Douglas proposes a new ideal in which values serve an essential function throughout scientific inquiry, but where the role values play is constrained at key points, protecting the integrity and objectivity of science.

Helen Longino seeks to break the current deadlock in the ongoing wars between philosophers of science and sociologists of science--academic battles founded on disagreement about the role of social forces in constructing scientific knowledge. While many philosophers of science downplay social forces, claiming that scientific knowledge is best considered as a product of cognitive processes, sociologists tend to argue that numerous noncognitive factors influence what scientists learn, how they package it, and how readily it is accepted. Underlying this disagreement, however, (...) is a common assumption that social forces are a source of bias and irrationality. Longino challenges this assumption, arguing that social interaction actually assists us in securing firm, rationally based knowledge. This important insight allows her to develop a durable and novel account of scientific knowledge that integrates the social and cognitive. Longino begins with a detailed discussion of a wide range of contemporary thinkers who write on scientific knowledge, clarifying the philosophical points at issue. She then critically analyzes the dichotomous understanding of the rational and the social that characterizes both sides of the science studies stalemate and the social account that she sees as necessary for an epistemology of science that includes the full spectrum of cognitive processes. Throughout, her account is responsive both to the normative uses of the term knowledge and to the social conditions in which scientific knowledge is produced. Building on ideas first advanced in her influential book Science as Social Knowledge, Longino brings her account into dialogue with current work in social epistemology and science studies and shows how her critical social approach can help solve a variety of stubborn problems. While the book focuses on epistemological concerns related to the sociality of inquiry, Longino also takes up its implications for scientific pluralism. The social approach, she concludes, best allows us to retain a meaningful concept of knowledge in the face of theoretical plurality and uncertainty. (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)

For the last forty years, two claims have been at the core of disputes about scientific change: that scientists reason rationally and that science is progressive. For most of this time discussions were polarized between philosophers, who defended traditional Enlightenment ideas about rationality and progress, and sociologists, who espoused relativism and constructivism. Recently, creative new ideas going beyond the polarized positions have come from the history of science, feminist criticism of science, psychology of science, and anthropology of science. Addressing the (...) traditional arguments as well as building on these new ideas, Miriam Solomon constructs a new epistemology of science. After discussions of the nature of empirical success and its relation to truth, Solomon offers a new, social account of scientific rationality. She shows that the pursuit of empirical success and truth can be consistent with both dissent and consensus, and that the distinction between dissent and consensus is of little epistemic significance. In building this social epistemology of science, she shows that scientific communities are not merely the locus of distributed expert knowledge and a resource for criticism but also the site of distributed decision making. Throughout, she illustrates her ideas with case studies from late-nineteenth- and twentieth-century physical and life sciences. Replacing the traditional focus on methods and heuristics to be applied by individual scientists, Solomon emphasizes science funding, administration, and policy. One of her goals is to have a positive influence on scientific decision making through practical social recommendations. (shrink)

The ideal of value free science states that the justification of scientific findings should not be based on non-epistemic (e.g. moral or political) values. It has been criticized on the grounds that scientists have to employ moral judgements in managing inductive risks. The paper seeks to defuse this methodological critique. Allegedly value-laden decisions can be systematically avoided, it argues, by making uncertainties explicit and articulating findings carefully. Such careful uncertainty articulation, understood as a methodological strategy, is exemplified by the current (...) practice of the Intergovernmental Panel on Climate Change (IPCC). (shrink)

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 (...) health, the practice of pathologists, “Cambridge changes” in health status, and comparative vs. absolute health concepts. I make no changes in doctrine, except to consider treating “normal aging” as pathological by taking young adults as the standard for all adults. (shrink)

When interests and preferences of researchers or their sponsors cause bias in experimental design, data interpretation or dissemination of research results, we normally think of it as an epistemic shortcoming. But as a result of the debate on science and values, the idea that all extra-scientific influences on research could be singled out and separated from pure science is now widely believed to be an illusion. I argue that nonetheless, there are cases in which research is rightfully regarded as epistemologically (...) deficient due to the influence of preferences on its outcomes. I present examples from biomedical research and offer an analysis in terms of social epistemology. (shrink)

Now available in a Harper Colophon edition, this classic book has revolutionized thinking throughout the Western world about the nature of the psychiatric profession and the moral implications of its practices. Book jacket.

