Sport is one of the first areas in which enhancement has become commonplace. It is also one of the first areas in which the use of enhancement technologies has been heavily regulated. Some have thus seen sport as a testing ground for arguments about whether to permit enhancement. However, I argue that there are fairness-based objections to enhancement in sport that do not apply as strongly in some other areas of human activity. Thus, I claim that there will often be (...) a stronger case for permitting enhancement outside of sport than for permitting enhancement in sport. I end by considering some methodological implications of this conclusion. (shrink)

Relative Energy Deficiency in Sport (RED-S) is a syndrome of impaired health and performance that occurs as a result of low energy availability (LEA). Whilst many health effects associated with RED-S have been widely studied from a physiological perspective, further research exploring the psychological antecedents and consequences of the syndrome is required. Therefore, the aim of this study was to qualitatively explore athlete experiences of RED-S. Twelve endurance athletes (female n= 10, male n= 2; M age = 28.33 years) reporting (...) past or current experiences of RED-S, associated with periods of LEA, took part in semi-structured interviews designed to explore: contexts and mechanisms underpinning the onset of RED-S; the subjective experience of RED-S; and contexts and mechanisms influencing “recovery” from RED-S. Regardless of how RED-S was initiated, all athletes experienced a multitude of physiological impairments, accompanied by significant psychological distress. This paper contributes novel understanding of the complex interplay between physiological and psychological components of RED-S from the perspective of information-rich cases. The findings suggest that system-wide educational prevention and awareness interventions are vital for athletes and support personnel, such as coaches, parents, dieticians, psychologists, and sports medicine staff. (shrink)

Sports physicians are continuously confronted with new biotechnological innovations. This applies not only to doping in sports, but to all kinds of so-called enhancement methods. One fundamental problem regarding the sports physician's self-image consists in a blurred distinction between therapeutic treatment and non-therapeutic performance enhancement. After a brief inventory of the sports physician's work environment I reject as insufficient the attempts to resolve the conflict of the sports physician by making it a classificatory problem. Followed (...) by a critical assessment of some ideas from the US President's Council on Bioethics, the formulation of ethical codes and attempts regarding a moral topography, it is argued that the sports physician's conflict cannot be resolved by the distinction between therapy and enhancement. Instead, we also have to consider the possibility that the therapy-based paradigm of medicine cannot do justice to the challenges of the continuously increasing technical manipulability of the human body and even our cognitive functions as well. At the same time we should not adhere to transhumanist ideas, because non-therapeutic interventions require clear criteria. Based on assistive technologies an alternative framework can be sketched that allows for the integration of therapeutic and non-therapeutic purposes. After a thorough definition of standards and criteria, the role of the sports physician might be defined as that of an assistant for enhancement. Yet the process of defining such an alternative framework is a societal and political task that cannot be accomplished by the sports physicians themselves. Until these questions are answered sports physicians continue to find themselves in a structural dilemma that they partially can come to terms with through personal integrity. (shrink)

Enhancement is a basic principle of modern sport. Their increase of achievement is usually attributed to the sportsmen’s natural assessment, their health, their training methods and their employment. In contrast, increase in output by pharmacological means is outlawed. The modern medical techniques created a whole range, by which sportsmen are supported. Consequently, sometimes difficult decisions with concrete medications develop. It is not always clearly to be differentiated whether something is a pharmacological interference, which serves the therapy or leads however to (...) the outlawed increase in output. At present Enhancement is in discussion, a phenomenon, which is related to doping in sports, but which concerns achievement-increasing use of medicines not only in sportsmen. -/- Leistungssteigerung ist ein Grundprinzip des modernen Sports. Gewöhnlich werden für die Steigerung der Leistung die natürliche Veranlagung der Sportler, ihre Gesundheit, ihre Trainingsmethoden und ihr Einsatzwille veranschlagt. Leistungssteigerung durch pharmakologische Mittel ist dagegen geächtet. Die modernen medizinischen Techniken haben einen ganzen Bereich geschaffen, durch den die Sportler bei der Erbringung ihrer Leistung und deren Erhalt unterstützt werden. Dabei entstehen mitunter schwierige Entscheidungsfragen bei konkreten Medikationen. Nicht immer ist klar zu unterscheiden, ob etwas ein pharmakologischer Eingriff ist, der der Therapie dient oder aber zur geächteten Leistungssteigerung führt. Gegenwärtig wird über Enhancement diskutiert, ein Phänomen, das mit dem Doping verwandt ist, aber leistungssteigernde Verwendung von Medikamenten bei Gesunden im Allgemeinen, also nicht nur bei Sportlern, betrifft. (shrink)

