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)

The biological sciences employ a concept of normality that must be distinguished from statistical or value concepts. The concept of normality is presupposed in the standard explications of biological functions, and it is crucial to the strategy of explanation by approximations in, for example, physiology. Nevertheless, this concept of normality does not seem to be captured in the language of physics. Thus attempts at explaining the methodological relationship between the biological sciences and the physical sciences by concentrating only on the (...) concept of biological function cannot go very far. An analysis of the concept of normality is also necessary. (shrink)

Accounts of the concepts of function and dysfunction have not adequately explained what factors determine the line between low‐normal function and dysfunction. I call the challenge of doing so the line‐drawing problem. Previous approaches emphasize facts involving the action of natural selection (Wakefield 1992a, 1999a, 1999b) or the statistical distribution of levels of functioning in the current population (Boorse 1977, 1997). I point out limitations of these two approaches and present a solution to the line‐drawing problem that builds on the (...) second one. (shrink)

The organizational account of biological functions interprets functions as contributions of a trait to the maintenance of the organization that, in turn, maintains the trait. As has been recently argued, however, the account seems unable to provide a unified grounding for both intra- and cross-generation functions, since the latter do not contribute to the maintenance of the same organization which produces them. To face this ‘ontological problem’, a splitting account has been proposed, according to which the two kinds of functions (...) require distinct organizational definitions. In this article, we propose a solution for the ontological problem, by arguing that intra- and cross-generation functions can be said to contribute in the same way to the maintenance of the biological organization, characterized in terms of organizational self-maintenance. As a consequence, we suggest maintaining a unified organizational account of biological functions. (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)

Looking for an adequate explication of the concept of a biological function, several authors have proposed to link function to design. Unfortunately, known explications of biological design in turn refer to functions. The concept of general design I will introduce here breaks up this circle. I specify design with respect to its ontogenetic role. This allows function to be based on design without making reference to the history of the design, or to the phylogeny of an organism, while retaining the (...) normative aspect of function ascriptions. The concept is applicable to the function and design of technical artifacts as well. Several problems well known with other definitions can be overcome by this approach. (shrink)

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 (...) environmental factors. The BST is impaled on either horn of this dilemma and therefore must be dismissed. (shrink)

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 (...) the functional theories of health and disease proposed by Wakefield and Boorse. More specifically, Wakefield and Boorse's theories are reconstructed as responses to a dilemma concerning how to allow for the ascription of health and disease to artefactual organisms without at the same time opening up the possibility of diseased nonliving artefacts such as cars and computers. It is argued that neither response will enable us to ascribe health and disease to artefactual organisms, because both theories, in order to rule out the possibility of ascribing health and disease to nonliving artefacts, make such ascriptions conditional on having a natural-selection history or being part of a species which has been designed by evolution. (shrink)

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, (...) I argue that the possibility of artifactual organisms and the case of oncomice and other bred or genetically modified strains of organism constitute a significant objection to Wakefield’s etiological account of the dysfunction requirement. I then develop a new alternative understanding of the dysfunction requirement that builds on the organizational theory of function. I conclude that my suggestion is superior to Wakefield’s theory because it (a) can accommodate both artifactual and naturally evolved organisms, (b) avoids the possibility of there being a conflict between what an organismic part is supposed to do and the health of the organism, and (c) provides a nonarbitrary and practical way of determining whether dysfunction occurs. (shrink)

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.

This essay develops an account of health, the functional efficiency theory, which derives from Christopher Boorse's biostatistical theory. Like the BST, the functional efficiency theory is a nonevaluative view of health, but unlike the BST, it argues that the fundamental theoretical task is to distinguish levels of efficiency with which the parts and processes within organisms and within systems within organisms function. Which of these to label as healthy or pathological is of secondary importance. Because the statistical distributions that Boorse's (...) account relies on are distributions of functional efficiency, the functional efficiency theory arguably complements rather than challenges the BST. (shrink)

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 (...) of that function); and (iv) dysfunction is the inability to perform a function at an appropriate rate in appropriate situations. Based on our theory, we sketch solutions to three problems that have afflicted Boorse’s theory of function, namely, Kingma’s ([2010]) problem of the situation-specificity of functions, the problem of multi-functional traits, and the problem of how to distinguish between appropriate and inappropriate rates of functioning. (shrink)

How should we define ‘health’ and ‘disease’? There are three main positions in the literature. Naturalists desire value-free definitions based on scientific theories. Normativists believe that our uses of ‘health’ and ‘disease’ reflect value judgments. Hybrid theorists offer definitions containing both normativist and naturalist elements. This paper discusses the problems with these views and offers an alternative approach to the debate over ‘health’ and ‘disease’. Instead of trying to find the correct definitions of ‘health’ and ‘disease’ we should explicitly talk (...) about the considerations that are central in medical discussions, namely state descriptions and normative claims . This distinction avoids the problems facing the major approaches to defining ‘health’ and ‘disease’, and it more clearly captures what matters in medical discussions. (shrink)

In responding to this debate, Ananth both surveys the existing literature, with special focus on the work of Christopher Boorse, and argues that a naturalistic ...

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)