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)

This paper aims to build a bridge between two areas of philosophical research, the structure of kinds and metaphysical modality. Our central thesis is that kinds typically involve super-explanatory properties, and that these properties are therefore metaphysically essential to natural kinds. Philosophers of science who work on kinds tend to emphasize their complexity, and are generally resistant to any suggestion that they have “essences”. The complexities are real enough, but they should not be allowed to obscure the way that kinds (...) are typically unified by certain core properties. We shall show how this unifying role offers a natural account of why certain properties are metaphysically essential to kinds. (shrink)

Conceptual engineering is to be explained by appeal to the externalist distinction between concepts and conceptions. If concepts are determined by non-conceptual relations to objective properties rather than by associated conceptions (whether individual or communal), then topic preservation through semantic change will be possible. The requisite level of objectivity is guaranteed by the possibility of collective error and does not depend on a stronger level of objectivity, such as mind-independence or independence from linguistic or social practice more generally. This means (...) that the requisite level of objectivity is exhibited not only by natural kinds, but also by a wide range of philosophical kinds, social kinds and artefactual kinds. The alternative externalist accounts of conceptual engineering offered by Herman Cappelen and Derek Ball fall back into a kind of descriptivism which is antithetical to externalism and fails to recognise this basic level of objectivity. (shrink)

Theories of function are conventionally divided up into historical and ahistorical ones. Proponents of ahistorical theories often cite the ahistoricity of their accounts as a major virtue. Here, I argue that none of the mainstream “ahistorical” accounts are actually ahistorical. All of them embed, implicitly or explicitly, an appeal to history. In Boorse’s goal-contribution account, history is latent in the idea of statistical-typicality. In the propensity theory, history is implicit in the idea of a species’ natural habitat. In the causal (...) role theory, history is required for making sense of dysfunction. I elaborate some consequences for the functions debate. (shrink)

I defend the historical definition of "function" originally given in my Language, Thought and Other Biological Categories (1984a). The definition was not offered in the spirit of conceptual analysis but is more akin to a theoretical definition of "function". A major theme is that nonhistorical analyses of "function" fail to deal adequately with items that are not capable of performing their functions.

“Conceptual analysis” is a misnomer—it refers, but it does not refer to a method or practice that involves the analysis of concepts. Once this is recognized, many of the main arguments for skepticism about conceptual analysis can be answered, since many of these arguments falsely assume that conceptual analyses target concepts. The present paper defends conceptual analysis from skepticism about its viability and, positively, presents an argument for viewing conceptual analyses as targeting philosophical phenomena, not our concepts of these phenomena.

I argue that philosophy is like science in three interesting and non-obvious ways. First, the claims made by philosophy are synthetic, not analytic: philosophical claims, just like scientific claims, are not guaranteed by the structure of the concepts they involve. Second, philosophical knowledge is a posteriori, not a priori: the claims established by philosophers depend on the same kind of empirical support as scientific theories. And finally, the central questions of philosophy concern actuality rather than necessity: philosophy is primarily aimed (...) at understanding the actual world studied by science, not some further realm of metaphysical modality. (shrink)

Christopher Boorse’s biostatistical theory of medical disorder claims that biological part-dysfunction (i.e., failure of an internal mechanism to perform its biological function), a factual criterion, is both necessary and sufficient for disorder. Jerome Wakefield’s harmful dysfunction analysis of medical disorder agrees that part-dysfunction is necessary but rejects the sufficiency claim, maintaining that disorder also requires that the part-dysfunction causes harm to the individual, a value criterion. In this paper, I present two considerations against the sufficiency claim. First, I analyze Boorse’s (...) central argument for the sufficiency claim, the “pathologist argument,” which takes pathologists’ intuitions about pathology as determinative of medical disorder and conclude that it begs the question and fails to support the sufficiency claim. Second, I present four counterexamples from the medical literature in which salient part-dysfunctions are considered nondisorders, including healthy disease carriers, HIV-positive status, benign mutations, and situs inversus totalis, thus falsifying the sufficiency claim and supporting the harm criterion. (shrink)