Many philosophers working on virtue theory have resisted the idea that the virtues are practical skills, apparently following Aristotle’s resistance to that idea. Bucking the trend, Matt Stichter defends a strong version of this idea in The Skillfulness of Virtue by marshaling a wide range of conceptual and empirical arguments to argue that the moral virtues are robust skills involving the cognitive-conative unification of Aristotelian phronêsis (‘practical intelligence’). Here I argue that Aristotle overlooks a more delimited kind of practical intelligence, (...) strongly analogous to his own account of phronêsis, that unifies complex forms of expertise such as medicine or even high-level sports. Insofar as the skill model of virtue is compelling, it must draw on a robust conception of practical expertise (technê) like the one developed here rather than the ordinary, anemic conception of practical skills. (shrink)

From 1900 onwards, scientists and novelists have explored the contours of a future society based on the use of “anthropotechnologies” (techniques applicable to human beings for the purpose of performance enhancement ranging from training and education to genome-based biotechnologies). Gradually but steadily, the technologies involved migrated from (science) fiction into scholarly publications, and from “utopia” (or “dystopia”) into science. Building on seminal ideas borrowed from Nietzsche, Peter Sloterdijk has outlined the challenges inherent in this development. Since time immemorial, and at (...) least since the days of Plato’s Academy, human beings have been interested in possibilities for (physical or mental) performance enhancement. We are constantly trying to improve ourselves, both collectively and individually, for better or for worse. At present, however, new genomics-based technologies are opening up new avenues for self-amelioration. Developments in research facilities using animal models may to a certain extent be seen as expeditions into our own future. Are we able to address the bioethical and biopolitical issues awaiting us? After analyzing and assessing Sloterdijk’s views, attention will shift to a concrete domain of application, namely sport genomics. For various reasons, top athletes are likely to play the role of genomics pioneers by using personalized genomics information to adjust diet, life-style, training schedules and doping intake to the strengths and weaknesses of their personalized genome information. Thus, sport genomics may be regarded as a test bed where the contours of genomics-based self-management are tried out. (shrink)

Since 2004, it has been mandated by law that all Danish undergraduate university programmes have to include a compulsory course on the philosophy of science for that particular program. At the Faculty of Science and Technology, Aarhus University, the responsibility for designing and running such courses were given to the Centre for Science Studies, where a series of courses were developed aiming at the various bachelor educations of the Faculty. Since 2005, the Centre has been running a dozen different courses (...) ranging from mathematics, computer science, physics, chemistry over medical chemistry, biology, molecular biology to sports science, geology, molecular medicine, nano science, and engineering. -/- We have adopted a teaching philosophy of using historical and contemporary case studies to anchor broader philosophical discussions in the particular subject discipline under consideration. Thus, the courses are tailored to the interests of the students of the particular programme whilst aiming for broader and important philosophical themes as well as addressing the specific mandated requirements to integrate philosophy, some introductory ethics, and some institutional history. These are multiple and diverse purposes which cannot be met except by compromise. -/- In this short presentation, we discuss our ambitions for using case studies to discuss philosophical issues and the relation between the specific philosophical discussions in the disciplines and the broader themes of philosophy of science. We give examples of the cases chosen to discuss various issues of scientific knowledge, the role of experiments, the relations between mathematics and science, and the issues of responsibility and trust in scientific results. Finally, we address the issue of how and why science students can be interested in and benefit from mandatory courses in the philosophy of their subject. (shrink)

Whilst in recent years sports studies have addressed the calls ‘to bring the body back in’ to theorisations of sport and physical activity, the ‘promise of phenomenology’ remains largely under-realised with regard to sporting embodiment. Relatively few accounts are grounded in the ‘flesh’ of the lived sporting body, and phenomenology offers a powerful framework for such analysis. A wide-ranging, multi-stranded, and interpretatively contested perspective, phenomenology in general has been taken up and utilised in very different ways within different disciplinary (...) fields. The purpose of this article is to consider some selected phenomenological threads, key qualities of the phenomenological method, and the potential for existentialist phenomenology in particular to contribute fresh perspectives to the sociological study of embodiment in sport and exercise. It offers one way to convey the ‘essences’, corporeal immediacy and textured sensuosity of the lived sporting body. The use of Interpretative Phenomenological Analysis (IPA) is also critically addressed. (shrink)

Whilst in recent years sports studies have addressed the calls ‘to bring the body back in’ to theorisations of sport and physical activity, the ‘promise of phenomenology’ remains largely under-realised with regard to sporting embodiment. Relatively few accounts are grounded in the ‘flesh’ of the lived sporting body, and phenomenology offers a powerful framework for such analysis. A wide-ranging, multi-stranded, and interpretatively contested perspective, phenomenology in general has been taken up and utilised in very different ways within different disciplinary (...) fields. The purpose of this article is to consider some selected phenomenological threads, key qualities of the phenomenological method, and the potential for existentialist phenomenology in particular to contribute fresh perspectives to the sociological study of embodiment in sport and exercise. It offers one way to convey the ‘essences’, corporeal immediacy and textured sensuosity of the lived sporting body. The use of Interpretative Phenomenological Analysis (IPA) is also critically addressed. Key words: phenomenology; existentialist phenomenology; interpretative phenomenological analysis (IPA); sporting embodiment; the lived-body; Merleau-Ponty. (shrink)

