The present paper constitutes a development of the position that illness, whether bodily or mental, should be analyzed as an incapacitating failure of bodily or mental capacities, respectively, to realize their functions. The paper undertakes this development by responding to two critics. It addresses first Szasz’s continued claims that (1) physical illness is the paradigm concept of illness and (2) a philosophical analysis of mental illness does not shed any light on the social and legal role of the idea. Then, (...) in reply to Wakefield, the aim is to defend the account as an interpretation of Aristotle and to argue that this Aristotelian view of mental illness is preferable to one that rests on a supposed value free account of human function. More generally the discussion points to the fact that both Wakefield and Szasz rely on a number of metaphysical assumptions about the supposedly empirical nature of medical diagnosis, about the relation between facts and values, and about mind and body (among others), which are open to challenge. In particular the paper indicates an aristotelian approach to the fusion, in the natural world, of so-called facts and values, and the relevance of this fusion to the analysis of the concept of illness. This suggests the debate over distinct conceptions of that concept must both illumine and be illuminated by these deeper metaphysical questions. (shrink)

The normal and the pathological are terms used for structures, activities, individual or collective situations proper to living beings and especially to man. The relation of a fact and a norm is its positive or negative value. Can the assessment of behaviours be reduced to noting a necessity? Is a living being's disease a fact similar to universal attraction? The author maintains that diseases are not merely predetermined effects, but are revealing of a normative regulation proper to living beings and (...) man. (shrink)

Patient support tools have drawn on a variety of disciplines, including psychotherapy, social psychology, and social care. One discipline that has not so far been used to support patients is philosophy. This paper proposes that a particular philosophical approach, phenomenology, could prove useful for patients, giving them tools to reflect on and expand their understanding of their illness. I present a framework for a resource that could help patients to philosophically examine their illness, its impact on their life, and its (...) meaning. I explain the need for such a resource, provide philosophical grounding for it, and outline the epistemic and existential gains philosophy offers. Illness often begins as an intrusion on one’s life but with time becomes a way of being. I argue that this transition impacts on core human features such as the experience of space and time, human abilities, and adaptability. It therefore requires philosophical analysis and response. The paper uses ideas from Husserl and Merleau-Ponty to present such a response in the form of a phenomenological toolkit for patients. The toolkit includes viewing illness as a form of phenomenological reduction, thematizing illness, and examining illness as altering the ill person’s being in the world. I suggest that this toolkit could be offered to patients as a workshop, using phenomenological concepts, texts, and film clips to reflect on illness. I conclude by arguing that examining illness as a limit case of embodied existence deepens our understanding of phenomenology. (shrink)

There are two general approaches to characterising biological functions. One originates with Cummins. According to this approach, the function of a part of a system is just its causal contribution to some specified activity of the system. Call this the ‘C-function’ concept. The other approach ties the function of a trait to some aspect of its evolutionary significance. Call this the ‘E-function’ concept. According to the latter view, a trait's function is determined by the forces of natural selection. The C-function (...) and E-function concepts are clearly quite different, but there is an important relation between them which heretofore has gone unnoticed. The purpose of this paper is to outline that relation.This is not the first paper to discuss the relation of C-function and E-function. Previous attempts all follow either one of two strategies. The first proposes that the two concepts are ‘unified.’ The other proposes that they are radically distinct and apply to wholly different fields within biology. (shrink)

We can readily identify goal-directed systems and distinguish them from non-goal-directed systems. A woodpecker hunting for grubs is the first, a pendulum returning to rest is the second. But what is it to be a goal-directed system? Perhaps the dominant answer to this question, inspired by systems theories such as cybernetics, is that goal-directed systems are distinguished by their tendency to seek, aim at, or maintain some more-or-less easily identifiable goal. Cybernetics and the like would hold that physical systems subject (...) only to physical laws can exhibit such behavior. If sound, this systems approach to teleology would unify a diverse range of goal-directed phenomena and neatly side-step many traditional bogey-men of teleology, such as anthropomorphism and future causation. Goal-directed phenomena would be a normal feature of the natural causal world that could be described in purely descriptive and quantitative terms, and receive ordinary causal explanations. Thus, the systems approach promises to provide a naturalistic-cum-descriptive account of teleology suitable for use in naturalistic accounts of other phenomena, including the intentionality of mental states and even self-consciousness. (shrink)

