of pathological conditions, is then a value-free scientific notion. Recent critics offer a mixture of old and new objections to this analysis. Some new ones relate to choice of reference class, situation-specificity of function, common diseases and healthy populations, improvements in population (...)
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  • Can We Define Mental Disorder by Using the Criterion of Mental Dysfunction?Thomas Schramme - 2010 - Theoretical Medicine and Bioethics 31 (1):35-47.
    The concept of mental disorder is often defined by reference to the notion of mental dysfunction, which is in line with how the concept of disease in somatic medicine is often defined. However, the notions of mental function and dysfunction seem to suffer from some problems that do not affect models of physiological function. Functions in general have a teleological structure; they are effects of traits that are supposed to have a particular purpose, such that, for example, the heart serves (...)
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  • Paracetamol, Poison, and Polio: Why Boorse's Account of Function Fails to Distinguish Health and Disease.Elselijn Kingma - 2010 - British Journal for the Philosophy of Science 61 (2):241-264.
    Christopher Boorse's Bio Statistical Theory (BST) defines health as the absence of disease, and disease as the adverse departure from normal species functioning. This paper presents a two-pronged problem for this account. First I demonstrate that, in order to accurately account for dynamic physiological functions, Boorse's account of normal function needs to be modified to index functions against situations. I then demonstrate that if functions are indexed against situations, the BST can no longer account for diseases that result from specific (...)
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  • Risk and Disease.Peter H. Schwartz - 2008 - Perspectives in Biology and Medicine 51 (3):320-334.
    The way that diseases such as high blood pressure (hypertension), high cholesterol, and diabetes are defined is closely tied to ideas about modifiable risk. In particular, the threshold for diagnosing each of these conditions is set at the level where future risk of disease can be reduced by lowering the relevant parameter (of blood pressure, low-density lipoprotein, or blood glucose, respectively). In this article, I make the case that these criteria, and those for diagnosing and treating other “risk-based diseases,” reflect (...)
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  • Rethinking Health: Healthy or Healthier Than?S. Andrew Schroeder - 2013 - British Journal for the Philosophy of Science 64 (1):131-159.
    Theorists of health have, to this point, focused exclusively on trying to define a state—health—that an organism might be in. I argue that they have overlooked the possibility of a comparativist theory of health, which would begin by defining a relation—healthier than—that holds between two organisms or two possible states of the same organism. I show that a comparativist approach to health has a number of attractive features, and has important implications for philosophers of medicine, bioethicists, health economists, and policy (...)
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  • On the Nature of Mental Disorder: Towards an Objectivist Account.Panagiotis Oulis - 2012 - Theoretical Medicine and Bioethics 33 (5):343-357.
    According to the predominant view within contemporary philosophy of psychiatry, mental disorders involve essentially personal and societal values, and thus, the concept of mental disorder cannot, even in principle, be elucidated in a thoroughly objective manner. Several arguments have been adduced in support of this impossibility thesis. My critical examination of two master arguments advanced to this effect by Derek Bolton and Jerome Wakefield, respectively, raises serious doubts about their soundness. Furthermore, I articulate an alternative, thoroughly objective, though in part (...)
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  • Statistical Theories of Functions and the Problem of Epidemic Disease.Daniel M. Kraemer - 2013 - Biology and Philosophy 28 (3):423-438.
    Several decades ago, Christopher Boorse formulated an influential statistical theory of normative biological functions but it has often been claimed that his theory suffers from insuperable problems such as an inability to handle cases of epidemic and universal diseases. This paper develops a new statistical theory of normative functions that is capable of dealing with the notorious problem of epidemic and universal diseases. The theory is also more detailed than its predecessors and offers other important advantages over them. It is (...)
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  • Health as a Property of Engineered Living Systems.Sune Holm - 2013 - Bioethics 27 (8):419-425.
    This article considers naturalistic analyses of the concepts of health and disease in light of the possibility of constructing novel living systems. The article begins by introducing the vision of synthetic biology as the application of engineering principles to the construction of biological systems, the main analyses of the concepts of health and disease, and the standard theories of function in artefacts and organisms. The article then suggests that reflection on the possibility of artefactual organisms amounts to a challenge to (...)
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  • Schizophrenia and the Dysfunctional Brain.Justin Garson - 2010 - Journal of Cognitive Science 11:215-246.
    Scientists, philosophers, and even the lay public commonly accept that schizophrenia stems from a biological or internal ‘dysfunction.’ However, this assessment is typically accompanied neither by well-defined criteria for determining that something is dysfunctional nor empirical evidence that schizophrenia satisfies those criteria. In the following, a concept of biological function is developed and applied to a neurobiological model of schizophrenia. It concludes that current evidence does not warrant the claim that schizophrenia stems from a biological dysfunction, and, in fact, that (...)