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)

Could low-level exposure to polluting chemicals be analogous to exercise -- a beneficial source of stress that strengthens the body? Some scientists studying the phenomenon of hormesis claim that that this may be the case.s A Little Pollution Good For You? critically examines the current evidence for hormesis.

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)

Classifying Madness (Springer, 2005) concerns philosophical problems with the Diagnostic and Statistical Manual of Mental Disorders, more commonly known as the D.S.M. The D.S.M. is published by the American Psychiatric Association and aims to list and describe all mental disorders. The first half of Classifying Madness asks whether the project of constructing a classification of mental disorders that reflects natural distinctions makes sense. Chapters examine the nature of mental illness, and also consider whether mental disorders fall into natural kinds. The (...) second half of the book addresses epistemic worries. Even supposing a natural classification system to be possible in principle, there may be reasons to be suspicious of the categories included in the D.S.M. I examine the extent to which the D.S.M. depends on psychiatric theory, and look at how it has been shaped by social and financial factors. I aim to be critical of the D.S.M. without being antagonistic towards it. Ultimately, however, I am forced to conclude that although the D.S.M. is of immense practical importance, it is unlikely to come to reflect the natural structure of mental disorders. (shrink)

The effects of mental disorder are apparent and pervasive, in suffering, loss of freedom and life opportunities, negative impacts on education, work satisfaction and productivity, complications in law, institutions of healthcare, and more. With a new edition of the 'bible' of psychiatric diagnosis - the DSM - under developmental, it is timely to take a step back and re-evalutate exactly how we diagnose and define mental disorder. This new book by Derek Bolton tackles the problems involved in the definition and (...) boundaries of mental disorder. It addresses two main questions regarding mental illness. Firstly, what is the basis of the standards or norms by which we judge that a person has a mental disorder - that the person's mind is not working as it should, that their mental functioning is abnormal? Controversies about these questions have been dominated by the contrast between norms that are medical, scientific or natural, on the one hand, and social norms on the other. The norms that define mental disorder seem to belong to psychiatry, to be medical and scientific, but are they really social norms, hijacked and disguised by the medical profession? Secondly, what is the validity of the distinction between mental disorder and order, between abnormal and normal mental functioning? To what extent, notwithstanding appearances, does mental disorder involve meaningful reactions and problem-solving? These responses may be to normal problems of living, or to not so normal problems - to severe psycho-social challenges. Is there after all order in mental disorder? With the closing of asylums and the appearance of care in the community, mental disorder is now in our midst. While attempts have been made to define clearly a concept of mental disorder that is truly medical as opposed to social, there is increasing evidence that such a distinction is unviable - there is no clear line between what is normal in the population and what is abnormal. 'What is Mental Disorder?' reviews these various crucial developments and their profound impact for the concept and its boundaries in a provocative and timely book. (shrink)

The terms ``objectivity'''' and ``objective'''' are among the mostused yet ill-defined terms in the philosophy of science and epistemology. Common to all thevarious usages is the rhetorical force of ``I endorse this and you should too'''', orto put it more mildly, that one should trust the outcome of the objectivity-producing process.The persuasive endorsement and call to trust provide some conceptual coherenceto objectivity, but the reference to objectivity is hopefully not merely an attemptat persuasive endorsement. What, in addition to epistemological endorsement,does (...) objectivity carry with it? Drawing on recent historical and philosophical work,I articulate eight operationally accessible and distinct senses of objectivity.While there are links among these senses, providing cohesion to the concept, I argue thatnone of the eight senses is strictly reducible to the others, giving objectivity itsirreducible complexity. (shrink)