The outcomes of sports and competitive games excite intense emotions in many people, even when those same people acknowledge that those outcomes are of trifling importance. I call this incongruity between the judged importance of the outcome and the intense reactions it provokes the Puzzle of Sport. The puzzle can be usefully compared to another puzzle in aesthetics: the Paradox of Fiction, which asks how it is we become emotionally caught up with events and characters we know to be (...) unreal. In this article, I examine the prospects of understanding our engagement with competitive games on the model of our engagement with works of fiction, thus enabling analogous explanations for both puzzles. I show that there are significant problems with such an approach and offer an alternative, mobilizing ideas from David Velleman and Thomas Nagel, that appeals to the volatility of our motivational attitudes. (shrink)

In this paper, I propose a new way of defining sport that I call a ‘core-periphery’ model. According to a core-periphery model, sport comes in degrees – what I refer to as ‘sport-likeness’ – and the aim of the philosopher of sport is to chart those dimensions along which an activity can be more or less a sport. By introducing the concept of sport-likeness, the core-periphery model complicates the picture of what is or is not a sport and encourages philosophers (...) interested in defining sport to engage with the social sciences in exploring the extension of the term sport in common usage. In this paper I present the results of a small survey about attitudes to sport, and use it to illustrate how a core-periphery definition of sport would proceed. (shrink)

It has become increasingly popular for sports fans, pundits, coaches and players to appeal to ideas of ‘sporting integrity’ when voicing their approval or disapproval of some aspect of the sporting world. My goal in this paper will be to examine whether there is any way to understand this idea in a way that both makes sense of the way in which it is used and presents a distinctly ‘sporting’ form of integrity. I will look at three recent high-profile (...) sporting incidents that caused sporting integrity to be called into question. I will then examine three different ways in which philosophers have sought to understand integrity and examine whether any of these accounts can provide us with a plausible account of sporting integrity. I will argue that such an account can be given and show how this helps us to understand the three cases. (shrink)

Our purpose in this article is to draw attention to a connection that obtains between two dilemmas from two separate spheres: sports and the law. It is our contention that umpires in the game of cricket may face a dilemma that is similar to a dilemma confronted by legal decision makers and that comparing the nature of the dilemmas, and the arguments advanced to solve them, will serve to advance our understanding of both the law and games.

This article critically details how the work of Slavoj Žižek theoretically elaborates on the links between nationalism and sport. Notably, it highlights how key terms, drawn from Žižek’s work on fantasy, ideology and the Real (itself grounded in the work of Jacques Lacan), can be used to explore the relationship between sport, nationalism and enjoyment (jouissance). In outlining this approach, specific attention is given to Žižek’s account of the ‘national Thing’. Accordingly, by considering the various ways in which sport organizes, (...) materializes and structures our enjoyment, the emotive significance of sport during national sporting occasions is both introduced and applied. Moreover, it is argued that such an approach offers a unique and valuable insight into the relationship between sport and nationalism, as well as an array of social and political antagonisms. (shrink)

A commonly accepted feature of commonsense morality is that there are some acts that are supererogatory or beyond the call of duty. Recently, philosophers have begun to ask whether something like supererogation might exist in other normative domains such as epistemology and esthetics. In this paper, I will argue that there is good reason to think that sporting supererogation exists. I will then argue that recognizing the existence of sporting supererogation is important because it highlights the value of sport as (...) a mutual pursuit of excellence and reinforces the value of sportsmanship. (shrink)

Previous discussions on the value of sport in remote locations have concentrated on 1) environmental and process concerns, with the rejection of competition and goal-directed or use oriented activity, or 2) the value of risk and dangerous sport for self-affirmation. It is argued that the value of risk in remote sport is in self-knowledge rather than self-affirmation and that risk in remote sport, while enhancing certain kinds of experience, is not necessary. The value of remote sport is in offering the (...) opportunity for experience that enhances the participants’ knowledge both of self and of the environment with which they interact. (shrink)

In mid-2019, the controversy regarding South African runner Caster Semenya’s eligibility to participate in competitions against other female runners culminated in a Court of Arbitration for Sport judgement. Semenya possessed high endogenous testosterone levels (arguably a performance advantage), secondary to a disorder of sexual development. In this commentary, Aristotelean teleology is used to defend the existence of ‘male’ and ‘female’ as discrete categories. It is argued that once the athlete’s sex is established, they should be allowed to compete in the (...) category of their sex without obligatory medical treatment. Indeed, other athletes who possess advantageous genetic or phenotypic traits that fall outside of the human norm have been allowed to compete as humans without restraint. In both cases, if an athlete possesses the essential attributes of being a human or being male or female they should be permitted to compete in those respective categories; athletes’ eligibilities should not be based upon accidental attributes. (shrink)

