Whipple disease is a rare, infectious, disease first described from a single case by Whipple in 1907. As well as characterising the clinical and pathological features of the condition, Whipple made two suggestions regarding its aetiology. These were either than the disease was caused by an infectious agent, or that it was of metabolic origin. As the disease is now thought to be caused by infection with the bacterium Tropheryma whipplei, historical reviews of the history of (...) the disease typically mention only the first of these suggestions. In this paper, we therefore revisit Whipple’s other theory. We argue that a diverse and often successful research programme was developed around this mechanism of disease causation which gave rise to many useful findings on the condition. In the later parts of this article, we then turn to discuss the surprising neglect of this period of Whipple disease research in the current literature, and conclude by offering a brief reconstruction of this early history suitable for use in a technical context. (shrink)

In the contemporary biomedical literature, every disease is considered genetic. This extension of the concept of genetic disease is usually interpreted either in a trivial or genocentrist sense, but it is never taken seriously as the expression of a genetic theory of disease. However, a group of French researchers defend the idea of a genetic theory of infectious diseases. By identifying four common genetic mechanisms (Mendelian predisposition to multiple infections, Mendelian predisposition to one infection, and (...) major gene and polygenic predispositions), they attempt to unify infectious diseases from a genetic point of view. In this article, I analyze this explicit example of a genetic theory, which relies on mechanisms and is applied only to a specific category of diseases, what we call “a regional genetic theory.” I have three aims: to prove that a genetic theory of disease can be devoid of genocentrism, to consider the possibility of a genetic theory applied to every disease, and to introduce two hypotheses about the form that such a genetic theory could take by distinguishing between a genetic theory of diseases and a genetic theory of Disease. Finally, I suggest that network medicine could be an interesting framework for a genetic theory of Disease. (shrink)

Similarly to other accounts of disease, Christopher Boorse’s Biostatistical Theory (BST) is generally presented and considered as conceptual analysis, that is, as making claims about the meaning of currently used concepts. But conceptual analysis has been convincingly critiqued as relying on problematic assumptions about the existence, meaning, and use of concepts. Because of these problems, accounts of disease and health should be evaluated not as claims about current meaning, I argue, but instead as proposals about how to (...) define and use these terms in the future, a methodology suggested by Quine and Carnap. I begin this article by describing problems with conceptual analysis and advantages of “philosophical explication,” my favored approach. I then describe two attacks on the BST that also question the entire project of defining “disease.” Finally, I defend the BST as a philosophical explication by showing how it could define useful terms for medical science and ethics. (shrink)

Some ‘naturalist’ accounts of disease employ a biostatistical account of dysfunction, whilst others use a ‘selected effect’ account. Several recent authors have argued that the biostatistical account offers the best hope for a naturalist account of disease. We show that the selected effect account survives the criticisms levelled by these authors relatively unscathed, and has significant advantages over the BST. Moreover, unlike the BST, it has a strong theoretical rationale and can provide substantive reasons to decide difficult cases. (...) This is illustrated by showing how life-history theory clarifies the status of so-called diseases of old age. The selected effect account of function deserves a more prominent place in the philosophy of medicine than it currently occupies. _1_ Introduction _2_ Biostatistical and Selected Effect Accounts of Function _3_ Objections to the Selected Effect Account _3.1_ Boorse _3.2_ Kingma _3.3_ Hausman _3.4_ Murphy and Woolfolk _4_ Problems for the Biostatistical Account _4.1_ Schwartz _5_ Analysis versus Explication _6_ Explicating Dysfunction: Life History Theory and Senescence _7_ Conclusion. (shrink)

In this paper, we identify some key features of what makes something a disease, and consider whether these apply to pregnancy. We argue that there are some compelling grounds for regarding pregnancy as a disease. Like a disease, pregnancy affects the health of the pregnant person, causing a range of symptoms from discomfort to death. Like a disease, pregnancy can be treated medically. Like a disease, pregnancy is caused by a pathogen, an external organism invading (...) the host’s body. Like a disease, the risk of getting pregnant can be reduced by using prophylactic measures. We address the question of whether the ‘normality’ of pregnancy, its current necessity for human survival, or the value often attached to it are reasons to reject the view that pregnancy is a disease. We point out that applying theories of disease to the case of pregnancy, can in many cases illuminate inconsistencies and problems within these theories. Finally, we show that it is difficult to find one theory of disease that captures all paradigm cases of diseases, while convincingly excluding pregnancy. We conclude that there are both normative and pragmatic reasons to consider pregnancy a disease. (shrink)

The early Stoics diagnose vicious agents with various psychological diseases, e.g. love of money and love of wine. Such diseases are characterized as false evaluative opinions that lead the agent to form emotional impulses for certain objects, e.g. money and wine. Scholars have therefore analyzed psychological diseases simply as dispositions for assent. This interpretation is incomplete, I argue, and should be augmented with the claim that psychological disease also affects what kind of action-guiding impressions are created prior to giving (...) assent. This proposal respects the Stoic insistence that impression-formation, no less than assent, is an activity of reason. In so far as the wine-lover’s reason is corrupted in a different way from the money-lover’s, the two vicious agents will form different action-guiding impressions when faced with similar stimuli. Here I juxtapose the Stoic account of expertise, according to which experts form more precise action-guiding impressions compared to the amateur, in virtue of possessing a system of grasps (katalēpseis). So expertise enhances, whereas psychological disease degrades, the representational fidelity of the impressions that prefigure action. With these commitments, the Stoics can be seen to offer a nuanced and principled theory of cognitive penetration and to anticipate some recent proposals in epistemology and cognitive science. (shrink)

Background: Despite the at least decades long record of philosophical recognition and interest, the intricacy of the deceptively familiar appearing concepts of ‘disease’, ‘disorder’, ‘disability’, etc., has only recently begun showing itself with clarity in the popular discourse wherein its newly emerging prominence stems from the liberties and restrictions contingent upon it. Whether a person is deemed to be afflicted by a disease or a disorder governs their ability to access health care, be it free at the point (...) of use or provided by an insurer; it also influences the treatment of individuals by the judicial system and employers; it even affects one’s own perception of self. -/- Aims: All existing philosophical definitions of disease struggle with coherency, causing much confusion and strife, and leading to inconsistencies in real-world practice. Hence, there is a real need for an alternative. -/- Materials & Methods: In the present article I analyse the variety of contemporary views of disease, showing them all to be inadequate and lacking in firm philosophical foundations, and failing to meet the desideratum of patient driven care. -/- Results: Illuminated by the insights emanating from the said analysis, I introduce a novel approach with firm ethical foundations, which foundations are rooted in sentience, that is the subjective experience of sentient beings. -/- Discussion: I argue that the notion of disease is at best superfluous, and likely even harmful in the provision of compassionate and patient-centred care. -/- Conclusion: Using a series of presently contentious cases illustrate the power of the proposed framework which is capable of providing actionable and humane solutions to problems that leave the current theories confounded. (shrink)

