Philosophers of medicine have formulated different accounts of the concept of disease. Which concept of disease one assumes has implications for what conditions count as diseases and, by extension, who may be regarded as having a disease and for who may be accorded the social privileges and personal responsibilities associated with being sick. In this article, we consider an ideal diagnostic test for coronavirus disease 2019 infection with respect to four groups of people—positive and (...) asymptomatic; positive and symptomatic; negative; and untested—and show how different concepts of disease impact on the disease and sickness judgements for these groups. The suggestion is that sickness judgements and social measures akin to those experienced during the current COVID-19 outbreak presuppose a concept of disease containing social harm as a component. We indicate the problems that arise when adopting this kind of disease concept beyond a state of emergency. (shrink)

In this paper we focus on some new normativist positions and compare them with traditional ones. In so doing, we claim that if normative judgments are involved in determining whether a condition is a disease only in the sense identified by new normativisms, then disease is normative only in a weak sense, which must be distinguished from the strong sense advocated by traditional normativisms. Specifically, we argue that weak and strong normativity are different to the point that one (...) ‘normativist’ label ceases to be appropriate for the whole range of positions. If values and norms are not explicit components of the concept of disease, but only intervene in other explanatory roles, then the concept of disease is no more value-laden than many other scientific concepts, or even any other scientific concept. We call the newly identified position “value-conscious naturalism” about disease, and point to some of its theoretical and practical advantages. (shrink)

The idea of disease as an objective malfunctioning cannot be accepted for many different reasons. “Malfunctioning” or “failure” have a meaning only if the perfect working condition or normality is univocally determined. The differences between a person and any other person are not unimportant and cannot be ignored neither in diagnosis nor in treatment. These differences can be ascribable to three different sets of reasons: 1.illnesses leave irreversible marks on the organic structure, for they modify the information an organism (...) has at least as far as the neuroendocrine and immune systems are involved; 2.there are individual differences in the immune system; 3.there are individual differences in the functional organization of the brain that are not due only to biological causes. Furthermore the subjective perception of the illness itself must be included among the elements that determine the features of an illness. Notwithstanding the presence of the same symptoms and the same tests readings, two people may perceive their illness in a different way, with effects on the course of the illness itself and the effectiveness of the treatment. The idea of disease also depends on the cultural context. (shrink)

If one had to identify the biggest change within the philosophical tradition in the twenty-first century, it would certainly be the rapid rise of experimental philosophy to address differences in intuitions about concepts. It is, therefore, surprising that the philosophy of medicine has so far not drawn on the tools of experimental philosophy in the context of a particular conceptual debate that has overshadowed all others in the field: the long-standing dispute between so-called naturalists and normativists about the concepts of (...) health and disease. In this paper, I defend and advocate the use of empirical methods to inform and advance this and other debates within the philosophy of medicine. (shrink)

Vaccination complacency occurs when perceived risks of vaccine-preventable diseases are sufficiently low so that vaccination is no longer perceived as a necessary precaution. Disease outbreaks can once again increase perceptions of risk, thereby decrease vaccine complacency, and in turn decrease vaccine hesitancy. It is not well understood, however, how change in perceived risk translates into change in vaccine hesitancy. -/- We advance the concept of vaccine propensity, which relates a change in willingness to vaccinate with a change in (...) perceived risk of infection—holding fixed other considerations such as vaccine confidence and convenience. (shrink)

Identifying the necessary and sufficient conditions for individuating and classifying diseases is a matter of great importance in the fields of law, ethics, epidemiology, and of course, medicine. In this paper, I first propose a means of achieving this goal, ensuring that no two distinct disease-types could correctly be ascribed to the same disease-token. I then posit a metaphysical ontology of diseases—that is, I give an account of what a disease is. This is essential to providing the (...) most effective means of interfering with disease processes. Following existing work in the philosophy of medicine and epidemiology (primarily Christopher Boorse; Caroline Whitbeck; Alexander Broadbent), philosophy of biology (Joseph LaPorte; D.L. Hull), conditional analyses of causation (J.L. Mackie; David Lewis), and recent literature on dispositional essentialism (Stephen Mumford and Rani Anjum; Alexander Bird), I endorse a dispositional conception of disease. Following discussion of various conceptions of disease-identity, their relations to the clinical and pathological effects of the diseases in question, and how diseases are treated, I conclude (i) that diseases should be individuated by their causes, and (ii) that diseases are causal processes best seen as simultaneously acting sequences of mutually manifesting dispositions. (shrink)