In this paper I argue for the usefulness of the concept of ‘movement compression’ for understanding sport and games, and particularly the differences between traditional sport and eSport (as currently practised). I suggest that movement compression allows us to distinguish between different activities in terms of how movement quality (in the sense of the qualities the movement possesses, rather than that the movement is of ‘high quality’) affects outcome. While it applies widely, this concept can in particular help us to (...) understand the persistent idea that eSports are in some key way distinct from traditional sports. (shrink)

Sport poses a number of important and no less significant questions, which, on the face of it, may not necessarily seem very important or significant to begin with – a peculiarity that we believe to be integral to sport itself. This article introduces, explores and outlines the psychoanalytic significance of this peculiarity. It explores how the emotions stirred by sport are intertwined with a realm of fiction and fantasy. Despite its lack of practical utility, sport carries an undeniable gravity, encapsulating (...) the aspirations of communities, nations and continents. As a result, psychoanalysis can be used to critically reflect on the purpose and meaning of sport: that is, why do we need sport, and why, for large sections of the world’s population, do we rely on it? Ultimately, while psychoanalysis maintains a unique relation to a variety of unexpected fields of study – including art, culture and neuroscience – we seek to add to this expanding list of inquiry by including sport in this critical domain. By utilising sport as a platform to elucidate psychoanalytic concepts, it is recognised that sport can also prompt questions for psychoanalysis. In so doing, theoretical discussions on the social, cultural and political dimensions of sport through psychoanalytic theory are introduced and applied. (shrink)

Sport is a global phenomenon, which can make sport an important arena for integration into new societies. However, sport is also an expression of national culture and identities. The aim of this study is to explore images and experiences that newly-arrived immigrant children in Sweden have about sport in their country of origin, and challenges that can arise in processes of integration through sport. We asked 20 newly arrived children aged 10 to 13 to make drawings about sporting experiences from (...) their countries of origin. Three themes emerged: sport as feeling joy, where activities were performed with friends during leisure time; sport as acting formally, where activities were carried out in clubs; and sport as a spectator, where children were non-participants. We emphasise that development of sport should be two-way processes, where cultural learning should be mutual processes. Immigrant children’s experiences should be foregrounded when utilising and developing sports programmes. (shrink)

The success of precision medicine depends on obtaining large amounts of information about at-risk populations. However, getting consent is often difficult. Why? In this commentary I point to the differentials in social status involved. These differentials are inevitable once personal information is surrendered, but are particularly intense when the studied populations are socioeconomically or socioculturally disadvantaged and/or ethnically stigmatized groups. I suggest how the deep distrust of the latter groups can be partially justified as a lack of confidence that (...) their core values or interests will sufficiently be taken into account. Hence, the ethical challenge here lies not in avoiding status differentials, but in dealing with them appropriately. Scientists should not assume trust from others but adopt a norm of “demonstrating trustworthiness”. (shrink)

Even in the increasingly individualized American medical system, advocates of 'personalized medicine' claim that healthcare isn't individualized enough. With the additional glamour of new biotechnologies such as genetic testing and pharmacogenetics behind it, 'Me Medicine'-- personalized or stratified medicine-- appears to its advocates as the inevitable and desirable way of the future. Drawing on an extensive evidence base, this book examines whether these claims are justified. It goes on to examine an alternative tradition rooted in communitarian ideals, (...) that of the common good as a goal in medicine. (shrink)

Weather experiences are currently surprisingly under-explored and under-theorised in sociology and sport sociology, despite the importance of weather in both routine, everyday life and in recreational sporting and physical–cultural contexts. To address this lacuna, we examine here the lived experience of weather, including ‘weather work’ and ‘weather learning’, in our specific physical–cultural worlds of distance-running, triathlon and jogging in the United Kingdom. Drawing on a theoretical framework of phenomenological sociology, and the findings from five separate auto/ethnographic projects, we explore the (...) ‘weather-worlds’ and weather work involved in our physical–cultural engagement. In so doing, we address ongoing sport sociological concerns about embodiment and somatic, sensory learning and ways of knowing. We highlight how weather work provides a key example of the phenomenological conceptualisation of the mind–body–world nexus in action, with key findings delineating weather learning across the meteorological seasons that contour our British weather-related training. (shrink)