In considering the debate about the meaning of ‘disease’, the positions are generally presented as falling into two categories: naturalist, e.g., Boorse, and normativist, e.g., Engelhardt and many others. This division is too coarse, and obscures much of what is going on in this debate. I therefore propose that accounts of the meaning of ‘disease’ be assessed according to Hare’s (1997) taxonomy of evaluative terms. Such an analysis will allow us to better understand both individual positions and their inter-relationships. Most (...) importantly, it will show that it is unlikely that there is a single unique disease-concept at issue. Rather, different authors are, for the most part, considering different concepts. (shrink)

In this paper, we develop an organizational account that defines biological functions as causal relations subject to closure in living systems, interpreted as the most typical example of organizationally closed and differentiated self-maintaining systems. We argue that this account adequately grounds the teleological and normative dimensions of functions in the current organization of a system, insofar as it provides an explanation for the existence of the function bearer and, at the same time, identifies in a non-arbitrary way the norms that (...) functions are supposed to obey. Accordingly, we suggest that the organizational account combines the etiological and dispositional perspectives in an integrated theoretical framework. IntroductionDispositional ApproachesEtiological TheoriesBiological Self-maintenance Closure, teleology, and normativityOrganizational differentiationFunctions C1: Contributing to the maintenance of the organization C2: Producing the functional trait Implications and Objections Functional versus useful Dysfunctions, side effects, and accidental contributionsProper functions and selected effectsReproductionRelation with other ‘unitarian’ approachesConclusions. (shrink)

I Deliberation, Practical Syllogisms , and Intuition. Introduction Aristotle's views on moral reasoning are a difficult and much disputed subject. ...

Philippa Foot has for many years been one of the most distinctive and influential thinkers in moral philosophy. Long dissatisfied with the moral theories of her contemporaries, she has gradually evolved a theory of her own that is radically opposed not only to emotivism and prescriptivism but also to the whole subjectivist, anti-naturalist movement deriving from David Hume. Dissatisfied with both Kantian and utilitarian ethics, she claims to have isolated a special form of evaluation that predicates goodness and defect only (...) to living things considered as such; she finds this form of evaluation in moral judgements. Her vivid discussion covers topics such as practical rationality, erring conscience, and the relation between virtue and happiness, ending with a critique of Nietzsche's immoralism. This long-awaited book exposes a highly original approach to moral philosophy and represents a fundamental break from the assumptions of recent debates. Foot challenges many prominent philosophical arguments and attitudes; but hers is a work full of life and feeling, written for anyone intrigued by the deepest questions about goodness and human. (shrink)

Godfrey-Smith ( 2001 ) has distinguished three types of adaptationism. This article builds on his analysis, and revises it in places, by distinguishing seven varieties of adaptationism. This taxonomy allows us to clarify what is at stake in debates over adaptationism, and it also helps to cement the importance of Gould and Lewontin’s ‘Spandrels’ essay. Some adaptationists have suggested that their essay does not offer any coherent alternative to the adaptationist programme: it consists only in an exhortation to test adaptationist (...) hypotheses more thoroughly than was usual in the 1970s. Here it is argued that the ‘Spandrels’ paper points towards a genuinely non-adaptationist methodology implicit in much evolutionary developmental biology. This conclusion helps to expose the links between older debates over adaptationism and more recent questions about the property of evolvability. (shrink)

