This paper aims to clarify the nature of understanding in medicine. The first part describes in more detail what it means to understand something and links a type of understanding (i.e., objectual understanding) to explanations. The second part proceeds to investigate what objectual understanding of a disease (i.e., biomedical understanding) requires by considering the case of scurvy from the history of medi- cine. The main hypothesis is that grasping a mechanistic explanation of a condi- tion is necessary for a biomedical (...) understanding of that condition. The third part of the paper argues that biomedical understanding is necessary, but not sufficient for understanding in a clinical context (i.e., clinical understanding). The hypothe- sis is that clinical understanding combines biomedical understanding of a disease or pathological condition with understanding illness, which involves some degree of personal understanding of the patient. It is argued that, in many cases, clinical understanding necessitates adopting a particular second-personal stance and using cognitive resources in addition to those involved in biomedical understanding. (shrink)

It is common to distinguish between “holist” and “reductionist” views of brain function, where the former envisions the brain as functioning as an indivisible unit and the latter as a collection of distinct units that serve different functions. Opposing reductionism, a number of researchers have pointed out that cortical network architecture does not respect functional boundaries, and the neuroanatomist V. Braitenberg proposed to understand the cerebral cortex as a “great mixing machine” of neuronal activity from sensory inputs, motor commands, and (...) intrinsically generated processes. In this paper, we offer a contextualization of Braitenberg’s point, and we review evidence for the interactions of neuronal activity from multiple sensory inputs and intrinsic neuronal processes in the cerebral cortex. We focus on new insights from studies on audiovisual interactions and on the influence of respiration on brain functions, which do not seem to align well with “reductionist” views of areal functional boundaries. Instead, they indicate that functional boundaries are fuzzy and context dependent. In addition, we discuss the relevance of the influence of sensory, proprioceptive, and interoceptive signals on cortical activity for understanding brain-body interactions, highlight some of the consequences of these new insights for debates on embodied cognition, and offer some suggestions for future studies. (shrink)

It is widely agreed that obsessive-compulsive disorder involves irrationality. But where in the complex of states and processes that constitutes OCD should this irrationality be located? A pervasive assumption in both the psychiatric and philosophical literature is that the seat of irrationality is located in the obsessive thoughts characteristic of OCD. Building on a puzzle about insight into OCD (Taylor 2022), we challenge this pervasive assumption, and argue instead that the irrationality of OCD is located in the emotions that are (...) characteristic of OCD, such as anxiety or fear. In particular, we propose to understand the irrationality of OCD as a matter of harboring recalcitrant emotions. We argue that this account not only solves the puzzle about insight, but also makes better sense of how OCD sufferers experience and describe their condition and helps explain some otherwise puzzling features of compulsive behavior. (shrink)

Amid criticism of medicine's scientific rigor and patient care, this book offers a philosophical examination of the nature and aims of medicine, and new perspectives on how these challenges can be addressed. It offers input for rethinking the agenda of medical research, healthcare delivery, and the education of healthcare personnel.

In this paper, we first review recent arguments about the direct perception of the intentions and emotions of others, emphasizing the role of embodied interaction. We then consider a possible objection to the direct perception hypothesis from social psychology, related to phenomena like ‘dehumanization’ and ‘implicit racial bias’, which manifest themselves on a basic bodily level. On the background of such data, one might object that social perception cannot be direct since it depends on and can in fact be interrupted (...) by a set of cultural beliefs. We argue, however, that far from threatening the idea of direct perception, these findings clearly contradict the idea of hardwired theory of mind modules. More generally, we suggest that in order to further the understanding of social cognition we must take seriously insights about in-group and out-group distinctions and related phenomena, all of which are currently neglected in the mainstream social cognition literature. (shrink)

Body checking, characterized by the repeated visual or physical inspection of particular parts of one’s own body (e.g. thighs, waist, or upper arms) is one of the most prominent behaviors associated with eating disorders, particularly Anorexia Nervosa (AN). In this paper, we explore the explanatory potential of the Recalcitrant Fear Model of AN (RFM) in relation to body checking. We argue that RFM, when combined with certain plausible auxiliary hypotheses about the cognitive and epistemic roles of emotions, is able to (...) explain key characteristics of body checking, including how body checking behavior becomes habitual and compulsive. (shrink)