A large part of the contemporary phenomenology of medicine has been devoted to accounts of health and illness, arguing that they contribute to the improvement of health care. Less focus has been paid to the issue of prevention of disease and the associated difficulty of adhering to health-promoting behaviours, which is arguably of equal importance. This article offers a phenomenological account of this disease prevention, focusing on how we—as embodied beings—engage with health-promoting behaviours. It specifically considers how we (...) engage with oral hygiene regimens to prevent periodontitis and why we are not good at it. The article suggests that poor adherence to health-promoting behaviours can be explained with reference to the concept of the absent body, because prevention of disease is generally concerned with pre-symptomatic illness experience. The final section contains a discussion of some strategies for the improvement of disease prevention based on this viewpoint. (shrink)

While philosophical questions about health and disease have attracted much attention in recent decades, and while opinions are divided on most issues, influential accounts seem to embrace negativism about health, according to which health is the absence of disease. Some subscribe to unrestricted negativism, which claims that negativism applies not only to the concepts of health and disease as used by healthcare professionals but also to the lay concept that underpins everyday thinking. Whether people conceptualize health (...) in this manner has implications for medical care and public health, and so we set out to examine this claim in two studies. Participants were asked to assess and compare the health states of two people presented in two vignettes. We found that both lay people and medical students conceptualize health as something more than the absence of disease. We argue that our findings highlight a need to rethink unrestricted negativism and indicate a need to rethink the way the debate has traditionally focused on disease. (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)

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)

Eli Feiring has developed a concept of forward-looking responsibility in healthcare. On this account, what matters morally in the allocation of scarce healthcare resources is not people's past behaviours but rather their commitment to take on lifestyles that will increase the benefit acquired from received treatment. According to Feiring, this is to be preferred over the backward-looking concept of responsibility often associated with luck egalitarianism. The article critically scrutinises Feiring's position. It begins by spelling out the wider implications (...) of Feiring's view. Against this background, it shows that (i) Feiring's distinction between backward-looking and forward-looking responsibility is incompatible with the Scanlonian notion of responsibility she apparently endorses; (ii) her favoured forward-looking notion of responsibility is subject to the objections levelled against the luck egalitarian view (whatever the strength of such objections). (shrink)

The influence of Kurt Goldstein on the thinking of Georges Canguilhem extended throughout his entire work. This paper seeks to examine this relationship in order to conduct a study of the norm as a nexus or connection between the concept and life. Consequently, this work will be a reflection on the approach to life as a normative activity and self-realization. For this, it will be necessary to redefine the concepts of health and disease, and make a crossover between (...) the two. At the end of this trajectory, it will be found that these concepts can explain the identity between the concept and life, which leads to the unexpected conclusion that the cure is ultimately self-healing. (shrink)

At present, psychiatric disorders are characterized descriptively, as the standard within the scientific community for communication and, to a certain extent, for diagnosis, is the DSM, now at its fifth edition. The main reasons for descriptivism are the aim of achieving reliability of diagnosis and improving communication in a situation of theoretical disagreement, and the Ignorance argument, which starts with acknowledgment of the relative failure of the project of finding biomarkers for most mental disorders. Descriptivism has also the advantage of (...) capturing the phenomenology of mental disorders, which appears to be essential for diagnosis, though not exhaustive of the nature of the disease. I argue that if we rely on the distinction between conceptions (procedures of identification) and concepts (reference-fixing representations), which was introduced in the philosophical debate on the nature of concepts, we may understand a limited but valid role for descriptive characterizations, and reply to common objections addressed by those who advocate a theoretically informed approach to nosology. (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)

Let’s begin by imagining a hypothetical psychotic illness called “Schneider’s Disease”, recognized for over 100 years. Let’s assume there has been great controversy as regards the “most valid” set of diagnostic criteria for SD.

Abstract: At present, psychiatric disorders are characterized descriptively, as the standard within the scientific community for communication and, to a cer- tain extent, for diagnosis, is the DSM, now at its fifth edition. The main rea- sons for descriptivism are the aim of achieving reliability of diagnosis and improving communication in a situation of theoretical disagreement, and the Ignorance argument, which starts with acknowledgment of the relative fail- ure of the project of finding biomarkers for most mental disorders. Descrip- tivism (...) has also the advantage of capturing the phenomenology of mental dis- orders, which appears to be essential for diagnosis, though not exhaustive of the nature of the disease. I argue that if we rely on the distinction between conceptions (procedures of identification) and concepts (reference-fixing representations), which was introduced in the philosophical debate on the nature of concepts, we may understand a limited but valid role for descrip- tive characterizations, and reply to common objections addressed by those who advocate a theoretically informed approach to nosology. (shrink)