I argue that ductal carcinoma in situ (DCIS), the tumor most commonly diagnosed by breast mammography, cannot be confidently classified as cancer, that is, as pathological. This is because there may not be dysfunction present in DCIS—as I argue based on its high prevalence and the small amount of risk it conveys—and thus DCIS may not count as a disease by dysfunction-requiring approaches, such as Boorse’s biostatistical theory and Wakefield’s harmful dysfunction account. Patients should decide about treatment for (...) DCIS based on the risks it poses and the risks and benefits of treatment, not on its disease status. (shrink)

Biomarkers are widely used not only as prognostic or diagnostic indicators, or as surrogate markers of disease in clinical trials, but also to formulate theories of pathogenesis. We identify two problems in the use of biomarkers in mechanistic studies. The first problem arises in the case of multifactorial diseases, where different combinations of multiple causes result in patient heterogeneity. The second problem arises when a pathogenic mediator is difficult to measure. This is the case of the oxidative stress (OS) (...) theory of disease, where the causal components are reactive oxygen species (ROS) that have very short half-lives. In this case, it is usual to measure the traces left by the reaction of ROS with biological molecules, rather than the ROS themselves. Borrowing from the philosophical theories of signs, we look at the different facets of biomarkers and discuss their different value and meaning in multifactorial diseases and system medicine to inform their use in patient stratification in personalized medicine. (shrink)

The study investigated ethical considerations and science diplomacy on coronavirus disease (Covid-19) pandemic in Nigeria. The outbreak of the coronavirus disease (Covid-19) in Nigeria has spread quickly to about 34 states out of the 36 states and over 5000 persons have tested positive as at the time of this research after the first index case of an Italian and there is a projection that in coming days and weeks the number of infected persons and states will increase. The (...) study was guided by two objectives and also adopted the normative ethical theory. The study employed the methods of exposition and critical analysis to explain better the ethical issues and science diplomacy of Covid-19 pandemic in Nigeria. Data was sourced from secondary sources such as journal articles, newspaper, books and internet sources. The findings of the study showed that the citizens have some obligations that will aid the containment of the virus and as well as the government. The study also found out that science diplomacy was used, which has led to Nigeria collaborating with China to get medical aids to effectively fight the pandemic. Consequently, the study recommended amongst others that the Ministry of Health and the Nigeria Center for Disease Control (NCDC) should adopt and enforce the World Health Organization (WHO) Guidance for Managing Ethical Issues in Infectious Disease Outbreak as a working document in crisis like the Covid-19 pandemic that has ravaged Nigeria and the government should involve more in science diplomacy with other countries so that it will help in the fight against Covid-19 and other diseases that may occur in the future. (shrink)

Evolutionary theory coheres with its neighboring theories, such as the theory of plate tectonics, molecular biology, electromagnetic theory, and the germ theory of disease. These neighboring theories were previously unconceived, but they were later conceived, and then they cohered with evolutionary theory. Since evolutionary theory has been strengthened by its several neighboring theories that were previously unconceived, it will be strengthened by infinitely many hitherto unconceived neighboring theories. This argument for evolutionary theory (...) echoes the problem of unconceived alternatives. Ironically, however, the former recommends that we take the realist attitude toward evolutionary theory, while the latter recommends that we take the antirealist attitude toward it. (shrink)

There are three main accounts of the proper function of the low mood system (LMS): the social risk theory, the disease theory, and the propitiousness theory. Adjudicating between these accounts has proven difficult, as there is little agreement in the literature about what a theory of the LMS’s proper function is supposed to explain. In this article, drawing upon influential work on the evolution of other affective systems, such as the disgust system and the fear (...) system, I argue that a theory of the proper function of the low mood system should: (i) account for the reliable, distal causes and effects of the system’s activation, and (ii) explain how having a system that performed such a function increased fitness in ancestral environments. On this basis, I show that the proper function of the low mood system is to limit resource expenditure in relatively unpropitious circumstances, exactly as hypothesised by the propitiousness theory. (shrink)

This contribution gives an overview of the few passages of Ancient Greek literature dealing with the causes of epidemics and contagions (i.e. in Hippocrates, Thucydides, Isocrates, ps-Aristotle’s Problems, Plutarch, and Galen). With the help of the distinction between an ontological and a physiological conception of what a disease is, I suggest that the latter was an obstacle to better understand the process through which epidemics spread. I nonetheless show that the ontological conception of these diseases was not entirely absent (...) from Antiquity, as it is shown by Galen, who offers an etiological explanation of the origin of epidemics that combines both conceptions, the ontological and the physiological one. (shrink)

Originally introduced by Plato and Aristotle, Moderation Theory in Ethics is the most prevalent theory of ethics among Islamic scholars. Moderation Theory suggests that every virtue or excellence of character lies in the mean between two vices: excess or defect. Every ethical virtue comes from moderation in actions or emotions and every ethical vice comes from excess or defect. This paper suggests that while Islamic scholars have been influenced by this doctrine, they have also developed and re-conceptualized (...) it in innovative ways. Kindī, Miskawayh, Avicenna, Rāghib Isfahānī, Nasīr al-Dīn Ṭusī, and others are among the Islamic contributors to the subject. Some of their innovations in this theory are as follows: bringing together Aristotle's doctrine of the mean with Plato's psychology (by Kindī), dividing virtues into four higher genuses, dividing vices into eight higher genuses, setting various kinds of vices and virtues under these higher genuses (by Miskawayh), adding the vice qualitative criteria to Aristotle's vice quantitative criteria (excess and defect) (by Ṭusī), dividing various conceptualizations of justice (by Avicenna), adding religious and mystical virtues into the existing list of virtues (by Rāghib Isfahānī), and proposing a comprehensive model for curing diseases of the soul. This paper seeks to establish the main contributions of these Muslim scholars to Moderation Theory and elaborate on this theory’s evolution within the Islamic world. (shrink)

The purpose of this paper is to support the idea that pragmatism is still a productive resource for the study of health and disease. Combining the results of thermodynamic theories with evolutionism, some said that the biological structures selected by evolution are perfect to maximize the conservation of energy; as a consequence, they tend to reduce the entropy in the organism. Thus, a process can be defined as pathological if it increases the entropy, which means a diminished efficiency of (...) the organism. .The point of view of pragmatism is useful to disprove the thesis of those who define disease only in relation to a reduced efficiency of the organism. (shrink)

Since the outbreak of the Coronavirus disease 2019 (Covid-19), tremendous efforts have been made by scientists, health professionals, business people, politicians, and laypeople around the world. Covid-19 vaccines are one of the most crucial innovations that help fight against the virus. This paper attempts to revisit the Covid-19 vaccines production process by employing the serendipity-mindsponge-3D creativity management theory. Vaccine production can be considered an information process and classified into three main stages. The first stage involved the processes of (...) absorbing information (e.g., digital data and open science) and rejecting unhelpful information (e.g., misinformation and fake news) for effectively acquiring useful insights. Useful insights were later employed by experts, enterprises, governments, and international organizations through interdisciplinary coordinated efforts for developing vaccines within a short period. Finally, the appearance of multiple types of vaccines enabled more strategic options for vaccine distribution and administration. Findings from this vaccine creativity management process could be used as critical lessons for further improvements of vaccination programs. (shrink)