Over the past twenty-five years, numerous articles in Hypatia have clarified, revised, and defended increasingly more nuanced views of both feminist empiricism and standpoint feminism. Feminist empiricists have argued that scientific knowledge is contextual and socially situated (Longino 1990; Nelson 1990; Anderson 1995), and standpoint feminists have begun to endorse virtues of theory choice that have been traditionally empiricist (Wylie 2003). In fact, it is unclear whether substantive differences remain. I demonstrate that current versions of feminist empiricism and standpoint feminism (...) now have much in common but that key differences remain. Specifically, they make competing claims about what is required for increasing scientific objectivity. They disagree about 1) the kind of diversity within scientific communities that is epistemically beneficial and 2) the role that ethical and political values can play. In these two respects, feminist empiricists have much to gain from the resources provided by standpoint theory. As a result, the views would be best merged into “feminist standpoint empiricism.”. (shrink)

This paper examines the state of the field of “science and values”—particularly regarding the implications of the thesis of transient underdetermination for the ideal of value-free science, or what I call the “ideal of epistemic purity.” I do this by discussing some of the main arguments in the literature, both for and against the ideal. I examine a preliminary argument from transient underdetermination against the ideal of epistemic purity, and I discuss two different formulations of an objection to this argument—an (...) objection that requires the strict separation of the epistemic from the practical. A secondary aim of the paper is to suggest some future directions for the field, one of which is to replace the vocabulary of values that is often employed in the literature with a more precise one. (shrink)

Innovative modes of collaboration between archaeologists and Indigenous communities are taking shape in a great many contexts, in the process transforming conventional research practice. While critics object that these partnerships cannot but compromise the objectivity of archaeological science, many of the archaeologists involved argue that their research is substantially enriched by them. I counter objections raised by internal critics and crystalized in philosophical terms by Boghossian, disentangling several different kinds of pluralism evident in these projects and offering an analysis of (...) why they are epistemically productive when they succeed. My central thesis is that they illustrate the virtues of epistemic inclusion central to proceduralist accounts of objectivity, but I draw on the resources of feminist standpoint theory to motivate the extension of these social -cognitive norms beyond the confines of the scientific community. (shrink)

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 (...) response to Schwartz (2007) and Hausman (2012) and expose a link between the arguments made by Schwartz (2007) and Kingma (2010). Distinguishing naturalist claims at these four domains will allow us to make progress by (1) providing more nuanced, intermediate positions about a possible role for values in health and disease; and (2) assisting in the addressing of relativistic worries about the value-ladenness of health and disease. (shrink)

The emphasis on the limitations of objectivity, in specific guises and networks, has been a continuing theme of contemporary analytic philosophy for the past few decades. The popular sport of baiting feminist philosophers — into pointing to what's left out of objective knowledge, or into describing what methods, exactly, they would offer to replace the powerful objective methods grounding scientific knowledge — embodies a blatant double standard which has the effect of constantly putting feminist epistemologists on the defensive, on the (...) fringes, on the run.This strategy can only work if objectivity is transparent, simple, stable, and clear in its meaning. It most certainly is not. In fact, taking objectivity as a sort of beautiful primitive, self-evident in its value, and all-powerful in its revelatory power, requires careless philosophy, and the best workers in metaphysics, epistemology, and philosophy of science have made reworked definitions of objectivity absolutely central to their own projects. In fact, classic feminist concerns with exploring the impact of sex and gender on knowledge, understanding, and other relations between human beings and the rest of the world fall squarely within the sort of human and social settings thatare already considered central in most current analytic metaphysics, epistemology, and philosophy of science. I argue that the burden of proof is clearly on those who wish toreject the centrality and relevance of sex and gender to our most fundamental philosophical work on knowledge and reality. (shrink)

Since the early 1980s, private, for-profit corporations have become increasingly involved in all aspects of scientific research, especially of biomedical research. In this essay, I argue that there are dangerous epistemic consequences of this trend, which should be more thoroughly examined by social epistemologists. In support of this claim, I discuss a recent episode of pharmaceutical research involving the painkiller Vioxx. I argue that the research on Vioxx was epistemically problematic and that the primary cause of these inadequacies was faulty (...) institutional arrangements. More specifically, the research was organized in such a way as to allow short-term commercial interests to compromise epistemic integrity. Thus, the Vioxx case study, in conjunction with numerous case studies developed elsewhere, provides strong reasons for believing that the privatization of the biomedical sciences is epistemically worrisome, and it suggests that the primary response to this situation should be a social, or organizational, one. What kind of organizational response would be most beneficial? I briefly discuss two prominent social epistemological proposals for how scientific research should be organized - namely those of Philip Kitcher and Helen Longino - and I suggest that they are incapable of dealing with the phenomenon of privatization. I then draw upon the Vioxx episode in order to outline an alternative suggestion for reorganizing certain aspects of pharmaceutical research. (shrink)