Organismal death is foundational to the evolution of life, and many biological concepts such as natural selection and life history strategy are so fashioned only because individuals are mortal. Organisms, irrespective of their organization, are composed of basic functional units—cells—and it is our understanding of cell death that lies at the heart of most general explanatory frameworks for organismal mortality. Cell death can be exogenous, arising from transmissible diseases, predation, or other misfortunes, but there are also endogenous forms of death (...) that are sometimes the result of adaptive evolution. These endogenous forms of death—often labeled programmed cell death, PCD—originated in the earliest cells and are maintained across the tree of life. Here, we consider two problematic issues related to PCD (and cell mortality generally). First, we trace the original discoveries of cell death from the nineteenth century and place current conceptions of PCD in their historical context. Revisions of our understanding of PCD demand a reassessment of its origin. Our second aim is thus to structure the proposed origin explanations of PCD into coherent arguments. In our analysis we argue for the evolutionary concept of PCD and the viral defense-immunity hypothesis for the origin of PCD. We suggest that this framework offers a plausible account of PCD early in the history of life, and also provides an epistemic basis for the future development of a general evolutionary account of mortality. (shrink)

In the present paper, we shall discuss the notion of prototype and show its benefits. First, we shall argue that the prototypes of common-sense concepts are necessary for making prompt and reliable categorisations and inferences. However, the features constituting the prototype of a particular concept are neither necessary nor sufficient conditions for determining category membership; in this sense, the prototype might lead to conclusions regarded as wrong from a theoretical perspective. That being said, the prototype remains essential to handling (...) most ordinary situations and helps us to perform important cognitive tasks. To exemplify this point, we shall focus on disease concepts. Our analysis concludes that the prototypical conception of disease is needed to make important inferences from a practical and clinical point of view. Moreover, it can still be compatible with a classical definition of disease, given in terms of necessary and sufficient conditions. In the first section, we shall compare the notion of stereotype, as it has been introduced in philosophy of language by Hilary Putnam, with the notion of prototype, as it has been developed in the cognitive sciences. In the second section, we shall discuss the general role of prototypical information in cognition and stress its centrality. In the third section, we shall apply our previous discussion to the specific case of medical concepts, before briefly summarising our conclusions in section four. (shrink)

Our goal in this paper is to articulate a precise concept of at least a certain kind of disease-mongering, showing how pharmaceutical marketing can commercially exploit certain diseases when their best definition is given through the success of a treatment in a clinical trial. We distinguish two types of disease-mongering according to the way they exploit the definition of the trial population for marketing purposes. We argue that behind these two forms of disease-mongering there are two (...) well-known problems in the statistical methodology of clinical trials (the reference class problem and the distinction between statistical and clinical significance). Overcoming them is far from simple. (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)

There is a lot of conceptual engineering going on in medical research. I substantiate this claim with two examples, the medical debate about cancer classification and about obesity as a disease I also argue that the proper target of conceptual engineering in medical research are experts’ conceptions. These are explicitly written down in documents and guidelines, and they bear on research and policies. In the second part of the chapter, I propose an externalist framework in which conceptions have both (...) the explanatory power of psychological concepts and that of semantic concepts. It is likely, however, that human activities and practices distinct from medical research, and regulated by different practices and epistemic rules, call for different targets for conceptual engineering. I conclude with indicating an open agenda of problems for philosophers of medicine interested in conceptual engineering. (shrink)

Claims about whether or not infertility is a disease are sometimes invoked to defend or criticize the provision of state-funded treatment for infertility. In this paper, I suggest that this strategy is problematic. By exploring infertility through key approaches to disease in the philosophy of medicine, I show that there are deep theoretical disagreements regarding what subtypes of infertility qualify as diseases. Given that infertility's disease status remains unclear, one cannot uncontroversially justify or undermine its claim to (...) medical treatment by claiming that it is or is not a disease. Instead of focusing on disease status, a preferable strategy to approach the debate about state-funded treatment is to explicitly address the specific ethical considerations raised by infertility. I show how this alternative strategy can be supported by a recent theoretical framework in the philosophy of medicine, which avoids the problems associated with the concepts of health and disease. (shrink)

On 11 March 2020, the World Health Organization declared a pandemic of the COVID-19 coronavirus disease that was first recognized in China in late 2019. Among the primary effects caused by the pandemic, there was the dissemination of health preventive measures such as physical distancing, travel restrictions, self-isolation, quarantines, and facility closures. This includes the global disruption of socio-economic systems including the postponement or cancellation of various public events (e.g., sporting, cultural, or religious), supply shortages and fears of the (...) same, schools and universities closure, evacuation of foreign citizens, a rise of unemployment, changes in the international aid schemes, misinformation, and incidents of discrimination toward people affected by or suspected of having the COVID-19 disease. The pandemic has brought to the fore unpreparedness in critical areas that require attention, amid prospects and challenges. Moreover, considerable reorganization efforts are required with implications for assets, resources, norms, and value systems. COVID-19 is challenging the concept of globalization and stimulating responses at the levels of local and regional socio-economic systems that lead to the mobilization of assets that have been unrecognized earlier on, such as various forms of economic capital, social capital, cultural capital, human capital, and creative capital. For example, through digital channels, local groups are forming to create schemes of support for physical and mental wellbeing. These emerging exchanges lead to various social and technological innovations by building on skills and assets that are less important in the free-market economy, such as empathy, skills for crafts, making and fixing; locally grown microgreens; and micromanufacturing. Isolation and local living are also making it much harder to ignore the civic responsibilities towards communities, meant as individuals, vulnerable groups, and local businesses. Whilst the pandemic is limiting physical participation, this challenging time is uncovering alternative ways of mutual support, which may create long-term benefits for socio-economic systems, including environmental and biodiversity protection, reduction of the air pollution, and climate action. The pandemic’s threat to public health will hopefully be overcome with implications for disruption for an extended period that we are unable to forecast at this stage. It is key to focus on studies recognizing the activities and interventions leading to the recovery of socio-economic systems after the pandemic. Reflecting and planning on how societies and economies will go back to “business as usual” requires new forms of communication and cooperation, imaginative design thinking, new styles of management, as well as new tools and forms of participation in various public policies. Many questions related to the care of the vulnerable, economic restart, and the risk of future pandemics, to mention but a few, are already occupying the academic, scientific, experts, and activist communities, who have started to imagine the “new normal.”. (shrink)