An abundance of data unequivocally shows that exercise can be an effective tool in the fight against obesity and its associated co-morbidities. Indeed, physical activity can be more effective than widely-used pharmaceutical interventions. Whilst metformin reduces the incidence of diabetes by 31% (as compared with a placebo) in both men and women across different racial and ethnic groups, lifestyle intervention (including exercise) reduces the incidence by 58%. In this context, it is notable that a group of prominent medics and exercise (...) scientists recently sent a well-publicised letter to the General Medical Council and Medical Schools Council calling for the introduction of evidence-based lifestyle education into all medical curricula. The letter warns that there is a lack of understanding of the impact that exercise and nutrition can have on physical health amongst doctors. In the absence of an educational overhaul, the signatories warn that the government is likely to fail to reach its goal of preventing tens of thousands of premature deaths from heart disease and cancer by 2020. Whilst we agree with the need to address this apparent lack of understanding, we argue that the ethical justification of doing so is not limited to this broadly beneficence-based justification. There is also a justification grounded in the duty of non-maleficence, that is, the duty to avoid unreasonably harming patients. This duty requires that doctors refrain from (i) preventing patients from undergoing beneficial treatment without good reason, (ii) exposing patients to unreasonable risks and (iii) reducing the therapeutic effect of an effective medical intervention. This requires an understanding of the physical impact of exercise. (shrink)

In this paper, I argue that the concept of normality in medical research and clinical practice is inextricable from the concept of ambiguity. I make this argument in the context of Edmund Pellegrino's call for a renewed reflection on medicine’s basic concepts and by drawing on work in critical disability studies concerning Deafness and body integrity identity disorder. If medical practitioners and philosophers of medicine wish to improve their understanding of the meaning of medicine as well as (...) its concrete practice, I contend that they should take seriously the import and centrality of ambiguity for biomedicine. (shrink)

The issue of how to incorporate the individual's first‐hand experience of illness into broader medical understanding is a major question in medical theory and practice. In a philosophical context, phenomenology, with its emphasis on the subject's perception of phenomena as the basis for knowledge and its questioning of naturalism, seems an obvious candidate for addressing these issues. This is a review of current phenomenological approaches to medicine, looking at what has motivated this philosophical approach, the main problems it faces (...) and suggesting how it might become a useful philosophical tool within medicine, with its own individual, but interrelated, contribution to make to current medical debates. After the general background, there is a brief summary of phenomenological ideas and their current usage in a medical context. Next is a critique of four key claims within current phenomenological medical works, concerning both the role phenomenology plays and the supposedly clear divide between phenomenology and other approaches. There are significant problems within these claims, largely because they overlook the complexity of the questions they consider. Finally, there is some more in‐depth examination of phenomenology itself and the true complexity of phenomenological debate concerning subjectivity. The aim is to show that it will be both more productive and truer to phenomenology itself, if we use phenomenology as a philosophical method for explicating and gaining deeper understanding of complex and fundamental problems, which are central to medicine, rather than as providing simple, but flawed solutions. (shrink)

ABSTRACT: Abstract Most modern knowledge is not science. The physical sciences have successfully validated theories to infer they can be used universally to predict in previously unexperienced circumstances. According to the conventional conception of science such inferences are falsified by a single irregular outcome. And verification is by the scientific method which requires strict regularity of outcome and establishes cause and effect. -/- Medicine, medical research and many “soft” sciences are concerned with individual people in complex heterogeneous populations. These (...) populations cannot be tested to demonstrate strict regularity of outcome in every individual. Neither randomised controlled trials nor observational studies in medicine are science in the conventional conception. Establishing and using medical and other “soft science” theories cannot be scientific. It requires conceptually different means: requiring expert judgement applying all available evidence in the relevant available factual matrix. -/- The practice of medicine is observational. Prediction of outcomes for the individual requires professional expertise applying available medical knowledge and evidence. Expertise in any profession can only be acquired through experience. Prior cases are the fundament of knowledge and expertise in medicine. Case histories, studies and series can provide knowledge of extremely high reliability applicable to establishing reliable general theories and falsifying others. Their collation, study and analysis should be a priority in medicine. Their devaluation as evidence, the failure to apply their lessons, the devaluation of expert professional judgement and the attempt to emulate the scientific method are all historic errors in the theory and practice of modern medicine. (shrink)

To uncover the main dimensions of sport personality traits, a lexical study was conducted. In the first two phases, 321 adjectives denoting the way somebody practices sports were selected. In the third phase, 555 respondents self-rated the adjectives. Congruence analyses provided evidence of six factors, five of which are sport personality trait factors plus one physical individual difference factor. Marker scales from the sport personality trait factors show convergent correlations with the generic HEXACO personality obtained years earlier. Furthermore, meaningful (...) relations with the six most frequently practiced sport and leisure activities were observed. Contextualized sport personality trait factors can be useful in research on sport preferences, sport behaviors, and sport outcomes. (shrink)