The public, mental health consumers, as well as mental health practitioners wonder about what kinds of values mental health professionals hold, and what kinds of values influence psychiatric diagnosis. Are mental disorders socio-political, practical, or scientific concepts? Is psychiatric diagnosis value-neutral? What role does the fundamental philosophical question "How should I live?" play in mental health care? In his carefully nuanced and exhaustively referenced monograph, psychiatrist and philosopher of psychiatry John Z. Sadler describes the manifold kinds of values and value (...) judgements involved in psychiatric diagnosis and classification systems like the DSM. Professor Sadler takes the reader on a fascinating conceptual tour of the inner workings of psychiatric diagnosis, considering the role of science, culture, sexuality, politics, gender, technology, human nature, patienthood, and professions in building his vision of a more humane psychiatric diagnostic process. (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)

This chapter examines naturalistic accounts of mental disorder: accounts that define disorder as biological dysfunction. There are three such accounts: an eliminativist account ; a forward-looking or goal-contribution account and a backward-looking or evolutionary account. I argue first, and contra Szasz, that biological functions can be attributed at a mental level. But our mental architecture might simultaneously support many different ways of attributing function claims, which might undermine a strong naturalism about mental disorder. Second, I argue that Boorse's forward-looking account (...) of disorder as dysfunction is not value-free. Third, I argue that Wakefield's backward-looking account does not accurately map onto our disorder judgments or medical purposes. I conclude that whilst Boorse's forward-looking account of disorder as dysfunction tracks medical usage better than Wakefield's evolutionary account, a truly value-free account of mental disorder cannot be sustained. (shrink)

Diagnosing the Diagnostic and Statistical Manual of Mental Disorders (Karnac, 2014) evaluates the latest edition of the D.S.M.The publication of D.S.M-5 in 2013 brought many changes. Diagnosing the Diagnostic and Statistical Manual of Mental Disorders asks whether the D.S.M.-5 classifies the right people in the right way. It is aimed at patients, mental health professionals, and academics with an interest in mental health. Issues addressed include: How is the D.S.M. affected by financial links with the pharmaceutical industry? To what extent (...) were and should patients involved in revising the classification? How are diagnoses added to the D.S.M.? Does medicalization threaten the idea that anyone is normal? What happens when changes to diagnostic criteria mean that people lose their diagnoses? How important will the D.S.M. be in the future? (shrink)

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, (...) and is out of step with medical processes for identifying disease boundaries. Although proponents of the biostatistical theory might regard these practical issues as irrelevant to the aim of providing a theoretical account of disease, we take them to indicate the need for a theoretical account that is adequate for current needs—including limiting new forms of medicalization that are driven by the identification of disease based on dysfunction. Our processes for determining the boundaries for disease need to recognize that there is no value-free method for making these decisions. (shrink)

This paper argues for the importance of approaching medicine, as a theoretical science, through values. The normative concepts of benefit and harm are held to provide a framework for the analysis of medicine which reflects the obligations of the doctor-patient relationship, suffices to define the key concept of medical relevance, yields a general necessary condition for the basic concepts of medicine, explains the role of such nonnormative conceptions as discomfort, dysfunction, and incapacity, and avoids the mistakes of other normative approaches (...) which hold that unhealthy conditions are disvaluable or should be treated. Neutralist analyses are criticized, especially those approaching health through proper functioning. (shrink)