The focal point of this chapter is to discuss the concept of computer regulated testing and its implications in an era of Severe Acute Respiratory Syndrome (SARS) related infection pandemics. This is especially significant because during the outbreak of most SARS-related diseases (like the COVID-19), social and physical distancing is advocated by the government of different nations. SARS-related diseases are caused by a virus known as the coronavirus which affects the respiration of infected persons or animals. These diseases can (...) be spread through air if droplets from an infected get to a non-tainted individual. (shrink)

This dissertation explores the idea and ethics of vaccination for the sake of others. It conceptually distinguishes four different kinds of vaccination—self-protective, paternalistic, altruistic, and indirect—based on who receives the primary benefits of vaccination and who ultimately makes the vaccination decision. It describes the results of focus group studies that were conducted to investigate what people who might get vaccinated altruistically think of this idea. It also applies the different kinds of vaccination to ethical issues surrounding COVID-19, such as lockdown (...) measures, routine or mandatory vaccination of healthy children, and the ethical justification of restrictive measures for unvaccinated people. A more general philosophical account of vaccination ethics is ultimately developed, which is based not on moral duties, but on the moral reasons that people may have to get vaccinated for the sake of others. It is argued that such reasons may be stronger or weaker, depending on various factors related to the vaccines in question and the specific epidemiological circumstances. (shrink)

In various documents the view emerges that contemporary biotechnosciences are currently experiencing a scientific revolution: a massive increase of pace, scale and scope. A significant part of the research endeavours involved in this scientific upheaval is devoted to understanding and, if possible, ameliorating humankind: from our genomes up to our bodies and brains. New developments in contemporary technosciences, such as synthetic biology and other genomics and “post-genomics” fields, tend to blur the distinctions between prevention, therapy and enhancement. An important dimension (...) of this development is “biomimesis”: i.e. the tendency of novel technologies and materials to mimic or plagiarize nature on a molecular and microscopic level in order to optimise prospects for the embedding of technological artefacts in natural systems such as human bodies and brains. In this paper, these developments are read and assessed from a psychoanalytical perspective. Three key concepts from psychoanalysis are used to come to terms with what is happening in research laboratories today. After assessing the general profile of the current revolution in this manner, I will focus on a particular case study, a line of research that may serve as exemplification of the vicissitudes of contemporary technosciences, namely viral biomaterials. Viral life forms can be genetically modified (their genomes can be rewritten) in such a manner that they may be inserted in human bodies in order to produce substances at specific sites such as hormones (testosterone), neurotransmitters (dopamine), enzymes (insulin) or bone and muscle tissue. Notably, certain target groups such as top athletes, soldiers or patients suffering from degenerative diseases may become the pioneers serving as research subjects for novel applications. The same technologies can be used for various purposes ranging from therapy up to prevention and enhancement. (shrink)

This paper explores how the diagnosis of mental disorder may affect the diagnosed subject’s self-concept by supplying an account that emphasizes the influence of autobiographical and social narratives on self-understanding. It focuses primarily on the diagnoses made according to the criteria provided by the Diagnostic Statistical Manual of Mental Disorders (DSM), and suggests that the DSM diagnosis may function as a source of narrative that affects the subject’s self-concept. Engaging in this analysis by appealing to autobiographies and memoirs (...) written by people diagnosed with mental disorder, the paper concludes that a DSM diagnosis is a double-edged sword for self- concept. On the one hand, it sets the subject’s experience in an established classificatory system which can facilitate self-understanding by providing insight into subject’s condition and guiding her personal growth, as well as treatment and recovery. In this sense, the DSM diagnosis may have positive repercussions on self-development. On the other hand, however, given the DSM’s symptom-based approach and its adoption of the Biomedical Disease model, a diagnosis may force the subject to make sense of her condition divorced from other elements in her life that may be affecting her mental- health. It may lead her frame her experience only as an irreversible imbalance. This form of self-understanding may set limits on the subject’s hopes of recovery and may create impediments to her flourishing. (shrink)