Proponents of manipulation arguments against compatibilism hold that manipulation scope (how many agents are manipulated) and manipulation type (whether the manipulator intends that an agent perform a particular action) do not impact judgments about free will and moral responsibility. Many opponents of manipulation arguments agree that manipulation scope has no impact but hold that manipulation type does. Recent work by Latham and Tierney (2022, 2023) found that people's judgments were sensitive to manipulation scope: people judged that an agent was less (...) free and responsible when a manipulation was existential (impacting at least one but not all agents) than when the manipulation was universal (impacting every agent). This study examines people's judgements about existential and universal manipulation cases that involve both intentional and non‐intentional outcomes. We found that manipulation scope also affects people's free will and responsibility judgments in manipulation cases involving both intentional and non‐intentional outcomes. Interestingly, we also found that manipulation type influences the effect that manipulation scope has on people's free will judgments but not their moral responsibility judgments, which indicates that people's free will and responsibility judgments can come apart. This puts pressure on the prevalent assumption that judgments about free will and moral responsibility are conceptually bound together. (shrink)

In this paper we engage in a reciprocal analysis of situated cognition and the notion of ‘meshed architecture’ as found in performance studies (Christensen, Sutton & McIlwain 2016). We argue that the model of meshed architecture can operate as a tool that enables us to better understand the notion of situated cognition. Reciprocally, by means of this new understanding of situation we develop a richer conception of meshed architecture. This enriched notion of a meshed architecture includes affect and bottom-up, non-automatic, (...) intrinsic control aspects of body-schematic processes and intelligent habits, on a vertical axis, as well as extended, ecological and worldly (material, normative, social, cultural) constraints and affordances on a horizontal axis. This gives us a very productive way to think about how various elements come together in skilled action and performance, but also a detailed way to characterize situated cognition. (shrink)

Gesellschaftskritik, or social philosophy that aims to provide firm criticism of pathological social practices, requires normatively grounded evaluative principles. In this article, we assess different possibilities for such principles with focus on a model that takes specific patterns of intersubjective interaction as its point of reference. We argue that in order to understand the full significance of this ‘intersubjective turn’ for social philosophy, and to strengthen the normative foundation of social philosophy, we need to distinguish several levels of intersubjectivity and, (...) in particular, focus on the somewhat neglected level of primary intersubjectivity. The article will discuss the account of primary intersubjectivity in Honneth’s work. We show that Honneth’s account runs into difficulties, and drawing on recent findings in developmental psychology, we suggest a rethinking of elementary recognition in terms of ‘affective proximity’. This both renders the account less susceptible to criticism and provides a normative perspective that can effortlessly enter into interdisciplinary collaboration. (shrink)

Respiratory rhythms sustain biological life, governing the homeostatic exchange of oxygen and carbon dioxide. Until recently, however, the influence of breathing on the brain has largely been overlooked. Yet new evidence demonstrates that the act of breathing exerts a substantive, rhythmic influence on perception, emotion, and cognition, largely through the direct modulation of neural oscillations. Here, we synthesize these findings to motivate a new predictive coding model of respiratory brain coupling, in which breathing rhythmically modulates both local and global neural (...) gain, to optimize cognitive and affective processing. Our model further explains how respiratory rhythms interact with the topology of the functional connectome, and we highlight key implications for the computational psychiatry of disordered respiratory and interoceptive inference. (shrink)

While research on Attention Deficit Hyperactivity Disorder (ADHD) has traditionally focused on cognitive and behavioral deficits, there is increasing interest in exploring possible resources associated with the disorder. In this paper, we argue that the attention-patterns associated with ADHD can be understood as expressing an alternative style of inquiry, or “zetetic” style, characterized mainly by a lower barrier for becoming curious and engaging in inquiry, and a weaker disposition to regulate curiosity in response to the cognitive and practical costs associated (...) with inquiry. Exploring this zetetic style from an epistemological perspective, we show that it is often epistemically rational and can be advantageous in important respects. We close by suggesting that the very aspects of the zetetic style that might at times render it disadvantageous from the point of view of individual subjects with ADHD, will often confer epistemic benefits to the social group that the subjects are part of. (shrink)