When sporting agents fail through wrongful or faulty behaviour, they should feel guilty; when they fail because of a deficiency in their abilities, they should feel shame. But sometimes we fail without being deficient and without being at fault. I illustrate this with two examples of players, Moacir Barbosa and Roberto Baggio, who failed in World Cup finals and cost their teams the greatest prize in sport. Although both players failed, I suggest that neither was at fault and neither was (...) deficient. I argue that we can fail through no fault of our own because our abilities are always fallible. This fallibility means that to succeed – to achieve sporting glory – we must run the risk of failure. The appropriate emotion to feel over such failures is agent-regret. Sporting agents and observers should not take up what I call the ‘critical position’: the idea that someone who fails must be deficient or must have been at fault. This allows for a softer, but also more accurate, attitude towards our own failures and the failures of others. I end by suggesting that the fallibility of our abilities is made clear through playing or watching sport, and this can illuminate life more broadly. (shrink)

This is a volume of twelve essays concerning the fundamental tension in personalised medicine between individual choice and the common good.

Part of a symposium devoted to ‘Prediction, Understanding, and Medicine’, in which Alex Broadbent argues that the nature of medicine is determined by its competences, i.e., which things it can do well. He argues that, although medicine cannot cure well, it can do a good job of enabling people not only to understand states of the human organism and of what has caused them, but also to predict future states of it. From this Broadbent concludes that (...) class='Hi'>medicine is (at least in part) essentially a practice of understanding and predicting, not curing. In reply to this bold position, I mount two major criticisms. First, I maintain that the reasons Broadbent gives for doubting that medicine can cure provide comparable reason for doubting that medicine can provide an understanding; roughly, the best explanation of why medicine cannot reliably cure is that we still lack much understanding of health and disease. Second, I object to the claim that a practice is medical only if it facilitates understanding and prediction. Although Broadbent has brought to light certain desirable purposes of medicine that are under-appreciated, my conclusion is that he has not yet provided enough reason to think that understanding and prediction are essential to it. Instead of supposing that medicine has an essence, in fact, I suggest that its nature is best understood in terms of a property cluster. (shrink)

As opposed to a ‘one size fits all’ approach, precision medicine uses relevant biological, medical, behavioural and environmental information about a person to further personalize their healthcare. This could mean better prediction of someone’s disease risk and more effective diagnosis and treatment if they have a condition. Big data allows for far more precision and tailoring than was ever before possible by linking together diverse datasets to reveal hitherto-unknown correlations and causal pathways. But it also raises ethical issues relating (...) to the balancing of interests, viability of anonymization, familial and group implications, as well as genetic discrimination. This article analyses these issues in light of the values of public benefit, justice, harm minimization, transparency, engagement and reflexivity and applies the deliberative balancing approach found in theEthical Framework for Big Data in Health and Research to a case study on clinical genomic data sharing. Please refer to that article for an explanation of how this framework is to be used, including a full explanation of the key values involved and the balancing approach used in the case study at the end. Our discussion is meant to be of use to those involved in the practice as well as governance and oversight of precision medicine to address ethical concerns that arise in a coherent and systematic manner. (shrink)

Successful athletic performance requires precision in many respects. A batter stands behind home plate awaiting the arrival of a ball that is less than three inches in diameter and moving close to 100 mph. His goal is to hit it with a ba­­t that is also less than three inches in diameter. This impressive feat requires extraordinary temporal and spatial coordination. The sweet spot of the bat must be at the same place, at the same time, as the ball. A (...) basketball player must keep a ball bouncing as she speeds from one end of the court to another, evading defensive players. She may never break pace as she lifts from the ground, throwing the ball fifteen feet toward a hoop that is eighteen inches in diameter. One task facing a psychologist involves explaining how the body does such things within the sometimes very demanding spatial and temporal constraints that a given task imposes. Part of the goal of this chapter is to sketch the commitments of an embodied approach to such an explanation. We shall see that an embodied account of motor skills draws concepts that depart radically from more traditional cognitivist theories of motor activity. Similarly, because an embodied approach to cognition introduces new ways to understand the human capacity for social interaction, it also promises to shed new light on how athletes coordinate their actions with each other. (shrink)

Lack of consent is valorized within popular culture to the point that sexual assault has become a spectator sport and creepshot entertainment on social media. Indeed, the valorization of nonconsensual sex has reached the extreme where sex with unconscious girls, especially accompanied by photographs as trophies, has become a goal of some boys and men.

