This paper examines the way in which causal relations are understood in the dominant model in contemporary medicine. It argues that the causal relation is not definable in terms of the condition relation, but that in general for conditions of an occurrence to be among its causes they must answer instrumental interests in a certain way, and there are further criteria for distinguishing 'the' cause of a disease (i.e., its etiological agent) from other causal factors, which are based upon instrumental (...) interests peculiar to medicine. It also argues that diseases are complex processes of which both clinical and underlying patho-physiological manifestations are proper parts (as contrasted with effects). (shrink)

To date, no satisfactory account of the connection between natural-scientific and historical explanation has been given, and philosophers seem to have largely given up on the problem. This paper is an attempt to resolve this old issue and to sort out and clarify some areas of historical explanation by developing and applying a method that will be called “pragmatic explication” involving the construction of definitions that are justified on pragmatic grounds. Explanations in general can be divided into “dynamic” and “static” (...) explanations, which are those that essentially require relations across time and those that do not, respectively. The problem of assimilating historical explanations concerns dynamic explanation, so a general analysis of dynamic explanation that captures both the structure of natural-scientific and historical explanation is offered. This is done in three stages: In the first stage, pragmatic explication is introduced and compared to other philosophical methods of explication. In the second stage pragmatic explication is used to tie together a series of definitions that are introduced in order to establish an account of explanation. This involves an investigation of the conditions that play the role in historiography that laws and statistical regularities play in the natural sciences. The essay argues that in the natural sciences, as well as in history, the model of explanation presented represents the aims and overarching structure of actual causal explanations offered in those disciplines. In the third stage the system arrived at in the preceding stage is filled in with conditions available to and relevant for historical inquiry. Further, the nature and treatment of causes in history and everyday life are explored and related to the system being proposed. This in turn makes room for a view connecting aspects of historical explanation and what we generally take to be causal relations. (shrink)