Gerontology together with its subfields, such as social gerontology, geragogy, educational gerontology, political gerontology, environmental gerontology, and financial gerontology, is still a relatively new academic discipline that is currently intensively developing, expanding research fields and combining various theoretical and practical perspectives. The interdisciplinarity, transdisciplinarity, and multidisciplinarity of research on ageing and old age, despite its vast thematic, methodological and theoretical diversity, have a common denominator, which is the focus of research work on improving the quality of life of older people. (...) It is the concern for the components of quality of life such as welfare and well-being as well as focus on learning about phenomena conditioning successful ageing that has become motivators and premises hidden or visible in many texts included in the Research Topic “Perspectives and Theories of Social Innovation for Ageing Population.” The Research Topic that we are presenting to our readers is unique not only because of its size but above all because of its novelty and social involvement, visible in the content of individual chapters. The presented collection includes 17 articles prepared in total by 76 authors from the following countries: China, Finland, Germany, Ghana, Hungary, Ireland, Israel, Italy, Japan, the Netherlands, Poland, Portugal, Slovenia, Spain, Sweden, the United Kingdom, and the United States. Two journals were combined with this Research Topic: “Frontiers in Public Health” and “Frontiers in Sociology.” The presented Research Topic contains seven types of articles covering: two community case studies, eight original research articles, two perspective articles, one hypothesis and theory paper, one policy and practice review, one methods article, and two book reviews. The rationale to start work on this set of texts was the desire to continue and deepen the research analyses of the editors of this set, which concern the development of social innovations for the ageing population as well as changes of public policy on ageing. This Research Topic deals with topics covering issues such as social learning, intergenerational transmission, senior entrepreneurship, creative content creation by older adults, care services, raising the independence of older people in their living environments, dementia challenges, the image of the older generation in local social policies, new trends in qualitative research on old age, strategies for dealing with chronic diseases, the use of digital tools in health education, the silver economy/longevity economy, age-friendly environments, the diversity of structures and social services, preparation for old age, and food safety. The wide variety of submitted texts shows several selected and, according to the authors, current challenges that contemporary seniors have to face. The articles comprising this Research Topic are organized according to five themes. (shrink)

In this article, we discuss epistemological limitations relating to the use of ethnoracial categories in biomedical research as devised by the Office of Management and Budget’s institutional guidelines. We argue that the obligation to use ethnoracial categories in genomics research should be abandoned. First, we outline how conceptual imprecision in the definition of ethnoracial categories can generate epistemic uncertainty in medical research and practice. Second, we focus on the use of ethnoracial categories in medical genetics, particularly genomics-based precision medicine, where (...) ethnoracial identity is understood as a proxy for medically relevant differences among individuals. Notably, extensive criticisms have been made already against the genetic interpretation of races, but, nonetheless, the concept of race remains a key element of contemporary genomics. This motivates us to explore possible reasons why such criticisms may have been ineffective in redirecting attention to other (non-race-based) ways of controlling for human variability. We contend that popular arguments against the idea that human races have a genetic basis, though convincing in many respects, are not sufficient to exclude the pragmatic use of race and ethnicity as proxies for genetic variability related to complex phenotypes. Finally, we provide two further arguments to support the idea that ethnoracial categories are unlikely to provide meaningful insights into medical genetics, which implies that even the interpretation of race as a useful tool to stratify disease risk is unwarranted. (shrink)

Padartha is a concept which has been clinically and academically described in Ayurveda. Health and disease are prime focus of Ayurveda and the principle causes behind both of these are Padatha. Ayurveda and Vaisheshika darshan considers similar padartha but with different views. How this view is different has been explained? Disease is a state of disequilibrium of physiological functions causing vriddhi or kshaya of structural entity (Dhatus). Vriddhi or Kshaya is based on samanya and vishesha and its treatment (...) is also based on same. An attempt to explain Doshavada, Dhatuposhan (nourishment of structural entity), Loka Purusha samyata (Universe human unified theory) etc. on basis of Samanyavada has been explained. How is Dravya, Guna, karma basis for therapeutics involving principles of samanya and vishesha with Samavaya acting as a cause for determined action due to its inherent relationship has been explained. From all findings, it can be said that sadapadartha are basic plinth of this Ayurveda. (shrink)

An appreciation of the "more philosophical" aspects of ancient medical writings casts considerable light on Aristotle's concept of nature, and how he understands nature to differ from art, on the one hand, and spontaneity or luck, on the other. The account of nature, and its comparison with art and spontaneity in Physics II is developed with continual reference to the medical art. The notion of spontaneous remission of disease (without the aid of the medical art) was a controversial subject (...) in the medical literature, and Aristotle's aporia about the notion of spontaneous generation of natural things runs parallel to this controversy. Aristotle's account of spontaneous generation in the Metaphysics and in the Generation of Animals can also be profitably illuminated by looking at the comparison with medicine in detail. The result, hopefully, is a clearer and more consistent picture not only of Aristotle's concepts of nature, art, and spontaneity, but also of the influence of medical writings and concepts on his natural philosophy. Joel Mann has written a commentary on the essay. (shrink)

Mindreading is the ability to attribute mental states to other individuals. According to the Theory-Theory (TT), mindreading is based on one's possession of a Theory of Mind. On the other hand, the Simulation Theory (ST) maintains that one arrives at the attribution of a mental state by simulating it in one's own mind. In this paper, I propose a ST-TT hybrid model of the ability to attribute disgust on the basis of visual stimuli such as facial (...) expressions, body postures, etc. More precisely, while I defend Goldman's (2006) thesis that the ability to attribute disgust based on observing disgusted facial expressions stems from a mirror-based simulation process, I argue that ST is unable to account for the ability to attribute disgust based on non-facial visual stimuli; I propose, rather, that this latter ability is theory-based. My model is grounded in evidence from individuals suffering from Huntington's Disease. (shrink)