According to historical theories of biological function, a trait's function is determined by natural selection in the past. I argue that, in addition to historical functions, ahistorical functions ought to be recognized. I propose a theory of biological function which accommodates both. The function of a trait is the way it contributes to fitness and fitness can only be determined relative to a selective regime. Therefore, the function of a trait can only be specified relative to a selective regime. Apart (...) from its desirable pluralism, only this view of relational function can support the function/accident and function/malfunction distinctions commonly thought to be part of the concept of function. Furthermore, only relational function correctly characterizes the explanatory consequences of function attributions in evolutionary biology. (shrink)

This paper argues that the medical conception of health as absence of disease is a value-free theoretical notion. Its main elements are biological function and statistical normality, in contrast to various other ideas prominent in the literature on health. Apart from universal environmental injuries, diseases are internal states that depress a functional ability below species-typical levels. Health as freedom from disease is then statistical normality of function, i.e., the ability to perform all typical physiological functions with at least typical efficiency. (...) This conception of health is as value-free as statements of biological function. The view that health is essentially value-laden, held by most writers on the topic, seems to have one of two sources: an assumption that health judgments must be practical judgments about the treatment of patients, or a commitment to "positive" health beyond the absence of disease. I suggest that the assumption is mistaken, the commitment possibly misdescribed. (shrink)

Wakefield's (2000) responses to our paper herein (Murphy and Woolfolk 2000) are not only unsuccessful, they force him into a position that leaves him unable to preserve any distinction between disorders and other problems. They also conflate distinct scientific concepts of function. Further, Wakefield fails to show that ascriptions of human dysfunction do not ineliminably involve values. -/- We suggest Wakefield is analyzing a concept that plays a role in commonsense thought and arguing that the task of science is to (...) identify the natural processes that accord with that commonsense concept. We argue that this represents an attempt to use conceptual analysis to legislate what should be acceptable science. We conclude that this constraint on science is unacceptable and that therefore Wakefield's overall position should be rejected. (shrink)

This is a book about how we see: the environment around us (its surfaces, their layout, and their colors and textures); where we are in the environment; whether or not we are moving and, if we are, where we are going; what things are good for; how to do things (to thread a needle or drive an automobile); or why things look as they do.The basic assumption is that vision depends on the eye which is connected to the brain. The (...) author suggests that natural vision depends on the eyes in the head on a body supported by the ground, the brain being only the central organ of a complete visual system. When no constraints are put on the visual system, people look around, walk up to something interesting and move around it so as to see it from all sides, and go from one vista to another. That is natural vision—and what this book is about. (shrink)

Defining the concepts of health and disease has proved rather difficult and many philosophers of medicine have simply concluded that we would be better off giving up on such endeavors. I feel that this view is misguided mainly because it seems to rest on a rather inadequate understanding of how philosophers use biology to clarify medical concepts. While some philosophers appeal to biology so as to clarify what we mean by the concepts of health and disease, others attempt to use (...) biology to develop a theory thathelps to explain what health and disease are. In this dissertation, I examine the work of an often overlooked philosopher of medicine, Georges Canguilhem, who sought to understand medical concepts by starting from the biological properties of variation and variability. In other words, in order to define health and disease, Canguilhem first tried to establish how what is normal can vary between organisms and even within the same organism due to the dynamic relation between the organism and its environment. Simply put: what is normal for one organism could be pathological for another and what is normal in one environment could become pathological in another. Consequently, variation and variability need to be included in our understanding of health and disease. Throughout this dissertation, I explore how Canguilhem goes about developing the implications of these biological properties for medical concepts and this allows me to distinguish his approach from some popular ones in philosophy of medicine, e.g. those trying to develop an objective biological approach (naturalism) and those appealingto evolutionary principles. I establish the plausibility of definingmedical concepts relative to individual organisms and their environments, while showing some of its potential limitations, especially when it comes to human social environments. Ultimately, a more nuanced understanding of how the inseparability of organisms and environments canhelp to clarify health and disease provides an interesting way to get past the apparent stalemate in philosophy of medicine and firmly establishes the relevance of Canguilhem’s philosophy. (shrink)

This is a short overview of the biological functions debate in philosophy. While it was fairly comprehensive when it was written, my short book ​A Critical Overview of Biological Functions has largely supplanted it as a definitive and up-to-date overview of the debate, both because the book takes into account new developments since then, and because the length of the book allowed me to go into substantially more detail about existing views.