In this paper, we draw on developmental findings to provide a nuanced understanding of background emotions, particularly those in depression. We demonstrate how they reflect our basic proximity (feeling of interpersonal connectedness) to others and defend both a phenomenological and a functional claim. First, we substantiate a conjecture by Fonagy & Target (International Journal of Psychoanalysis 88(4):917–937, 2007) that an important phenomenological aspect of depression is the experiential recreation of the infantile loss of proximity to significant others. Second, we argue (...) that proximity has a particular cognitive function that allows individuals to morph into a cohesive dyadic system able to carry out distributed emotion regulation. We show that elevated levels of psychological suffering connected to depressive background emotions may be explained not only in terms of a psychological loss, but also as the felt inability to enter into dyadic regulatory relations with others—an experiential constraint that decreases the individual’s ability to adapt to demanding situations. (shrink)

The DSM‐5 highlights two essential psychological features of anorexia nervosa (AN): recalcitrant fear of gaining weight and body image disturbance. Prominent accounts grant false beliefs about body weight and shape a central role in the explanation of AN behavior. In this article, we propose a stronger emphasis on recalcitrant fear. We show that such fear can explain AN behavior without the intermediary of a false belief, and thus without the associated explanatory burdens and conceptual difficulties. We illustrate how shifting the (...) emphasis from false belief to recalcitrant fear can supplement a number of different non‐doxastic models of AN. (shrink)

Scaffolded Minds offers a novel account of cognitive scaffolding and its significance for understanding mental disorders. The book is part of the growing philosophical engagement with empirically informed philosophy of mind, which studies the interfaces between philosophy and cognitive science. It draws on two recent shifts within empirically informed philosophy of mind: the first, toward an intensified study of the embodied mind; and the second, toward a study of the disordered mind that acknowledges the convergence of the explanatory concerns of (...) psychiatry and interdisciplinary inquiries into the mind. The book sets out to accomplish a dual task: theoretical mapping of cognitive scaffolding; and the application/calibration of fine-grained philosophical distinctions to empirical research. It introduces the notion of actively scaffolded cognition (ASC) and offers a taxonomy that distinguishes between intrasomatic and extrasomatic scaffolding. It then shows that ASC offers a productive framework for considering certain characteristic features of mental disorders, focusing on altered bodily experience and social cognition deficits. (shrink)

Authenticity has become a widespread ethical ideal that represents a way of dealing with normative gaps in contemporary life. This ideal suggests that one should be true to oneself and lead a life expressive of what one takes oneself to be. However, many contemporary thinkers have pointed out that the ideal of authenticity has increasingly turned into a kind of aestheticism and egoistic self-indulgence. In his book, Varga systematically constructs a critical concept of authenticity that takes into account the (...) reciprocal shaping of capitalism and the ideal of authenticity. Drawing on different traditions in critical social theory, moral philosophy and phenomenology, Varga builds a concept of authenticity that can make intelligible various problematic and potentially exhausting practices of the self. (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)

This collection of essays provides the first systematic investigation of practical necessity and offers novel perspectives on this intriguing phenomenon. While debates on necessity often take place in the realm of metaphysics, there is a form of necessity that is pertinent to practical philosophy. “Here I stand. I can do no other,” a phrase habitually attributed to Luther, is often interpreted as revealing underlying normative reasons that exhibit a special kind of necessitating force, experienced as an inescapable constraint by the (...) agent. However, one of the features that make this phenomenon so fascinating is that this constraint is often deciphered as stemming from a form of necessitation that articulates the agent’s autonomy or practical identity. Luther’s saying serves as a leitmotif for an exploration of different claims and challenges related to practical necessity. (shrink)

While medicine is solidly grounded on scientific areas such as biology and chemistry, some argue that it is in its essence not a science at all. With medicine playing a substantial societal role, addressing questions about the scientific nature of medicine is of obvious urgency. This paper takes on such a task and starts by consulting the literature on the “demarcation” problem in the philosophy of science. Learning from failures of earlier approaches, it proposes that we adopt a Deflated Approach, (...) which acknowledges that “science” is a family resemblance concept that admits differences of degrees to nonscientific undertakings. Then, drawing on Paul Hoyningen-Huene’s (Systematicity: The nature of science, Oxford University Press, Oxford, 2013); (Synthese 196: 907–928, 2019) account of systematicity and Alexander Bird’s (Synthese 196: 863–879, 2019) analysis of examples from the history of medicine, the paper argues that medicine meets the requirement for systematicity on all dimensions and thereby qualifies as a science. The paper then considers and defuses two objections. First, it is shown that nonepistemic differences linked to the distinctive duality of medicine do not warrant thinking that medicine is not science. Second, against some recent criticism (Oreskes in Synthese 196: 881–905, 2019), the paper uses homeopathy as an example to show that (synchronic and diachronic) systematicity can succeed as a demarcation criterion. (shrink)