The concept of transhumanism is based on a specific understanding of human limitations that should or could be transcended. Among them, the question of overcoming our own corporeality through the delaying of ageing or death is of major importance for a new understanding of human plasticity and fluidity when shaping ourselves and our environment. As transhumanism advocates for human enhancement through technological means, it considers ageing and death as diseases and criticizes their necessity in the human evolutionary process. In (...) light of this transhumanist question, this article discusses ageing and death as diseases for which there must be technological solutions. It underlines that a philosophical approach is necessary to highlight how correlated and interrelated those subjects are and tries to go beyond humanist dichotomies to make clearer how major notions (health, enhancement, etc.) are intertwined with each other and consequently shape our socio-political subjectivities. Given this context, this article discusses the fact that medicine is traditionally structured on a limit that seems to be more and more plastic to pave the way for new debates, such as human enhancement, morphological freedom, and biocultural capital. It then discusses how transhumanism tries to transcend what is considered human structures by examining death as a fatal degeneration that could be overcome through biological amortality and informational immortality. (shrink)

Group-based reasons are reasons to play one’s part in some pattern of action that the members of some group could perform, because of the good features of the pattern. This paper discusses three broad conceptions of such reasons. According to the agency-first conception, there are no group-based reasons in cases where the relevant group is not or would not be itself an agent. According to the behaviour-first conception, what matters is that the other members of the group would play their (...) parts in the relevant pattern, not whether they would have the cooperative intentional states constitutive of group agency in doing so. This paper argues against these conceptions and in favour of the powers-first conception, according to which what matters is that the members of the group have practically relevant powers. (shrink)

To be effective, a medical intervention must improve one's health by targeting a disease. The concept of disease, though, is controversial. Among the leading accounts of disease-naturalism, normativism, hybridism, and eliminativism-I defend a version of hybridism. A hybrid account of disease holds that for a state to be a disease that state must both (i) have a constitutive causal basis and (ii) cause harm. The dual requirement of hybridism entails that a medical intervention, to (...) be deemed effective, must target either the constitutive causal basis of a disease or the harms caused by the disease (or ideally both). This provides a theoretical underpinning to the two principle aims of medical treatment: care and cure. (shrink)

Harry Frankfurt had insightfully pointed out that an agent acts freely when he acts in accord with the mental states with which he identifies. The concept of identification rightly captures the ownership condition (something being one’s really own), which plays a significant role in the issues of freedom and moral responsibility. For Frankfurt, identification consists of one’s forming second-order volitions, endorsing first-order desires, and issuing in his actions wholeheartedly. An agent not only wants to φ but also fully embraces (...) his desire to φ (and φ). Frankfurt’s official theory above encounters some serious problems, especially since it is believed that his concept of wholehearted identification is too strong to be necessary for freedom. In this paper, I propose that we can uncouple identification from wholeheartedness and thus get two different senses of identification: weak identification and strong identification. Then, I argue that this distinction does a better job than Frankfurt’s official theory. On the one hand, weak identification is enough for ownership and freedom and thus more promising than strong identification; on the other hand, this distinction has an attractive implication that it fits well with our intuition about the degree of freedom and responsibility. (shrink)

Are psychiatric disorders natural kinds? This question has received a lot of attention within present-day philosophy of psychiatry, where many authors debate the ontology and nature of mental disorders. Similarly, historians of psychiatry, dating back to Foucault, have debated whether psychiatric researchers conceived of mental disorders as natural kinds or not. However, historians of psychiatry have paid little to no attention to the influence of (a) theories within logic, and (b) theories within metaphysics on psychiatric accounts of proper method, and (...) on accounts of the nature and classification of mental disorders. Historically, however, logic and metaphysics have extensively shaped methods and interpretations of classifications in the natural sciences. This paper corrects this lacuna in the history of psychiatry, and demonstrates that theories within logic and metaphysics, articulated by Christian Wolff (1679-1754), have significantly shaped the conception of medical method and (psychiatric) nosology of the influential nosologist Boissier De Sauvages (1706-1767). After treating Sauvages, I discuss the method of the influential nosologist William Cullen (1710-1790), and demonstrate the continuity between the classificatory methods of Sauvages and Cullen. I show that both Sauvages and Cullen were essentialists concerning medical diseases in general and psychiatric disorders in particular, contributing to the history of conceptions of the ontology and nature of mental disorders. (shrink)