The key objectives of this book are to demonstrate the applicability of issues in the philosophy of science to problems in psychiatry and to show how the conceptual issues raised by psychiatry should be considered more closely by philosophers of science. These are worthy aims: the philosophy of psychiatry needs to draw more thoughtfully upon contemporary philosophical debates and stimulating interest within the philosophy of science is a good way to do this.Cooper's book succeeds for both of these desiderata. The (...) first five chapters discuss the central issues in the philosophy of psychiatry: whether mental illness is a disease/natural kind and what follows from this. There is a large literature on these questions, some of which …. (shrink)

'Most of us are still groping for answers about what makes life worth living, or what confers meaning on individual lives', writes Charles Taylor in Sources of the Self. 'This is an essentially modern predicament.' Charles Taylor's latest book sets out to define the modern identity by tracing its genesis, analysing the writings of such thinkers as Augustine, Descartes, Montaigne, Luther, and many others. This then serves as a starting point for a renewed understanding of modernity. Taylor argues that modern (...) subjectivity has its roots in ideas of human good, and is in fact the result of our long efforts to define and attain the good. The modern turn inwards is far from being a disastrous rejection of rationality, as its critics contend, but has at its heart what Taylor calls the affirmation of ordinary life. He concludes that the modern identity, and its attendant rejection of an objective order of reason, is far richer in moral sources that its detractors allow. Sources of the Self provides a decisive defence of the modern order and a sharp rebuff to its critics. (shrink)

This 2001 book offers an examination of functional explanation as it is used in biology and the social sciences, and focuses on the kinds of philosophical presuppositions that such explanations carry with them. It tackles such questions as: why are some things explained functionally while others are not? What do the functional explanations tell us about how these objects are conceptualized? What do we commit ourselves to when we give and take functional explanations in the life sciences and the social (...) sciences? McLaughlin gives a critical review of the debate on functional explanation in the philosophy of science. He discusses the history of the philosophical question of teleology, and provides a comprehensive review of the post-war literature on functional explanation. What Functions Explain provides a sophisticated and detailed Aristotelian analysis of our concept of natural functions, and offers a positive contribution to the ongoing debate on the topic. (shrink)

"Psychiatry and Philosophy of Science" explores conceptual issues in psychiatry from the perspective of analytic philosophy of science. Through an examination of those features of psychiatry that distinguish it from other sciences - for example, its contested subject matter, its particular modes of explanation, its multiple different theoretical frameworks, and its research links with big business - Rachel Cooper explores some of the many conceptual, metaphysical and epistemological issues that arise in psychiatry. She shows how these pose interesting challenges for (...) the philosopher of science while also showing how ideas from the philosophy of science can help to solve conceptual problems within psychiatry. Cooper's discussion ranges over such topics as the nature of mental illnesses, the treatment decisions and diagnostic categories of psychiatry, the case-history as a form of explanation, how psychiatry might be value-laden, the claim that psychiatry is a multi-paradigm science, the distortion of psychiatric research by pharmaceutical industries, as well as engaging with the fundamental question whether the mind is reducible to something at the physical level. "Psychiatry and Philosophy of Science" demonstrates that cross-disciplinary contact between philosophy of science and psychiatry can be immensely productive for both subjects and it will be required reading for mental health professionals and philosophers alike. (shrink)

The central insight of Darwin's Origin of Species is that evolution is an ecological phenomenon, arising from the activities of organisms in the 'struggle for life'. By contrast, the Modern Synthesis theory of evolution, which rose to prominence in the twentieth century, presents evolution as a fundamentally molecular phenomenon, occurring in populations of sub-organismal entities - genes. After nearly a century of success, the Modern Synthesis theory is now being challenged by empirical advances in the study of organismal development and (...) inheritance. In this important study, D. M. Walsh shows that the principal defect of the Modern Synthesis resides in its rejection of Darwin's organismal perspective, and argues for 'situated Darwinism': an alternative, organism-centred conception of evolution that prioritises organisms as adaptive agents. His book will be of interest to scholars and advanced students of evolutionary biology and the philosophy of biology. (shrink)