Grief is often described as characterized by a particular emotional response to another person’s death. While this is true of paradigm cases, we argue that a broader notion of grief allows accommodating forms of this emotional experience that deviate from the paradigmatic case. The bulk of the paper explores such a nonparadigmatic form of grief, anticipatory-vicarious grief, which is typically triggered by pondering the inevitability of our own death. We argue that AV-grief is a particular moral emotion that serves a (...) unique function and is indissolubly linked to the practical identities of human agents. An agent’s AV-grief is about the harm that occurs to individuals whose practical identities depend on the agent. (shrink)

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

Debates about the genuine disease status of controversial diseases rely on intuitions about a range of factors. Adopting tools from experimental philosophy, this paper explores some of the factors that influence judgments about whether low sexual desire should be considered a disease and whether it should be medically treated. Drawing in part on some assumptions underpinning a divide in the literature between viewing low sexual desire as a genuine disease and seeing it as improperly medicalized, we investigate whether health and (...) disease judgments are affected by factors such as an individual’s gender, the cause of the low desire, whether the desire is high or low, and both personal and societal valuations of the condition. Our main findings indicate that (a) the cause of a condition influences whether it is judged a disorder, (b) how the individual values the condition influences whether the condition is seen as a proper target of medical intervention, and (c) perceived dysfunction influences judgments regarding health, disorder classification, medicalization, and medical intervention. Our findings help further illuminate the intricate interplay of factors that influence judgments about health and disease in controversial conditions. (shrink)

In contemporary philosophy of the cognitive sciences, proponents of the ‘Hypothesis of Extended Cognition’ have focused on demonstrating how cognitive processes at times extend beyond the boundaries of the human body to include external physical devices. In recent years the HEC framework has been put to use in cases of “socially” extended cognition. The guiding intuition in this paper is that exploring the cognitive incorporations of genuinely social elements may advance HEC debates. The paper provides an analysis of emotion regulation (...) in ‘dyadic synchronic interaction’ between infant and caretaker and argues that some ‘socially extended’ cases of cognition cannot be captured with the HEC. Instead, the ‘Hypothesis of Emergent Extended Cognition’ is introduced that complements the HEC and helps in understanding how cognitive properties are sometimes irreducibly emergent, non-programmed properties of coupled social systems. It will be concluded that operating with the HEEC leads to both a more precise grip on the explanandum and to a more robust explanans. (shrink)

Philosophy and Phenomenological Research, EarlyView.

The question of how we actually arrive at our knowledge of others’ mental lives is lively debated, and some philosophers defend the idea that mentality is sometimes accessible to perception. In this paper, a distinction is introduced between “mind awareness” and “mental state awareness,” and it is argued that the former at least sometimes belongs to perceptual, rather than cognitive, processing.

How do people understand the concepts of mental health and disorder? The objective of this paper is to examine the impact of several factors on people’s judgments about whether a condition constitutes a mental disorder or a healthy state. Specifically, this study examines the impact of the source of the condition, its outcome, individual valuation (i.e., the value the individual attaches to the condition), and group valuation (i.e., the value the relevant group attaches to the condition). While we find that (...) people’s health and disorder judgments are driven by perceived dysfunction, we also find that health and disorder judgments are impacted differently by these factors. Health judgements are impacted by outcome and individual valuation, and disorder judgments are impacted by condition source. These results suggest that the folk concept of mental health is positive (i.e., mental health is more than the absence of mental disorder) and normativist (i.e., value judgments play a significant role in determining whether a condition counts as healthy), while the concept of mental disorder aligns with a naturalist perspective, at least to the extent that dysfunction plays an important role in categorizing a condition as a disorder. However, our finding that people’s dysfunction judgments are influenced by individual valuation and outcomes poses a strong challenge to naturalist accounts. To provide access to our supplementary data, an appendix has been included. (shrink)