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  • Reframing the Disease Debate and Defending the Biostatistical Theory.Peter H. Schwartz - 2014 - Journal of Medicine and Philosophy 39 (6):572-589.
    Similarly to other accounts of disease, Christopher Boorse’s Biostatistical Theory (BST) is generally presented and considered as conceptual analysis, that is, as making claims about the meaning of currently used concepts. But conceptual analysis has been convincingly critiqued as relying on problematic assumptions about the existence, meaning, and use of concepts. Because of these problems, accounts of disease and health should be evaluated not as claims about current meaning, I argue, but instead as proposals about how to define and use (...)
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  • Functions Must Be Performed at Appropriate Rates in Appropriate Situations.G. Piccinini & Justin Garson - 2014 - British Journal for the Philosophy of Science 65 (1):1-20.
    We sketch a novel and improved version of Boorse’s biostatistical theory of functions. Roughly, our theory maintains that (i) functions are non-negligible contributions to survival or inclusive fitness (when a trait contributes to survival or inclusive fitness); (ii) situations appropriate for the performance of a function are typical situations in which a trait contributes to survival or inclusive fitness; (iii) appropriate rates of functioning are rates that make adequate contributions to survival or inclusive fitness (in situations appropriate for the performance (...)
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  • Disease, Dysfunction, and Synthetic Biology.Sune Holm - 2014 - Journal of Medicine and Philosophy 39 (4):329-345.
    Theorists analyzing the concept of disease on the basis of the notion of dysfunction consider disease to be dysfunction requiring. More specifically, dysfunction-requiring theories of disease claim that for an individual to be diseased certain biological facts about it must be the case. Disease is not wholly a matter of evaluative attitudes. In this paper, I consider the dysfunction-requiring component of Wakefield’s hybrid account of disease in light of the artifactual organisms envisioned by current research in synthetic biology. In particular, (...)
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  • Health and Functional Efficiency.Daniel M. Hausman - 2014 - Journal of Medicine and Philosophy 39 (6):634-647.
    This essay argues that what is central to Christopher Boorse’s biostatistical theory of disease as statistically subnormal part function (BST) are comparisons of the “functional efficiency” of parts and processes and that statistical considerations serve only to pick out a healthy level of functional efficiency. On this interpretation, the distinction between health and pathology is less important than comparisons of functional efficiency, which are entirely independent of statistical considerations. The clarifications or revisions of the BST that this essay offers are (...)
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  • Naturalism About Health and Disease: Adding Nuance for Progress.Elselijn Kingma - 2014 - Journal of Medicine and Philosophy 39 (6):590-608.
    The literature on health and diseases is usually presented as an opposition between naturalism and normativism. This article argues that such a picture is too simplistic: there is not one opposition between naturalism and normativism, but many. I distinguish four different domains where naturalist and normativist claims can be contrasted: (1) ordinary usage, (2) conceptually clean versions of “health” and “disease,” (3) the operationalization of dysfunction, and (4) the justification for that operationalization. In the process I present new arguments in (...)
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  • A Verisimilitudinarian Analysis of the Linda Paradox.Gustavo Cevolani, Vincenzo Crupi & Roberto Festa - 2012 - VII Conference of the Spanish Society for Logic, Methodology and Philosphy of Science.
    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.
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  • Small Tumors as Risk Factors Not Disease.Peter H. Schwartz - 2014 - Philosophy of Science 81 (5):986-998.
    I argue that ductal carcinoma in situ (DCIS), the tumor most commonly diagnosed by breast mammography, cannot be confidently classified as cancer, that is, as pathological. This is because there may not be dysfunction present in DCIS—as I argue based on its high prevalence and the small amount of risk it conveys—and thus DCIS may not count as a disease by dysfunction-requiring approaches, such as Boorse’s biostatistical theory and Wakefield’s harmful dysfunction account. Patients should decide about treatment for DCIS based (...)
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  • Is “Chronic Kidney Disease” a Disease?Benjamin T. H. Smart, Richard J. Stevens & Jan Y. Verbakel - 2018 - Journal of Evaluation in Clinical Practice 24 (5):1033-1040.
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  • Biological Pathology From an Organizational Perspective.Cristian Saborido & Alvaro Moreno - 2015 - Theoretical Medicine and Bioethics 36 (1):83-95.
    In contrast to the “normativist” view, “naturalist” theorists claim that the concept of health refers to natural or normal states and propose different characterizations of healthy and diseased conditions that are meant to be objectivist and biologically grounded. In this article, we examine the core concept of these naturalist accounts of disease, i.e., the concept of biological malfunction, and develop a new formulation of the notion of malfunction following the recent organizational approach to functions in the philosophy of biology. We (...)
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  • Epidemiology and the Bio-Statistical Theory of Disease: A Challenging Perspective.Élodie Giroux - 2015 - Theoretical Medicine and Bioethics 36 (3):175-195.