There are several conceptions of man in the history of philosophy. However, two considerable tendencies are recurring throughout modern history. A human being can be perceived as a complex mechanism or as a living organism. The response to the query has essential consequences in different areas. The article aims to provide a view of humankind that builds upon an organic conception of life, nature, and human beings, especially as elaborated by A. N. Whitehead and some of his followers. The article (...) also briefly examines the emergence and development of a mechanistic view. The historical overview exposes the close relationship between the worldview of a given era and the understanding of man. Finally, the article argues that the organic conceptions of life developed in the first half of the 20th century provide an essential alternative to mechanistic views and could help us to deal with several problems we are currently encountering. (shrink)

Suppose we consider knowledge to be valuable because of the role known propositions play in practical reasoning. This, I argue, does not provide a reason to think that knowledge is valuable in itself. Rather, it provides a reason to think that true belief is valuable from one standpoint, and that justified belief is valuable from another standpoint, and similarly for other epistemic concepts. The value of the concept of knowledge is that it provides an economical way of talking about (...) many epistemic concepts that are valuable in itself from one standpoint or another. In this way knowledge is like a Swiss Army Knife; a Swiss Army Knife is not useful as such on any occasion, but it provides an efficient way of carrying around different tools that are useful in themselves on different occasions. (shrink)

"Our literature is replete with complaints about the chaotic state of the systematics of psychoses and every psychiatrist knows that it is impossible to come to any common understanding on the basis of the old diagnostic labels. ... Thus, not even the masters of science can make themselves understood on the basis of the old concepts and with many patients the number of diagnoses made equals the number of institutions they have been too. ... Errors are the greatest obstacles to (...) the progress of science; to correct such errors is of more practical value than to achieve new knowledge. We have here eliminated chaos of terms behind which useful concepts of disease were mistakenly sought; we have eliminated a veritable forest of boundary posts, not one of which indicated any natural line of demarcation. ... By the term „dementia praecox“ or „schizophrenia“ we designate a group of psychoses whose course is at times chronic, at times marked by intermittent attacks, and which can stop or retrograde at any stage, but does not permit a full restitutio ad integrum. The disease is characterized by a specific type of alteration of thinking, feeling, and relation to the external world which appears nowhere else in this particular fashion." Eugen Bleuler. Dementia Praecox or the Group of Schizophrenias. Translated by Joseph Zinkin. International Universities Press, New York, 1950. (shrink)

The epidemiologist Bradford Hill famously argued that in epidemiology, specificity of association (roughly, the fact that an environmental or behavioral risk factor is associated with just one or at most a few medical outcomes) is strong evidence of causation. Prominent epidemiologists have dismissed Hill’s claim on the ground that it relies on a dubious `one-cause one effect’ model of disease causation. The paper examines this methodological controversy, and argues that specificity considerations do have a useful role to play in (...) causal inference in epidemiology. More precisely, I argue that specificity considerations help solve a pervasive inferential problem in contemporary epidemiology: the problem of determining whether an exposure-outcome correlation might be due to confounding by a social factor. This examination of specificity has interesting consequences for our understanding of the methodology of epidemiology. It highlights how the methodology of epidemiology relies on local tools designed to address specific inference problems peculiar to the discipline, and shows that observational causal inference in epidemiology can proceed with little prior knowledge of the causal structure of the phenomenon investigated. I also argue that specificity of association cannot (despite claims to the contrary) be entirely explained in terms of Woodward’s well-known concept of “one-to-one” causal specificity. This is because specificity as understood by epidemiologists depends on whether an exposure (or outcome) is associated with a `heterogeneous’ set of variables. This dimension of heterogeneity is not captured in Woodward’s notion, but is crucial for understanding the evidential import of specificity of association. (shrink)

The modern concept of ideology was established by the liberal politician and philosopher Destutt de Tracy, with the objective of creating an all-embracing and general science of ideas, which followed the sensualist and empiricist trend initiated by Locke that culminated in the positivism of Comte. Natural selection and immunity are two key concepts in the history of biology that were strongly based on the Malthusian concept of struggle for existence. This concept wrongly assumed that population grew faster (...) than the means of existence. This “natural” law contained implicitly the idea that the poor and least gifted would not survive. This idea led to the progressive development of the concept of natural selection, whose definitive version was given by Darwin. Mechnikov took the concepts of struggle for existence and natural selection and conceived infectious diseases as a struggle between a host and its invader, the so-called phagocytosis theory. This theory created the necessity to possess mechanisms to discriminate between the own and the foreign, and led to the conception of the immune self. These concepts were not developed from ideas coming from perceptions or sensations, but from ideas coming from their values: individual interest, inevitable inequality, property, utility and profit. Values are ideals that constitute an ideological matrix which exerts a numinous activity and influence the development of our future actions. In consequence, science and its practice cannot avoid and ignore the values that drive them and impulse them towards certain directions. (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)