Precision medicine and molecular systems medicine (MSM) are highly utilized and successful approaches to improve understanding, diagnosis, and treatment of many diseases from bench-to-bedside. Especially in the COVID-19 pandemic, molecular techniques and biotechnological innovation have proven to be of utmost importance for rapid developments in disease diagnostics and treatment, including DNA and RNA sequencing technology, treatment with drugs and natural products and vaccine development. The COVID-19 crisis, however, has also demonstrated the need for systemic thinking and transdisciplinarity and the (...) limits of MSM: the neglect of the bio-psycho-social systemic nature of humans and their context as the object of individual therapeutic and population-oriented interventions. COVID-19 illustrates how a medical problem requires a transdisciplinary approach in epidemiology, pathology, internal medicine, public health, environmental medicine, and socio-economic modeling. Regarding the need for conceptual integration of these different kinds of knowledge we suggest the application of general system theory (GST). This approach endorses an organism-centered view on health and disease, which according to Ludwig von Bertalanffy who was the founder of GST, we call Organismal Systems Medicine (OSM). We argue that systems science offers wider applications in the field of pathology and can contribute to an integrative systems medicine by (i) integration of evidence across functional and structural differentially scaled subsystems, (ii) conceptualization of complex multilevel systems, and (iii) suggesting mechanisms and non-linear relationships underlying the observed phenomena. We underline these points with a proposal on multi-level systems pathology including neurophysiology, endocrinology, immune system, genetics, and general metabolism. An integration of these areas is necessary to understand excess mortality rates and polypharmacological treatments. In the pandemic era this multi-level systems pathology is most important to assess potential vaccines, their effectiveness, short-, and long-time adverse effects. We further argue that these conceptual frameworks are not only valid in the COVID-19 era but also important to be integrated in a medicinal curriculum. (shrink)

This paper was written to study the order of medical advances throughout history. It investigates changing human beliefs concerning the causes of diseases, how modern surgery developed and improved methods of diagnosis and the use of medical statistics. Human beliefs about the causes of disease followed a logical progression from supernatural causes, such as the wrath of the Gods, to natural causes, involving imbalances within the human body. The invention of the microscope led to the discovery of microorganisms which (...) were eventually identified as the cause of infectious diseases. Identification of the particular microorganism causing a disease led to immunization against the disease. Modern surgery only developed after the ending of the taboo against human dissection and the discovery of modern anesthesia and the discovery of the need for anti-septic practices. Modern diagnostic practices began with the discovery of x-rays and the invention of medical scanners. Improved mathematics, especially in probability theory, led to statistical studies which led to a much greater ability, to identify the causes of disease, and to evaluate the effectiveness of treatments. These discoveries all occurred in a necessary and inevitable order with the easiest discoveries being made first and the harder discoveries being made later. The order of discovery determined the course of the history of medicine and is an example of how social and cultural history has to follow a particular course determined by the structure of the world around us. (shrink)

Fear of cancer is mostly related to cancer recurrence, metastasis, additional cancer, and diagnostic tests. Its legacy as a lethal disease has raised fear of approaching death. Currently, cancer’s total suffering and the worsening phenomena have raised fear, especially among female patients. Family caregivers (FCGs) who are responsible for the day-to-day cancer care at home need to help the patients deal with this fear frequently. Due to the limited care competencies, they need supportive care from healthcare professionals in cancer (...) fear management. This study aims to assess how types of demanded healthcare information affect the FCG’s role in reducing the fear of female cancer patients. The mindsponge theory was used in conceptual development and interpretation. Bayesian Mindsponge Framework (BMF) analytics were used for statistical analysis on a dataset of 48 spouses (husbands) and 12 other family members in five congested communities of Surabaya, Indonesia. Results showed that among the six types of healthcare information, FCGs with higher demand on cancer-specific information and information on cancer physical needs were more likely to need support in reducing the fear of female cancer patients. Meanwhile, FCGs with a higher demand for information on support services were less likely to need support to reduce cancer patients’ fear. Other types of healthcare information have ambiguous effects on the need for support in reducing cancer-induced fear. This study reveals that the demanded cancer-specific information, e.g., cancer’s prognosis or likely outcome and information on cancer physical needs, need to be met in priority to assist FCG’s role in cancer fear management. (shrink)

This chapter summarizes the conceptual foundations and research on emotional creativity. Emotional creativity is defined as a pattern of cognitive abilities and personality traits related to originality and appropriateness in emotional experience. This construct pervades human creative performance and represents an important link between emotional experience and cognitive processes. Empirical research in this field has revealed various links of emotional creativity to personality variables (e.g., openness to experience), positive affect, fantasy proneness, coping strategies, post-traumatic growth, better self-understanding, and one’s engagement (...) in practicing creative leisure activities. In the applied settings, emotional creativity has been found to be positively related to the intrinsic motivation of employees, the innovative performance of employees, teaching efficacy, and an increased awareness of professional roles. Interestingly, the available meta-analysis of past studies revealed that women showed significantly higher emotional creativity than men. Emotional creativity has also been found to be lower in older adulthood compared to younger age. Because the levels of emotional creativity were found to be sensitive to the decline of cognitive functions in older adults, their decrease can be considered as one of the indicators of cognitive aging. Recent research in clinical neuropsychology has also revealed that older adults in the early stages of Parkinson’s disease showed decreased emotional creativity compared to healthy older adults. (shrink)

With the growing focus on prevention in medicine, studies of how to describe risk have become increasing important. Recently, some researchers have argued against giving patients “comparative risk information,” such as data about whether their baseline risk of developing a particular disease is above or below average. The concern is that giving patients this information will interfere with their consideration of more relevant data, such as the specific chance of getting the disease (the “personal risk”), the risk reduction (...) the treatment provides, and any possible side effects. I explore this view and the theories of rationality that ground it, and I argue instead that comparative risk information can play a positive role in decision-making. The criticism of disclosing this sort of information to patients, I conclude, rests on a mistakenly narrow account of the goals of prevention and the nature of rational choice in medicine. (shrink)

Abstract The quasispecies theory is a helpful concept in the explanation of RNA virus evolution and behaviour, with a relevant impact on methods used to fight viral diseases. It has undergone some adaptations to integrate new empirical data, especially the non-deterministic nature of mutagenesis, and the variety of behavioural motifs in cooperation, competition, communication, innovation, integration, and exaptation. Also, the consortial structure of quasispecies with complementary roles of memory genomes of minority populations better fits the empirical data than did (...) the original concept of a master sequence and its mutant spectra. The high productivity of quasispecies variants generates unique sequences that never existed before and will never exist again. In the present essay, we underline that such sequences represent really new ontological entities, not just error copies of previous ones. Their primary unique property, the incredible variant production, is suggested here as quasispecies productivity, which replaces the error-replication narrative to better fit into a new relationship between mankind and living nature in the twenty-first century. (shrink)

Mismatch is a prominent concept in evolutionary medicine and a number of philosophers have published analyses of this concept. The word ‘mismatch’ has been used in a diversity of ways across a range of sciences, leading these authors to regard it as a vague concept in need of philosophical clarification. Here, in contrast, we concentrate on the use of mismatch in modelling and experimentation in evolutionary medicine. This reveals a rigorous theory of mismatch within which the term ‘mismatch’ is (...) indeed used in several ways, not because it is ill-defined but because different forms of mismatch are.distinguished within the theory. Contemporary evolutionary medicine has unified the idea of ‘evolutionary mismatch’, derived from the older idea of ‘adaptive lag’ in evolution, with ideas about mismatch in development and physiology derived from the Developmental Origins of Health and Disease (DOHaD) paradigm. A number of publications in evolutionary medicine have tried to make this theoretical framework explicit. We build on these to present the theory in as simple and general a form as possible. We introduce terminology, largely drawn from the existing literature, to distinguish the different forms of mismatch. This integrative theory of mismatch captures how organisms track environments across space and time on multiple scales in order to maintain an adaptive match to the environment, and how failures of adaptive tracking lead to disease. Mismatch is a productive organising concept within this theory which helps researchers articulate how physiology, development and evolution interact with one another and with environmental change to explain health outcomes. (shrink)