    Christopher Boorse’s bio-statistical theory of health and disease argues that the central discipline on which theoretical medicine relies is physiology. His theory has been much discussed but little has been said about its focus on physiology or, conversely, about the role that other biomedical disciplines may play in establishing a theoretical concept of health. Since at least the 1950s, epidemiology has gained in strength and legitimacy as an independent medical science that contributes to our knowledge of health and disease. Indeed, (...)
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  • Naturalism, Interpretation, and Mental Disorder.Somogy Varga - 2015 - Oxford University Press UK.
    The Philosophy of Psychiatry is a unique area of research because the nature of the subject matter leads to quite distinct methodological issues. Naturalism, Interpretation, and Mental Disorder is an original new work focusing on the challenges we face when trying to interpret and understand mental illness. The book integrates a hermeneutical perspective, and shows how such an approach can reveal important facts about historical sources in psychiatry and the nature of dialogue in the therapeutic encounter. In addition, the book (...)
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  • The Philosophy of Diseases and Causes.Benjamin T. H. Smart - unknown
    This is a draft manuscript of a book that examines the philosophy of disease; in particular, the book focuses on the concept of disease, and on concepts of causation, and causal inference in clinical medicine and epidemiology.
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  • Effectiveness of Medical Interventions.Jacob Stegenga - 2015 - Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences 54:34-44.
    To be effective, a medical intervention must improve one's health by targeting a disease. The concept of disease, though, is controversial. Among the leading accounts of disease-naturalism, normativism, hybridism, and eliminativism-I defend a version of hybridism. A hybrid account of disease holds that for a state to be a disease that state must both (i) have a constitutive causal basis and (ii) cause harm. The dual requirement of hybridism entails that a medical intervention, to be deemed effective, must target either (...)
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  • Biological Criteria of Disease: Four Ways of Going Wrong.John Matthewson & Paul Edmund Griffiths - 2017 - Journal of Medicine and Philosophy 1 (4).
    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 (...)
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  • Progress in Defining Disease: Improved Approaches and Increased Impact.Peter H. Schwartz - 2017 - Journal of Medicine and Philosophy 42 (4):485-502.
    In a series of recent papers, I have made three arguments about how to define “disease” and evaluate and apply possible definitions. First, I have argued that definitions should not be seen as traditional conceptual analyses, but instead as proposals about how to define and use the term “disease” in the future. Second, I have pointed out and attempted to address a challenge for dysfunction-requiring accounts of disease that I call the “line-drawing” problem: distinguishing between low-normal functioning and dysfunctioning. Finally, (...)
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  • The Line-Drawing Problem in Disease Definition.Wendy A. Rogers & Mary Jean Walker - 2017 - Journal of Medicine and Philosophy 42 (4):405-423.
    Biological dysfunction is regarded, in many accounts, as necessary and perhaps sufficient for disease. But although disease is conceptualized as all-or-nothing, biological functions often differ by degree. A tension is created by attempting to use a continuous variable as the basis for a categorical definition, raising questions about how we are to pinpoint the boundary between health and disease. This is the line-drawing problem. In this paper, we show how the line-drawing problem arises within “dysfunction-requiring” accounts of disease, such as (...)
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  • Functions and Health: Towards a Praxis-Oriented Concept of Health.Lennart Nordenfelt - 2018 - Biological Theory 13 (1):10-16.
    Contemporary philosophy of health and disease has been quite focused on the problem of determining the nature of the concepts of health and disease from a scientific point of view. Some theorists claim and argue that these concepts are value-free and descriptive in the same sense as the concepts of atoms, metal, and rain are value-free and descriptive. According to this descriptive or naturalist line of thought, the notions of health and disease are furthermore related to the idea of a (...)
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  • Evolution, Dysfunction, and Disease: A Reappraisal: Table 1.Paul E. Griffiths & John Matthewson - 2018 - British Journal for the Philosophy of Science 69 (2):301-327.
    Some ‘naturalist’ accounts of disease employ a biostatistical account of dysfunction, whilst others use a ‘selected effect’ account. Several recent authors have argued that the biostatistical account offers the best hope for a naturalist account of disease. We show that the selected effect account survives the criticisms levelled by these authors relatively unscathed, and has significant advantages over the BST. Moreover, unlike the BST, it has a strong theoretical rationale and can provide substantive reasons to decide difficult cases. This is (...)
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  • Boorse’s Theory of Disease: Do Values Matter?Brent M. Kious - 2018 - Journal of Medicine and Philosophy 43 (4):421-438.