In this article we argue that the social value of health research should be conceptualized as a function of both the expected benefits of the research and the priority that the beneficiaries deserve. People deserve greater priority the worse off they are. This conception of social value can be applied for at least two important purposes: in health research priority setting when research funders, policy-makers, or researchers decide between alternative research projects; and in evaluating the ethics of proposed research proposals (...) when research ethics committees assess whether the social value of the research is sufficient to justify the risks and burdens to research participants and others. In assessing how far a proposed research project will advance the interests of people who are more disadvantaged, research priority setters and RECs should examine the diseases that the research targets and the type of research. Just as certain diseases impose a greater burden on people who are more disadvantaged, so certain types of intervention and forms of research are more likely to benefit people who are more disadvantaged. We outline which populations are likely to be representative of the global worst off and identify what types of health research, and which disease categories, are priorities for these populations. (shrink)

Praktykowanie teorii. Koncepty wczesnych prac Daniela Libeskinda jako wzorce realnej architektury Treści wczesnych prac Libeskinda, w tym zwłaszcza idee zawarte w cyklach rysunków pod nazwą Micromegas: The Architecture of End Space (1979) i Chamber Works: Architectural Meditations on the Themes from Heraclitus (1983) oraz trzy maszyny określone jako Three Lessons in Architecture (1985) w decydujący sposób wpłynęły na wszystkie późniejsze realizacje architekta. Prace te w dużym zakresie zmieniły zasady oddzielania teorii od praktyki budowlanej, w tym tak- że odgraniczania architektury od (...) literatury czy filozofii. Już Micromegas były polemiką z traktowaniem rysunku architektonicznego wyłącznie jako utylitarnego narzędzia w procesie stwarzania budowli i postawiły na uczynienie z tej techniki pełnoprawnej postaci realnej architektury. Chamber Works w jeszcze większym stopniu niż prace z serii Micromegas akcentowały samodzielność rysunku i jego odrębność od wszelkiej rzeczywistości czy zewnętrznych źródeł treści. Maszyny połączone w Three Lessons in Architecture streszczały dokonania dawnych epok historii sztuki budowania. Reading Machine opowiadała o rzemieślniczych początkach, Memory Machine o intelektualizmie okresu nowożytnego, Writing Machine zaś o współczesnym okresie mechanizacji pamięci i kreacji. Zadaniem maszyn była metafizyczna refleksja nad głównymi założeniami i mitami architektury, a zarazem przeniesienie tej refleksji na poziom doświadczenia zmysłowego. W berlińskim Jüdisches Museum wymyślone liternictwo architektoniczne połączyło się z narracją na temat zagłady żydowskich mieszkańców miasta. Libeskind wykreował nie tyle budowlę,ile literacką relację o zbrodni przełamującej historię ludzkość. (shrink)

This paper presents a conception of corruption informed by epistemic democratic theory. I first explain the view of corruption as a disease of the political body. Following this view, we have to consider the type of actions that debase a political entity of its constitutive principal in order to assess corruption. Accordingly, we need to consider what the constitutive principle of democracy is. This is the task I undertake in the second section where I explicate democratic legitimacy. I present (...) democracy as a procedure of social inquiry about what ought to be done that includes epistemic and practical considerations. In the third section, I argue that the problem of corruption for a procedural conception of democracy is that the epistemic value of the procedure is diminished by corrupted agents’ lack of concern for truth. Corruption, according to this view, consists in two deformities of truth: lying and bullshit. These deformities corrupt since they conceal private interests under the guise of a concern for truth. In the fourth section, I discuss the difficulties a procedural account may face in formulating solutions to the problem of corruption. (shrink)

This paper aims to recover the history of health concept evolution from its birth in Ancient Greece to the contemporary days, drawing an overview of the firsts philosophical thoughts about health in distinctive historical periods, analyzing how this concept has been impacted by knowledge improvement and both research and technological discoveries over time. In order to understand the persistence of Neglected Tropical Diseases which causes physical disabilities and social discrimination, this paper will focus on Leprosy and Cutaneous Leishmaniasis (...) and its relation to social inequality mainly in developing countries. These approaches on the understanding of the health-disease binomial are necessary to reflect on health in the course of human history and, from there, to promote joint actions both in the area of scientific research and health education. (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)

The paper describes the work of the Czech physician Ctibor Bezděk and his relation to the Russian philosopher Nikolai Lossky. The study examines Bezděk’s ethical theories (i.e. ‘ethicotherapy’) which he tried to incorporate into Medicine and focuses particularly on the role of intuition in Bezděk’s approach to Medicine, comparing it with the concepts of intuition and of substantival agents elaborated by Lossky. Lossky’s theories about disease and healing influenced several physicians and psychiatrists, and his work also received support from (...) T.G. Masaryk. Although he has been included among the pioneers of psychotherapy, Bezděk still remains unknown in the Czech Republic. The present study aims to introduce Ctibor Bezděk and his contributions to a wider audience. (shrink)