Through this contribution I aim to explore the horizons and limits of digital medicine in light of an embodied approach to the issue of care. I will sketch the historical background of digital medicine and show the contemporary status of this interdisciplinary field, as well as its applications and outcomes. Then, I will address a critique of the computational theory of mind (CTM) upon which many contemporary mental health apps are designed. This approach to the mind is inscribed (...) into the modern trend of neuromania, which conceives the embodied, living human being as a mere series of data analyses and algorithms, with the brain as the seat of the person. Drawing on continental philosophy and classical phenomenology I will develop a notion of health conceived as a moral enterprise, showing how wellbeing and vitality are not reducible to a product made by technologies or doctors, but rather they are the results of an embodied encounter. As such, empathy and person-centered care cannot be achieved by digital medicine. They are the result of a journey into the regions of recognition, embodied presence and the aliveness constituting the person. Finally, I will show how the issue of care cannot be separated from an embodied encounter between people, especially in case of dementia. (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)

It has been argued that competitive elite sport both (i) reduces the humanity of athletes by turning them into beings whose sole value is determined in relation to others, and (ii) is motivated by a celebration of the genetically superior and humiliation of the weak. This paper argues that while (i) is a morally reproachable attitude to competition, it is not what competitive elite sport revolves around, and that (ii) simply is not the essence of competitive elite sport. Competitive elite (...) sport is an exploration of the physical and mental demands of sport. Finally, the paper explores a number of consequences of the different views of sport with respect to the problem of intersexual women. (shrink)

David Tomasi presents new, groundbreaking research on the science and application of Mind-Body Medicine strategies to improve clinical outcomes in inpatient psychiatry settings. Much more than a list of therapeutic recommendations, this book is a thorough description of how Mind-Body Medicine can be successfully applied, from a therapeutic as well as from an organizational, cost-effective analysis viewpoint, to the full spectrum of psychiatric treatments. Furthermore, this study examines the role of multidisciplinary and interdisciplinary treatment teams, with a special (...) focus on the profession and the role of psychotherapists and group therapists, thereby providing solid scientific evidence of the benefits of patient-provider therapeutic alliances. In this sense, this book serves as a guide for professionals and institutions both in the private and the public sphere, to learn effective treatment and management strategies. About the Author Psychotherapist, Researcher, and Philosopher Dr. David Låg Tomasi is the author of Medical Philosophy (ibidem, 2016) and the co-author of Positive Patient Response to a Structured Exercise Program Delivered in Inpatient Psychiatry (Global Advances in Health and Medicine, 2019), the most-read research item from the University of Vermont (Researchgate, 2019). A member of several national and international Academies of Sciences, Dr. Tomasi works in the Inpatient Psychiatry Unit at the UVM Medical Center, and teaches at the University of Vermont and the Community College of Vermont. ---- Ibidem / Columbia University Press. (shrink)

This article considers a novel approach to researching sporting embodiment via what has been termed ‘autophenomenography’. Whilst having some similarities with autoethnography, autophenomenography provides a distinctive research form, located within phenomenology as theoretical and methodological tradition. Its focus is upon the researcher’s own lived experience of a phenomenon or phenomena. This article examines some of the key elements of a sociological phenomenological approach to studying sporting embodiment in general before portraying how autophenomenography was utilised specifically within two recent research projects (...) on distance running. The thorny issues of epoche and bracketing within phenomenological and autophenomenographical research are addressed and some practical suggestions tentatively posited. (shrink)

Recent criticisms of medicine converge on fundamental questions about the aim of medicine. The main task of this paper is to propose an account of the aim of medicine. Discussing and rejecting the initially plausible proposal according to which medicine is pathocentric, the paper presents and defends the Autonomy Thesis, which holds that medicine is not pathocentric, but sanocentric, aiming to promote health with the final aim to enhance autonomy. The paper closes by considering the (...) objection that the Autonomy Thesis is overly permissive and allows many highly controversial procedures as legitimate parts of medicine. (shrink)

The controversy around the accommodation of conscientious objections in medicine persists, especially for such contentious services as abortions. COs are typically considered in their negativ...

In this paper, I offer one example of conceptual change. Specifically, I contend that the discovery that viruses could cause cancer represents an excellent example of branch jumping, one of Thagard’s nine forms of conceptual change. Prior to about 1960, cancer was generally regarded as a degenerative, chronic, non-infectious disease. Cancer causation was therefore usually held to be a gradual process of accumulating cellular damage, caused by relatively non-specific component causes, acting over long periods of time. Viral infections, on the (...) other hand, were generally understood to be acute processes, whereby single, specific and necessary causal agents acted alone to produce disease. However, during the 1960s and 1970s, a number of cancers were discovered to have an infectious aetiology. Of particular note were two—Burkitt’s lymphoma and cervical cancer—which I will discuss in detail later in this piece. Together, these discoveries led, in the short term, to a tentative aetiological reclassification of some types of cancer as infectious diseases and, in the longer term, to a full-blown reclassification of cancer as an aetiological disease branch in its own right. This process of reclassification forms the empirical basis for my concluding remarks on the influence of classification upon causation in medicine. Through this, I aim to demonstrate that conceptual change, far from being a purely abstract concern of the philosopher of science, is of substantial import to scientific practitioners. (shrink)