In his article Banicki proposes a universal model for all forms of philosophical therapy. He is guided by works of Martha Nussbaum, who in turn makes recourse to Aristotle. As compared to Nussbaum’s approach, Banicki’s model is more medical and less based on ethical argument. He mentions Foucault’s vision to apply the same theoretical analysis for the ailments of the body and the soul and to use the same kind of approach in treating and curing them. In his interpretation of (...) philosophical therapy, there are, however, some controversial issues, to which we would like to call attention: -/- Is restoring health by a philosophical method of treatment – health understood as a person’s ability to reach his/her vital goals – a convincing explication of philosophical therapy in general? In order to answer this question, it may be useful to look at Plato. It is not only Platonism (and especially Neo-platonism since Plotinus) that questions the idea that therapy is necessarily connected with „vital goals“. Buddhist and Gnostic philosophies are questioning „the vital“ in general. The immense effort in the history of philosophy to liberate the mind from the body casts doubt on the project to explain philosophical therapy solely in analogy to medical therapy. -/- According to Banicki a therapeutic philosophy has to identify the diseases it attempts at curing. There are, however, reasons for associating the term therapy with suffering/risk rather than disease. If a therapy aims at reducing the fear of death, as for example many classical philosophical therapies do, then there is no disease to be cured. A model based on chances and risks also has the advantage that the Buddhist and Stoic reinterpretation of desires/emotions as “diseases” can be dropped in contemporary philosophical therapy. -/- Banicki mentions the comparison of therapies as one of the primary goals of modelling. Methods should be verified by a statistical correlation between method and therapeutic success and/or by a theory which justifies the method. Some forms of therapies, however, avoid theory-specific terms and concepts in favor of an unprejudiced interpretation of the patient’s statements. Others share the (Nietzschean) aspiration to explore and change measures of value. If the therapeutic process is seen as a unique phenomenon, then there can be no theory and no statistics with co-occurrences. -/- According to Banicki philosophical therapy has to describe techniques which qualify as genuinely philosophical. Techniques like maieutics and hermeneutics, however, are antique philosophical “inventions”, which were later adopted by psychotherapy. If meditation is accepted as a therapeutic tool – as it was in ancient times – then there is not only a methodical but also an emotional relation to religion. If finally, the Socratic search for a good life is seen as one of the characteristics of philosophical therapy, then delimitation even turns into a criterion for non-philosophical therapies. The search for a good life requires an interdisciplinary approach. -/- For the concretization of the formal structure, we suggest a typology of therapies, which is based on chances and risks. Such a typology has the advantage, that it can model conflicting (and even opposing) forms of therapies. The variety of therapeutic goals and methods is a consequence of the historical development towards conceptual freedom. (shrink)

Thales is considered to be the first philosopher to pose a question about fundamental principles on which everything else relied. His candidate for ἀρχή was water because he believed that everything comes from water and that the remaining three elements can also be created from water. Alchemists, or the first chemists, relied on the ancient tradition, especially Aristotle and the theory of the four elements. That is how they came to Aristotle’s testimonies about Thales, after which alchemists, like Helmont, (...) accepted Thales’ idea that water is the basis of everything that exists. Alchemists were characterized by a tendency to experiment, not only because they tried to turn other metals into gold but also because they tried to devise medical solutions that would prevent the appearance of various diseases. Due to their rich experimental experience, alchemists have been a convenient target for “new philosophers” since the early seventeenth century. Robert Boyle belonged to that circle because he was a supporter of corpuscular theory. In this paper, I will present Boyle‘s attempt to replicate alchemical experiments, especially Helmont’s experiment with the willow tree and Bacon‘s experiment with water. After that, I will show whether Boyle’s interest in the experimental procedures of alchemists contributed more to the development of modern science than his mechanistic philosophy. (shrink)

In a recent paper, we describe how a model of quantum communication based on combining consciousness experiment and entanglement can serve as impetus to stop 5G-caused diseases. Therefore, in this paper we will discuss how entanglement can be explained in terms of quantum theory. This short review may be considered as an effort to bring QM into real problem solving, i.e. telecommunication.

Recently, it has been argued that the use of Big Data transforms the sciences, making data-driven research possible and studying causality redundant. In this paper, I focus on the claim on causal knowledge by examining the Big Data project EXPOsOMICS, whose research is funded by the European Commission and considered capable of improving our understanding of the relation between exposure and disease. While EXPOsOMICS may seem the perfect exemplification of the data-driven view, I show how causal knowledge is necessary (...) for the project, both as a source for handling complexity and as an output for meeting the project’s goals. Consequently, I argue that data-driven claims about causality are fundamentally flawed and causal knowledge should be considered a necessary aspect of Big Data science. In addition, I present the consequences of this result on other data-driven claims, concerning the role of theoretical considerations. I argue that the importance of causal knowledge and other kinds of theoretical engagement in EXPOsOMICS undermine theory-free accounts and suggest alternative ways of framing science based on Big Data. (shrink)

Since Boorse [Philos Sci 44(4):542–573, 1977] published his paper “Health as a theoretical concept” one of the most lively debates within philosophy of medicine has been on the question of whether health and disease are in some sense ‘objective’ and ‘value-free’ or ‘subjective’ and ‘value-laden’. Due to the apparent ‘failure’ of pure naturalist, constructivist, or normativist accounts, much in the recent literature has appealed to more conciliatory approaches or so-called ‘hybrid accounts’ of health and disease. A recent paper (...) by Matthewson and Griffiths [J Med Philos 42(4):447–466, 2017], however, may bear the seeds for the revival of purely naturalist approach to health and disease. In this paper, I defend their idea of Biological Normativity against recent criticism by Schwartz [J Med Philos Forum Bioethics Philos Med 42(4):485–502, 2017] and hope to help it flower into a revival of naturalist approaches in the philosophy of medicine. (shrink)