Mosquito-borne diseases represent a significant global disease burden, and recent outbreaks of such diseases have led to calls to reduce mosquito populations. Furthermore, advances in ‘gene-drive’ technology have raised the prospect of eradicating certain species of mosquito via genetic modification. This technology has attracted a great deal of media attention, and the idea of using gene-drive technology to eradicate mosquitoes has been met with criticism in the public domain. In this paper, I shall dispel two moral objections that have (...) been raised in the public domain against the use of gene-drive technologies to eradicate mosquitoes. The first objection invokes the concept of the ‘sanctity of life’ in order to claim that we should not drive an animal to extinction. In response, I follow Peter Singer in raising doubts about general appeals to the sanctity of life, and argue that neither individual mosquitoes nor mosquitoes species considered holistically are appropriately described as bearing a significant degree of moral status. The second objection claims that seeking to eradicate mosquitoes amounts to displaying unacceptable degrees of hubris. Although I argue that this objection also fails, I conclude by claiming that it raises the important point that we need to acquire more empirical data about, inter alia, the likely effects of mosquito eradication on the ecosystem, and the likelihood of gene-drive technology successfully eradicating the intended mosquito species, in order to adequately inform our moral analysis of gene-drive technologies in this context. (shrink)

This academic paper on Ethical issues of using umbilical cord blood stem cell therapy of John Stuart Mill perspective aim to investigate the new approaches in the treatment of diseases by using umbilical cord blood stem cells. And also to study ethical issues from the use of umbilical cord blood stem cells in the treatment of diseases considered by Mill’s utilitarianism. 21st century, the medical industry was interested in organ transplantation from stem cells especially stem cells from the umbilical cord (...) to treat chronic and degenerative organ diseases, blood cancer and organ transplantation which successful and widespread throughout the world. Thailand has about 900 new children with Leukemia every year. About 50 percent are leukemia which needs to be treated correctly and urgently. In general Standardized chemotherapy but if the cancer patient has a bad prognosis Or have recurrent cancer Patients need to be treated with bone marrow transplants or stem cells to have a chance to heal. According to Mill’s Utilitarianism, the ethical concepts that determine what is the basic criterion used to determine whether it should or should not concern with the popular benefit that the criterion used is the amount of happiness that results from actions. Treating the disease using stem cells will make the patient recover from the disease, healthier and happier in life. As Mill said "The correctness of an action depends on the tendency that the action will lead to happiness. (shrink)

Aim of Ayurveda is to build a society through building an individual with ideal norms and character. In explanation of hitayu it has been clearly stated that one should follow norms of hitayu for sound health and ideal society. To maintain the health and prevent somatic and psychic diseases course of health education is prescribed based on adhyatma gyana. Promotion of physical and mental health and for improvement of morality in society is a specific concept of Achara rasayana based (...) on adhyatma gyana. A new approach to explore three dimensional health education in preventive, promotive and absolute health has been done and there is role of adhyatma in strata of preventive in form of sadavritta, promotive in form of achara rasayana and absolute through moksha marga. All these can only be achieved once adhyatma gyana is present. (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)

This paper provides a philosophical evaluation of the concept of handedness prevalent but largely unspoken in the scientific literature. This literature defines handedness as the preference or ability to use one hand rather than the other across a range of common activities. Using the philosophical discipline of phenomenology, I articulate and critique this conceptualization of handedness. Phenomenology shows defining a concept of handedness by focusing on hand use leads to a right hand biased concept. I argue further (...) that a phenomenological model based in spatial orientation rather than hand use provides a more inclusive concept of handedness. (shrink)

The fundamental principle holds a strong ground in Ayurveda. Every medical stream has its own science in which its matter is developed, evolved and explained. From creation of living to issues of health, disease and its treatment these fundamental principles are the root. These can be enumerated as Tridosha, Panchamahabhuta, Prakriti, Ojas, Dhatu, Mala, Agni, Manas, Atma etc. They are most unique and original approach to the material creation and it has all scope to incorporate the modern development in (...) the elemental physics. The aim of Ayurveda is to maintain the proper equilibrium of dosa, dhatus, and mala constituent in order to preserve health in a healthy person and cure a disease in a diseased person.The presence of cognition as well as the absence of cognition is an indication of the mind. In the presence of senses with senses object and soul the man does not perceive a thing in the absence of mind that is to say that senses are unable to grasp the object in the absence of Manas. The term Ojas has been used in Ayurveda for the factor which prevents decay and degeneratioif the body and provides strength and support against a disease. Concept of Agni which incorporates all activities and factors responsible for digestion and metabolism in the living organism as known today, knowledge to these fundamental principles is a key to health and diseases .Maintenances of health depend on good and sound knowledge of these. Detail will be given in full paper. Keywords: Ayurveda, health, dosa, Agni, mind. (shrink)