This paper examines what it is for a condition to be a disease. It falls into two sections. In the first I examine the best existing account of disease (as proposed by Christopher Boorse) and argue that it must be rejected. In the second I outline a more acceptable account of disease. According to this account, by disease we mean a condition that it is a bad thing to have, that is such that we consider the afflicted person to have (...) been unlucky, and that can potentially be medically treated. All three criteria must be fulfilled for a condition to be a disease. The criterion that for a condition to be a disease it must be a bad thing is required to distinguish the biologically different from the diseased. The claim that the sufferer must be unlucky is needed to distinguish diseases from conditions that are unpleasant but normal, for example teething. Finally, the claim that for a condition to be a disease it must be potentially medically treatable is needed to distinguish diseases from other types of misfortune, for example economic problems and legal problems. (shrink)

Contemporary philosophy of health has been quite focused on the problem of determining the nature of the concepts of health, illness 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 atom, metal and rain are value-free and descriptive. To say that a person has a certain disease or that he or she is unhealthy is thus to objectively describe this person. On (...) the other hand it certainly does not preclude an additional evaluation of the state of affairs as undesirable or bad. The basic scientific description and the evaluation are, however, two independent matters, according to this kind of theory. Other philosophers claim that the concept of health, together with the other medical concepts, is essentially value-laden. To establish that a person is healthy does not just entail some objective inspection and measurement. It presupposes also an evaluation of the general state of the person. A statement that he or she is healthy does not merely imply certain scientific facts regarding the person’s body or mind but implies also a (positive) evaluation of the person’s bodily and mental state. My task in this paper will be, first, to present the two principal rival types of theories and present what I take to be the main kind of reasoning by which we could assess these theories, and second, to present a deeper characterization of the principal rival theories of health and illness. (shrink)

Phenomenology is a useful methodology for describing and ordering experience. As such, phenomenology can be specifically applied to the first person experience of illness in order to illuminate this experience and enable health care providers to enhance their understanding of it. However, this approach has been underutilized in the philosophy of medicine as well as in medical training and practice. This paper demonstrates the usefulness of phenomenology to clinical medicine. In order to describe the experience of illness, we need a (...) phenomenological approach that gives the body a central role and acknowledges the primacy of perception. I present such a phenomenological method and show how it could usefully illuminate the experience of illness through a set of concepts taken from Merleau-Ponty. His distinction between the biological body and the body as lived, analysis of the habitual body, and the notions of motor intentionality and intentional arc are used to capture the experience of illness. I then discuss the applications this approach could have in medicine. These include narrowing the gap between objective assessments of well-being in illness and subjective experiences which are varied and diverse; developing a more attuned dialogue between physicians and patients based on a thick understanding of illness; developing research methods that are informed by phenomenology and thus go beyond existing qualitative methods; and providing medical staff with a concrete understanding of the impact of illness on the life-world of patients. (shrink)

This paper suggests that the paradigm of lived body (as it is developed in the works of Merleau-Ponty, Sartre and Zaner) provides important insights into the experience of illness. In particular it is noted that, as embodied persons, we experience illness primarily as a disruption of lived body rather than as a dysfunction of biological body. An account is given of the manner in which such fundamental features of embodiment as bodily intentionality, primary meaning, contextural organization, body image, gestural display, (...) lived spatiality and temporality, are disrupted in illness causing a concurrent disorganization of the patient's self and world. The paradigm of lived body has important applications for medical practice. It provides a fuller account of illness than does the prevailing reductionist Cartesian paradigm of body, more directly addresses the existential predicament of illness, and orients the clinical focus around the personhood of the patient. (shrink)