An empirically sensitive formulation of the norms of transformative criticism must recognize that even public and shared standards of evaluation can be implemented in ways that unintentionally perpetuate and reproduce forms of social bias that are epistemically detrimental. Helen Longino’s theory can explain and redress such social bias by treating peer evaluations as hypotheses based on data and by requiring a kind of perspectival diversity that bears, not on the content of the community’s knowledge claims, but on the beliefs and (...) norms of the culture of the knowledge community itself. To illustrate how socializing cognition can bias evaluations, we focus on peer-review practices, with some discussion of peer-review practices in philosophy. Data include responses to surveys by editors from general philosophy journals, as well as analyses of reviews and editorial decisions for the 2007 Cognitive Science Society Conference. (shrink)

Due to several socio-political factors, to many psychiatrists only a strictly objective definition of mental disorder, free of value components, seems really acceptable. In this paper, I will explore a variant of such an objectivist approach to defining metal disorder, natural function objectivism. Proponents of this approach make recourse to the notion of natural function in order to reach a value-free definition of mental disorder. The exploration of Christopher Boorse's 'biostatistical' account of natural function (1) will be followed an investigation (...) of the 'hybrid naturalism' approach to natural functions by Jerome Wakefield (2). In the third part, I will explore two proposals that call into question the whole attempt to define mental disorder (3). I will conclude that while 'natural function objectivism' accounts fail to provide the backdrop for a reliable definition of mental disorder, there is no compelling reason to conclude that a definition cannot be achieved. (shrink)

In the literature on health, naturalism and normativism are typically characterized as espousing and rejecting, respectively, the view that health is objective and value-free. This article points out that there are two distinct dimensions of disagreement, regarding objectivity and value-ladenness, and thus arranges naturalism and normativism as diagonal opposites on a two-by-two matrix of possible positions. One of the remaining quadrants is occupied by value-dependent realism, holding that health facts are value-laden and objective. The remaining quadrant, which holds that they (...) are non-objective but value-free, is unexplored. The article endorses a view in the latter quadrant, namely, the view that health is a secondary property. The article argues that a secondary property framework provides the resources to respond to the deepest objections to a broadly Boorsean account of natural function, and so preserves the spirit, though not the letter, of that account. Treating health as a secondary property permits a naturalistic explanation—specifically, an evolutionary explanation—of the health concept, in terms of the assistance such a concept might have provided to the survival and reproduction of those organisms that had it. This provides the explanation, missing from Boorse's account, for the fact that function is determined with reference to the contribution to the goals of survival and reproduction, relative to the age of the sex of the species, rather than some other equally natural goals or reference classes. _1_ Introduction _2_ Two Ways to Disagree about Health _3_ Secondary Properties _4_ Health as a Secondary Property _5_ Conclusion. (shrink)

Psychiatric classification, as exemplified by the Diagnostic and Statistical Manual of Mental Disorders, is dealing with a lack of trust and credibility—in the scientific, but also in the public realm. Regarding the latter in particular, one possible remedial measure for this crisis in trust lies in an increased integration of patients into the DSM revision process. The DSM, as a manual for clinical practice, is forced to make decisions that exceed available data and involve value-judgments. Regarding such decisions, public epistemic (...) trustworthiness requires that these value-judgments should be representative of those of the affected public, and that the public has a reason to believe such a representation to be realized. Due to the long tradition of distrust in psychiatry, such a reason can in this case best be provided by an actual integration of patients into the decision-making process, rather than by their representation through scientific experts. (shrink)

Psychiatric classification is highly controversial, as could be witnessed again with the latest revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM). These controversies comprise multiple kinds of critiques by a variety of actors. It is unlikely that all these issues will be overcome by one perfect solution in the future. Rather, it is precisely the DSM’s “one-size-fits-all-approach” that lies at the root of many of the current problems. To restore the scientific and public credibility of psychiatric classification, (...) a multi-dimensional pluralist response is thus needed: (1) theoretical pluralism, meaning a promotion of different research projects and heuristic strategies, (2) taxonomic pluralism, which allows for different classifications used in research versus clinical practice, and (3) participatory pluralism, which concerns the diversity of perspectives and stakeholders in DSM-revisions. (shrink)

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 (...) demonstrates how such an approach can be valuable for understanding the concept of mental disorder itself. Naturalism, Interpretation, and Mental Disorder brings fresh thinking to the philosophy of psychiatry, and will be of interest to students and scholars in the fields of Mental Health and Philosophy. (shrink)