Sara Suleri has written recently, in Meatless Days, of being treated as an "otherness machine"-and of being heartily sick of it.20 Perhaps the predicament of the postcolonial intellectual is simply that as intellectuals-a category instituted in black Africa by colonialism-we are, indeed, always at the risk of becoming otherness machines, with the manufacture of alterity as our principal role. Our only distinction in the world of texts to which we are latecomers is that we can mediate it to our fellows. (...) This is especially true when postcolonial meets postmodern; for what the postmodern reader seems to demand of Africa is all too close to what modernism-in the form of the postimpressionists-demanded of it. The role that Africa, like the rest of the Third World, plays for Euro-American postmodernism-like its better-documented significance for modernist art-must be distinguished from the role postmodernism might play in the Third World; what that might be it is, I think, too early to tell. What happens will happen not because we pronounce on the matter in theory, but will happen out of the changing everyday practices of African cultural life.For all the while, in Africa's cultures, there are those who will not see themselves as Other. Despite the overwhelming reality of economic decline; despite unimaginable poverty; despite wars, malnutrition, disease, and political instability, African cultural productivity grows apace: popular literatures, oral narrative and poetry, dance, drama, music, and visual art all thrive. The contemporary cultural production of many African societies, and the many traditions whose evidences so vigorously remain, is an antidote to the dark vision of the postcolonial novelist. 20. Sara Suleri, Meatless Days , p. 105. Kwame Anthony Appiah, professor of philosophy and literature at Duke University, is the author of a number of books, including For Truth in Semantics , Necessary Questions , and In My Father's House , a collection of essays on African cultural politics. His first novel, Avenging Angel, was published in 1990. (shrink)

Originally introduced by Plato and Aristotle, the doctrine of the mean is the most prevalent theory of ethics among Islamic scholars. According to this doctrine, every virtue or excellence of character lies in the observance of the mean, whereas vices are the excess or deficiency of the soul in his functions. Islamic scholars have been influenced by the doctrine, but they have also developed and re-conceptualized it in innovative ways. Kindi, Miskawayh, Avicenna, Raghib Isfahani, Nasir al-Din Tusi, and others (...) are among the Islamic contributors to the subject. Some of their contributions are as follows: bringing together Aristotle's doctrine of the mean with Plato's psychology, dividing virtues into four higher geniuses, dividing vices into eight higher geniuses, setting various kinds of vices and virtues under these higher geniuses, adding the criteria of quality to Aristotle's quantitative evaluation of excess and deficiency, dividing various conceptualizations of justice, adding religious and mystical virtues into the existing list of virtues, and proposing a comprehensive model for curing diseases of the soul. (shrink)

I reconstruct Adam Smith’s theory of irony and its application. I illustrate how he defines it as a combination of something “grand” with something “mean” and how this is consistent with his anti-Cartesian and post-skeptic epistemology. I suggest that, for Smith, “systems” of any kind, from Cartesian physics to philosophical monotheism, Stoic ethics, and the “mercantile system” draw their apparent plausibility from some disease of human imagination. I argue that in every field, including political economy, in his view, (...) the philosopher’s task is partially sceptical and partially ironical. That is, it is the task to fight erroneous systems by showing how these arise from unwarranted associations of ideas between apparently “grand” ideas —say, the public interest— with “mean” ones, say, the merchants’ self-interest. In this light, the phrase “invisible hand” turns out to be both an ironic joke and one more application of Smith’s post-skeptical theory of knowledge whose target is dismantling all kind of “invisible” entities that human imagination tends to create. (shrink)

● Any given placement (e.g. Sun in Taurus; Mars in Capricorn; Mercury in the third house) is necessarily common to tens of thousands of people. Saturn in the ninth house, for example, will not behave the same or produce the same effects in the twenty or one hundred charts in which we find it there. In each case Saturn will behave in accordance with the rest of the astrographic/chart composition (as if we stayed in the same hotel in different epochs (...) or different people contracted the same disease; our stay will be different each time, according to the epoch, and each person’s symptoms will too, be different, according to their individual biochemistry; not to mention that each chart or astrography, like each genetic code or sequence, is unrepeatable). Certainly, “no planet can produce, on its own, what only the combined or concerted action of all can” (BUSTAMANTE, 2023, SPICA magazine, pp. 93-111). Hence the synergistic nature of the interpretative exercise (i.e., the whole is greater than all its parts). The fundamental component of the mathematical expression of the interpretive exercise is: astrological triangulation, the functional denomination for what we know as synthesis (WEISS, 1946; LEO, 1983, HAND, 1981). In order to demonstrate its usefulness, as well as the convenience of its mathematical expression, we have chosen two individuals (JEFFREY DAHMER, STEVEN SPIELBERG) whose astrographies do not—according to the community—explain their lives. The rest of the astrographies correspond to those of serial killers JOHN WAYNE GACY, DAVID CARPENTER, and TED BUNDY. ● We explain, by means of algebraic notations, the synthesis and the functional values that make up the synthesis. ● We take the Moon and Neptune as relevant bodies for the purpose of diagnosing or studying endocrine or neurohormonal issues, and Mars, Pluto, and Saturn as relevant planets for the purpose of inferring violence or sinister behaviour, upon the case, and quadratures or oppositions—and conjunctions—between Venus and the Moon, the Moon and Neptune, and the Sun or Venus and Neptune or Uranus as indicators of neurohormonal disorders and/or sexual deviance (APA definition) . ● We consider quadratures (90º) or oppositions (180º)—and conjunctions—between Mercury or the Moon and Saturn, or between Mars or the Moon and Saturn, Uranus, Neptune, and/or Pluto as powerful indications of violence or mental disorders, upon the case. ● We have also regarded Sagittarius as a sign as expansive and abundant as its ruler, Jupiter, according to the best of its characterisations (or as an exceptionally swift and wild sign, according to other characterisations), and the fifth region of a natal chart as one closely related to fortune in a broad sense (material and immaterial). ● Because we advocate the idea that orbs should be predicated of the planet (size, speed), not the aspect itself, the gas giants (Jupiter, Saturn, Uranus, and Neptune) and the Sun have been granted up to 10º of orb (or 12º, in the case of broad influence ). We understand aspectual relationships as angular relationships held between two or more celestial bodies placed in signs with at least one property in common (according to our molecular theory of the ecliptic, compatible with the optical theory of the aspects from the Hellenistic tradition). (shrink)

In computer science, Artificial Intelligence (AI), sometimes called machine intelligence, is intelligence demonstrated by machines, in contrast to the natural intelligence displayed by humans and other animals. Computer science defines AI research as the study of "intelligent agents": any device that perceives its environment and takes actions that maximize its chance of successfully achieving its goals. Deep Learning is a new field of research. One of the branches of Artificial Intelligence Science deals with the creation of theories and algorithms that (...) allow the machine to learn by simulating neurons in the human body. Most in-depth learning research focuses on finding high-level methods. The strippers analyze a large data set using linear and nonlinear transformations. The method of deep learning is used in the detection of several diseases including blood cell diseases and their classification using the radiography of blood cells to help decision makers to know the type of blood cell and its associated diseases and the results will be presented in detail and discussed. This thesis is using python language and deep learning to detect blood cell diseases and their classifications. The proposed deep learning model was trained, validated and the tested. The accuracy of proposed model was 98.00%. (shrink)