    There has been much debate about whether the concept of disease articulated in Boorse’s biostatistical theory is value-neutral or value-laden. Here, I want to examine whether this debate matters. I suggest that there are two basic respects in which value-ladenness might be important: it could threaten either scientific legitimacy or moral permissibility. I argue that value-ladenness does not threaten the scientific legitimacy of our disease-concept because the concept makes little difference to the formulation and testing of scientific hypotheses. Likewise, even (...)
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  • Benjamin Smart: Concepts and Causes in the Philosophy of Disease: Palgrave Macmillan, Basingstoke, 2016, X + 100 Pp, $67.50, ISBN: 978-1-137-55291-4.Jeremy Simon - 2018 - Theoretical Medicine and Bioethics 39 (4):343-346.
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  • Précising Definitions as a Way to Combat Overdiagnosis.Wendy A. Rogers & Mary J. Walker - 2018 - Journal of Evaluation in Clinical Practice 24 (5):1019-1025.
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  • Malfunctions and Teleology: On the Chances of Statistical Accounts of Functions.Lorenzo Casini - 2017 - European Journal for Philosophy of Science 7 (2):319-335.
    The core idea of statistical accounts of biological functions is that to function normally is to provide a statistically typical contribution to some goal state of the organism. In this way, statistical accounts purport to naturalize the teleological notion of function in terms of statistical facts. Boorse’s, 542–573, 1977) original biostatistical account was criticized for failing to distinguish functions from malfunctions. Recently, many have attempted to circumvent the criticism, 519–541, 2012, Journal of Medicine and Philosophy, 39, 634–647, 2014). Here, I (...)
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  • Precision Medicine in an Imprecise and Complex World: Magic Bullets, Hype, and the Fuzzy Line Between Health and Disease.David Clark Aron - forthcoming - Journal of Evaluation in Clinical Practice.
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  • A Lockean Argument for Universal Access to Health Care.Daniel M. Hausman - 2011 - Social Philosophy and Policy 28 (2):166-191.
    This essay defends the controversial and indeed counterintuitive claim that there is a good argument to be made from a Lockean perspective for government action to guarantee access to health care. The essay maintains that this argument is in some regards more robust than the well-known argument in defense of universal health care spelled out by Norman Daniels, which this essay also examines in some detail. Locke's view that government should protect people's lives, property, and freedom–where freedom is understood as (...)
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  • Is an Overdose of Paracetamol Bad for One's Health?D. M. Hausman - 2011 - British Journal for the Philosophy of Science 62 (3):657-668.
    1 Overview of the problem2 Situationally Specific Normal Functioning and Capacities3 Kingma’s Criticism4 How Normal Responses can be Pathological5 Too Many Pathologies?6 Conclusions.
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  • Health, Homeostasis, and the Situation-Specificity of Normality.Antoine C. Dussault & Anne-Marie Gagné-Julien - 2015 - Theoretical Medicine and Bioethics 36 (1):61-81.
    Christopher Boorse’s Biostatistical Theory of Health has been the main contender among naturalistic accounts of health for the last 40 years. Yet, a recent criticism of this theory, presented by Elselijn Kingma, identifies a dilemma resulting from the BST’s conceptual linking of health and statistical typicality. Kingma argues that the BST either cannot accommodate the situation- specificity of many normal functions or cannot account for many situation-specific diseases. In this article, we expand upon with Daniel Hausman’s response to Kingma’s dilemma. (...)
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  • Health, Naturalism, and Functional Efficiency.Daniel M. Hausman - 2012 - Philosophy of Science 79 (4):519-541.
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  • Why Health Matters to Justice: A Capability Theory Perspective.Lasse Nielsen - 2015 - Ethical Theory and Moral Practice 18 (2):403-415.
    The capability approach, originated by Amartya Sen is among the most comprehensive and influential accounts of justice that applies to issues of health and health care. However, although health is always presumed as an important capability in Sen’s works, he never manages to fully explain why health is distinctively valuable. This paper provides an explanation. It does this by firstly laying out the general capability-based argument for health justice. It then discusses two recent attempts to justify why health is distinctively (...)
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  • The Current Status of the Philosophy of Biology.Peter Takacs & Michael Ruse - 2013 - Science & Education 22 (1):5-48.
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  • Health, Disease and Naturalism: Hausman on the Public Value of Health.Elselijn Kingma - 2017 - Public Health Ethics 10 (2):109-121.
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  • Functional Analysis and the Species Design.Karen Neander - 2017 - Synthese 194 (4).
    This paper argues that a minimal notion of function and a notion of normal-proper function are used in explaining how bodies and brains operate. Neither is Cummins’ notion, as originally defined, and yet his is often taken to be the clearly relevant notion for such an explanatory context. This paper also explains how adverting to normal-proper functions, even if these are selected functions, can play a significant scientific role in the operational explanations of complex systems that physiologists and neurophysiologists provide, (...)
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  • The Function of the Heart is Not Obvious.Nicholas Binney - 2018 - Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences 68:56-69.
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