New forms of neoliberal femininity create demanding horizons of expectation for young women. For talented athletes, these pressures are intensified by the establishment of dual-career discourses that construct the combination of high-performance sport and education as a normative, ‘ideal’ pathway. The pressed time perspective inherent in dual-careers requires athletes to employ a variety of time-related skills, especially for young women who aim to live up to ‘superwoman’ ideals that valorize ‘success’ in all walks of life. Drawing on existential phenomenology, and (...) in-depth interviews with 10 talented Finnish sportswomen (aged 19-22), we explored their experiences of lived time when pursuing dual-careers in upper secondary sport schools. Exploring participants’ bodily experiences of inhabiting the achievement life-world, we analyze how these sportswomen either learned ways of living up to this ambitious script or came to understand the detrimental effects of the script, necessitating other ways of being. For those who experience a disjuncture between the ‘perfect’ and their embodied experience, self-care practices are needed to restore life-world harmony, and orient to alternative futures. (shrink)

Within the sociology of sport, phenomenologically-inspired perspectives on sensory embodiment have emerged in recent years. This corpus includes investigations into the senses in water-based sports such as scuba diving (Merchant, 2011), performance swimming (Allen-Collinson et al., 2021 ; McNarry et al., 2021) and in land-based sports such as distance running (Allen-Collinson et al., 2018, 2021 ; Allen-Collinson & Jackman, 2021), and cycling (Hammer, 2015 ; Spinney, 2006). In this article, I draw upon phenomenological sociology (Allen-Collinson, 2009) and ‘sensory (...) work’, to investigate the experience of asthma in sports participants. Currently, despite the prevalence of asthma globally, there remains a lack of in-depth research on actual experiences of coping with asthma and ‘breathing battles’ in sporting contexts. Here, I draw on data from two linked research projects: a collaborative autoethnography and an interview-based study , which generated findings that highlighted sensory aspects relating to the lived experience of asthma and sporting embodiment. (shrink)

Proponents of evidence-based medicine have argued convincingly for applying this scientific method to medicine. However, the current methodological framework of the EBM movement has recently been called into question, especially in epidemiology and the philosophy of science. The debate has focused on whether the methodology of randomized controlled trials provides the best evidence available. This paper attempts to shift the focus of the debate by arguing that clinical reasoning involves a patchwork of evidential approaches and that the emphasis (...) on evidence hierarchies of methodology fails to lend credence to the common practice of corroboration in medicine. I argue that the strength of evidence lies in the evidence itself, and not the methodology used to obtain that evidence. Ultimately, when it comes to evaluating the effectiveness of medical interventions, it is the evidence obtained from the methodology rather than the methodology that should establish the strength of the evidence. (shrink)

What position on dualism does medicine require? Our understanding of that ques- tion has been dictated by holism, as defined by the biopsychosocial model, since the late twentieth century. Unfortunately, holism was characterized at the start with con- fused definitions of ‘dualism’ and ‘reductionism’, and that problem has led to a deep, unrecognized conceptual split in the medical professions. Some insist that holism is a nonreductionist approach that aligns with some form of dualism, while others insist it’s a reductionist (...) view that sets out to eradicate dualism. It’s important to consider each version. Nonreductive holism is philosophically consistent and clinically unprob- lematic. Reductive holism, however, is conceptually incoherent—yet it is the basis for the common idea that the boundary between medical and mental health disorders must be vague. When we trace that idea through to its implementation in medical practice, we find evidence that it compromises the safety of patient care in the large portion of cases where clinicians grapple with diagnosis at the boundary between psychiatry and medicine. Having established that medicine must embrace some form of nonreduc- tionism, I argue that Chalmers’ naturalistic dualism is a stronger prima facie candidate than the nonreductive alternatives. Regardless of which form of nonreductionism we prefer, some philosophical corrections are needed to give medicine a safe and coherent foundation. (shrink)

The connections between medicine and well-being are myriad. This paper focuses on the place of well-being in clinical medicine. It is here that different views of well-being, and their connection to concepts like “autonomy” and “authenticity”, both illuminate and are illuminated by looking closely at the kinds of interactions that routinely take place between clinicians, patients, and family members. -/- In the first part of the paper, I explore the place of well-being in a paradigmatic clinical encounter, one (...) where a competent patient interacts with a clinician. The main question here is how, or even whether, the pursuit of patient well-being – however we construe it – figures into a paradigmatic clinical encounter. In the second part of the paper, I consider what I will call a marginal clinical encounter – one where the patient is, as Agnieska Jaworska (1999) puts it, at the “margins of agency” – to theorize about the nature of well-being and to show how different theories of well-being can have dramatic consequences for clinical decision-making. (shrink)