In view of the publication of the DSM-V researchers were asked to discuss the theoretical implications of the definition of mental disorders. The reasons for the use, in the DSM-III, of the term disorder instead of disease are considered. The analysis of these reasons clarifies the distinction between the general definition of disorder and its implicit, technical meaning which arises from concrete use in DSM disorders. The characteristics and limits of this technical meaning are discussed and contrasted to alternative (...) definitions, like Wakefield’s harmful/dysfunction analysis. It is shown that Wakefield’s analysis faces internal theoretical problems in addition to practical limits for its acceptance in the DSM-V. In particular, it is shown that: a) the term dysfunction is not purely factual but intrinsically normative/evaluative; b) it is difficult to clarify what dysfunctions are in the psychiatric context (the dysfunctional mechanism involved being unknown in most cases and the use of evolutionary theory being even more problematic); c) the use of conceptual analysis and commonsense intuition to define dysfunctions leaves unsatisfied empiricists; d) it is unlikely that the authors of the DSM-V will accept Wakefield’s suggestion to revise the diagnostic criteria of any single DSM disorder in accordance with his analysis, because this is an excessively extensive change and also because this would probably reduce DSM reliability. In conclusion, it is pointed up in which sense DSM mental disorders have to be conceived as constructs, and that this undermines the realistic search for a clear-cut demarcation criterion between what is disorder and what is not. (shrink)

The conditions animals experience during the early developmental stages of their lives can have critical ongoing effects on their future health, welfare, and proper development. In this paper we draw on evolutionary theory to improve our understanding of the processes of developmental programming, particularly Predictive Adaptive Responses (PAR) that serve to match offspring phenotype with predicted future environmental conditions. When these predictions fail, a mismatch occurs between offspring phenotype and the environment, which can have long-lasting health and welfare effects. (...) Examples include metabolic diseases resulting from maternal nutrition and behavioral changes from maternal stress. An understanding of these processes and their evolutionary origins will help in identifying and providing appropriate developmental conditions to optimize offspring welfare. This serves as an example of the benefits of using evolutionary thinking within veterinary science and we suggest that in the same way that evolutionary medicine has helped our understanding of human health, the implementation of evolutionary veterinary science (EvoVetSci) could be a useful way forward for research in animal health and welfare. (shrink)

In addiction, apparently causally significant phenomena occur at a huge number of levels; addiction is affected by biomedical, neurological, pharmacological, clinical, social, and politico-legal factors, among many others. In such a complex, multifaceted field of inquiry, it seems very unlikely that all the many layers of explanation will prove amenable to any simple or straightforward, reductive analysis; if we are to unify the many different sciences of addiction while respecting their causal autonomy, then, what we are likely to need is (...) an integrative framework. In this paper, we propose the theory of “Externalist” or “4E” – for extended, embodied, embedded, and enactive – cognition, which focuses on the empirical and conceptual centrality of the wider extra-neural environment to cognitive and mental processes, as a candidate for such a framework. We begin in Section 2 by outlining how such a perspective might apply to psychiatry more generally, before turning to some of the ways it can illuminate addiction in particular: Section 3 points to a way of dissolving the classic dichotomy between the “choice model” and “disease model” in the addiction literature; Section 4 shows how 4E concepts can clarify the interplay between the addict’s brain and her environment; and Section 5 considers how these insights help to explain the success of some recovery strategies, and may help to inform the development of new ones. (shrink)

Moral reasoning traditionally distinguishes two types of evil:moral (ME) and natural (NE). The standard view is that ME is the product of human agency and so includes phenomena such as war,torture and psychological cruelty; that NE is the product of nonhuman agency, and so includes natural disasters such as earthquakes, floods, disease and famine; and finally, that more complex cases are appropriately analysed as a combination of ME and NE. Recently, as a result of developments in autonomous agents in (...) cyberspace, a new class of interesting and important examples of hybrid evil has come to light. In this paper, it is called artificial evil (AE) and a case is made for considering it to complement ME and NE to produce a more adequate taxonomy. By isolating the features that have led to the appearance of AE, cyberspace is characterised as a self-contained environment that forms the essential component in any foundation of the emerging field of Computer Ethics (CE). It is argued that this goes someway towards providing a methodological explanation of why cyberspace is central to so many of CE's concerns; and it is shown how notions of good and evil can be formulated in cyberspace. Of considerable interest is how the propensity for an agent's action to be morally good or evil can be determined even in the absence of biologically sentient participants and thus allows artificial agents not only to perpetrate evil (and fort that matter good) but conversely to `receive' or `suffer from' it. The thesis defended is that the notion of entropy structure, which encapsulates human value judgement concerning cyberspace in a formal mathematical definition, is sufficient to achieve this purpose and, moreover, that the concept of AE can be determined formally, by mathematical methods. A consequence of this approach is that the debate on whether CE should be considered unique, and hence developed as a Macroethics, may be viewed, constructively,in an alternative manner. The case is made that whilst CE issues are not uncontroversially unique, they are sufficiently novel to render inadequate the approach of standard Macroethics such as Utilitarianism and Deontologism and hence to prompt the search for a robust ethical theory that can deal with them successfully. The name Information Ethics (IE) is proposed for that theory. Itis argued that the uniqueness of IE is justified by its being non-biologically biased and patient-oriented: IE is an Environmental Macroethics based on the concept of data entity rather than life. It follows that the novelty of CE issues such as AE can be appreciated properly because IE provides a new perspective (though not vice versa). In light of the discussion provided in this paper, it is concluded that Computer Ethics is worthy of independent study because it requires its own application-specific knowledge and is capable of supporting a methodological foundation, Information Ethics. (shrink)

Moral reasoning traditionally distinguishes two types of evil: moral and natural. The standard view is that ME is the product of human agency and so includes phenomena such as war, torture and psychological cruelty; that NE is the product of nonhuman agency, and so includes natural disasters such as earthquakes, floods, disease and famine; and finally, that more complex cases are appropriately analysed as a combination of ME and NE. Recently, as a result of developments in autonomous agents in (...) cyberspace, a new class of interesting and important examples of hybrid evil has come to light. In this paper, it is called artificial evil and a case is made for considering it to complement ME and NE to produce a more adequate taxonomy. By isolating the features that have led to the appearance of AE, cyberspace is characterised as a self-contained environment that forms the essential component in any foundation of the emerging field of Computer Ethics. It is argued that this goes some way towards providing a methodological explanation of why cyberspace is central to so many of CE’s concerns; and it is shown how notions of good and evil can be formulated in cyberspace. Of considerable interest is how the propensity for an agent’s action to be morally good or evil can be determined even in the absence of biologically sentient participants and thus allows artificial agents not only to perpetrate evil but conversely to ‘receive’ or ‘suffer from’ it. The thesis defended is that the notion of entropy structure, which encapsulates human value judgement concerning cyberspace in a formal mathematical definition, is sufficient to achieve this purpose and, moreover, that the concept of AE can be determined formally, by mathematical methods. A consequence of this approach is that the debate on whether CE should be considered unique, and hence developed as a Macroethics, may be viewed, constructively, in an alternative manner. The case is made that whilst CE issues are not uncontroversially unique, they are sufficiently novel to render inadequate the approach of standard Macroethics such as Utilitarianism and Deontologism and hence to prompt the search for a robust ethical theory that can deal with them successfully. The name Information Ethics is proposed for that theory. It is argued that the uniqueness of IE is justified by its being non-biologically biased and patient-oriented: IE is an Environmental Macroethics based on the concept of data entity rather than life. It follows that the novelty of CE issues such as AE can be appreciated properly because IE provides a new perspective. In light of the discussion provided in this paper, it is concluded that Computer Ethics is worthy of independent study because it requires its own application-specific knowledge and is capable of supporting a methodological foundation, Information Ethics. (shrink)

Reification is to abstraction as disease is to health. Whereas abstraction is singling out, symbolizing, and systematizing, reification is neglecting abstractive context, especially functional, historical, and analytical-level context. William James and John Dewey provide similar and nuanced arguments regarding the perils and promises of abstraction. They share an abstraction-reification account. The stages of abstraction and the concepts of “vicious abstractionism,” “/the/ psychologist’s fallacy,” and “the philosophic fallacy” in the works of these pragmatists are here analyzed in detail. For instance, (...) in 1896 Dewey exposes various fallacies associated with reifying dualistic reflex arc theory. The conclusion prescribes treatments (pluralism and assumption archaeology) for de-reifying ill models (i.e., universalized, narrowed, and ontologized models) in contemporary scientific fields such as cognitive science and biology. (shrink)

In bioethics vaccine refusal is often discussed as an instance of free riding on the herd immunity of an infectious disease. However, the social science of vaccine refusal suggests that the reasoning behind refusal to vaccinate more often stems from previous negative experiences in healthcare practice as well as deeply felt distrust of healthcare institutions. Moreover, vaccine refusal often acts like an exit mechanism. Whilst free riding is often met with sanctions, exit, according to Albert Hirschman’s theory of (...) exit and voice is most efficiently met by addressing concerns and increasing the quality and number of feedback channels. If the legitimate grievances responsible for vaccine refusal are not heard or addressed by healthcare policy, further polarization of attitudes to vaccines is likely to ensue. Thus, there is a need in the bioethics of vaccine refusal to understand the diverse ethical questions of this inflammable issue in addition to those of individual responsibility to vaccinate. (shrink)

Because the poorest people tend to die from easily preventable diseases, addressing poverty is a relatively cheap way to save lives. War, by contrast, is extremely expensive. This article argues that, since states that wage war could alleviate poverty instead, poverty can render war unjust. Two just war theory conditions prove relevant: proportionality and last resort. Proportionality requires that war does not yield excessive costs in relation to the benefits. Standardly, just war theorists count only the direct costs: the (...) death and destruction wrought by war. This article argues that it can sometimes be appropriate to add the opportunity costs of a failure to alleviate poverty. Last resort is the condition that there must be no better alternative means of achieving the same just end for which the war is waged. This article argues that there are some cases in which alleviating poverty may constitute a better alternative. These are cases in which the most fitting description of the just end for war is sufficiently general that poverty alleviation offers a means to pursue it. The idea that poverty can sometimes render war unjust has, to date, been largely overlooked. It is, nevertheless, an idea with profound implications since, once taken seriously, war becomes much harder to justify. Wars that, in every other respect, seem just may prove disproportionate or unnecessary given the alternative of alleviating poverty. (shrink)

Recent epidemiological reports of associations between socioeconomic status and epigenetic markers that predict vulnerability to diseases are bringing to light substantial biological effects of social inequalities. Here, we start the discussion of the moral consequences of these findings. We firstly highlight their explanatory importance in the context of the research program on the Developmental Origins of Health and Disease (DOHaD) and the social determinants of health. In the second section, we review some theories of the moral status of health (...) inequalities. Rather than a complete outline of the debate, we single out those theories that rest on the principle of equality of opportunity and analyze the consequences of DOHaD and epigenetics for these particular conceptions of justice. We argue that DOHaD and epigenetics reshape the conceptual distinction between natural and acquired traits on which these theories rely and might provide important policy tools to tackle unjust distributions of health. (shrink)

The definitions and conceptualizations of health, and the management of healthcare have been challenged by the current global scenarios (e.g., new diseases, new geographical distribution of diseases, effects of climate change on health, etc.) and by the ongoing scholarship in humanities and science. In this paper we question the mainstream definition of health adopted by the WHO—‘a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’ (WHO in Preamble to the constitution (...) of the World Health Organization as adopted by the international health conference, The World Health Organization, 1948)—and its role in providing tools to understand what health is in the contemporary context. More specifically, we argue that this context requires to take into account the role of the environment both in medical theory and in the healthcare practice. To do so, we analyse WHO documents dated 1984 and 1986 which define health as ‘coping with the environment’. We develop the idea of ‘coping with the environment’, by focusing on two cardinal concepts: adaptation in public health and adaptivity in philosophy of biology. We argue that the notions of adaptation and adaptivity can be of major benefit for the characterization of health, and have practical implications. We explore some of these implications by discussing two recent case studies of adaptivity in public health, which can be valuable to further develop adaptive strategies in the current pandemic scenario: community-centred care and microbiologically healthier buildings. (shrink)

Advanced medical imaging, such as CT, fMRI and PET, has undergone enormous progress in recent years, both in accuracy and utilization. Such techniques often bring with them an illusion of immediacy, the idea that the body and its diseases can be directly inspected. In this paper we target this illusion and address the issue of the reliability of advanced imaging tests as knowledge procedures, taking positron emission tomography in oncology as paradigmatic case study. After individuating a suitable notion of reliability, (...) we argue that PET is a highly theory-laden and non-immediate knowledge procedure, in spite of the photographic-like quality of the images it delivers; the diagnostic conclusions based on the interpretation of PET images are population-dependent; PET images require interpretation, which is inherently observer-dependent and therefore variable. We conclude with a three-step methodological proposal for enhancing the reliability of advanced medical imaging. (shrink)

Every year, hundreds of patients in England die whilst waiting for a kidney transplant, and this is evidence that the current system of altruistic-based donation is not sufficient to address the shortage of kidneys available for transplant. To address this problem, we propose a monopsony system whereby kidney donors can opt-in to receive financial compensation, whilst still preserving the right of individuals to donate without receiving any compensation. A monopsony system describes a market structure where there is only one ‘buyer’—in (...) this case the National Health Service. By doing so, several hundred lives could be saved each year in England, wait times for a kidney transplant could be significantly reduced, and it would lessen the burden on dialysis services. Furthermore, compensation would help alleviate the common disincentives to living kidney donation, such as its potential associated health and psychological costs, and it would also help to increase awareness of living kidney donation. The proposed system would also result in significant cost savings that could then be redirected towards preventing kidney disease and reducing health disparities. While concerns about exploitation, coercion, and the ‘crowding out’ of altruistic donors exist, we believe that careful implementation can mitigate these issues. Therefore, we recommend piloting financial compensation for living kidney donors at a transplant centre in England. (shrink)