The Philosophy of Psychiatry is a unique area of research because the nature of the subject matter leads to quite distinct methodological issues. Naturalism, Interpretation, and Mental Disorder is an original new work focusing on the challenges we face when trying to interpret and understand mental illness. The book integrates a hermeneutical perspective, and shows how such an approach can reveal important facts about historical sources in psychiatry and the nature of dialogue in the therapeutic encounter. In addition, the book (...) demonstrates how such an approach can be valuable for understanding the concept of mental disorder itself. Naturalism, Interpretation, and Mental Disorder brings fresh thinking to the philosophy of psychiatry, and will be of interest to students and scholars in the fields of Mental Health and Philosophy. (shrink)

This paper starts by distinguishing three views about the phenomenal character of perceptual experience. ‘Low-level theorists’ argue that perceptual experience is reducible to the experience of low-level properties, ‘high-level theorists’ argue that we have perceptual experiences of high-level properties, while ‘disunified view theorists’ argue that perceptual seemings can present high-level properties. The paper explores how cognitive states can penetrate perceptual experience and provides an interpretation of cognitive penetration that offers some support for the high-level view.

Drawing on empirical material from social psychology, ‘situationism’ argues that the astonishing susceptibility of moral behaviour to situational influences undermines certain conceptions of character. The related, albeit more limited, thesis proposed in this paper, ‘embodied situationism’, engages a larger number of empirical sources from different fields of study and sheds light on the mechanisms responsible for particular, seemingly puzzling, situational judgments and behaviours. It is demonstrated that the empirical material supports the claims of ES and that ES is immune to (...) some important objections against situationism. (shrink)

The Extended Mind Hypothesis has given rise to stimulating philosophical debates about the boundaries of the realm of the cognitive. This paper first investigates the usefulness of a “mark of the cognitive,” and then focuses on two accounts that aim to provide such a mark, put forward by Fred Adams and Rebecca Garrison on one side and Mark Rowlands on the other. The paper provides a critical assessment of these accounts and uses empirical work on emotion regulation in infants to (...) unearth some crucial challenges that any attempt at offering a mark of the cognitive should address. (shrink)

Medicine is increasingly subject to various forms of criticism. This paper focuses on dominant forms of criticism and offers a better account of their normative character. It is argued that together, these forms of criticism are comprehensive, raising questions about both medical science and medical practice. Furthermore, it is shown that these forms of criticism mainly rely on standards of evaluation that are assumed to be internal to medicine and converge on a broader question about the aim of medicine. Further (...) work making medicine’s internal norms explicit and determining the aim of medicine would not only help to clarify to what extent the criticism is justified, but also assist an informed deliberation about the future of medicine. To illustrate some of the general difficulties associated with such a task, the paper concludes by critically engaging Edmund Pellegrino’s account of the aim of medicine as well as the Hastings Center’s consensus report. (shrink)

This paper aims to clarify the nature of understanding in medicine. The first part describes in more detail what it means to understand something and links a type of understanding (i.e., objectual understanding) to explanations. The second part proceeds to investigate what objectual understanding of a disease (i.e., biomedical understanding) requires by considering the case of scurvy from the history of medicine. The main hypothesis is that grasping a mechanistic explanation of a condition is necessary for a biomedical understanding of (...) that condition. The third part of the paper argues that biomedical understanding is necessary, but not sufficient for understanding in a clinical context (i.e., clinical understanding). The hypothesis is that clinical understanding combines biomedical understanding of a _disease_ or pathological condition with understanding _illness,_ which involves some degree of personal understanding of the patient. It is argued that, in many cases, clinical understanding necessitates adopting a particular second-personal stance and using cognitive resources _in addition_ to those involved in biomedical understanding. (shrink)

A large part of the contemporary literature on dehumanization is committed to three ideas: (a) dehumanization involves some degree of denial of humanness, (b) such denial is to be comprehended in mental terms, and (c) whatever exact mechanisms underlie the denial of humanness, they belong in the realm of post-perceptual processing. This chapter examines (c) and argues that the awareness of minds might belong to perceptual processing. This paves the way for the possibility that dehumanization might, at least in part, (...) be a perceptual phenomenon, such that dehumanizers visually perceive the dehumanized as exhibiting lesser-than-human minds. It is perhaps unsurprising that the first systematic investigations of dehumanization approached the phenomenon as linked to contexts of war, genocide, extreme hatred, and violence. One guiding hypothesis was that dehumanizers exclude the dehumanized from a moral community of human beings, implicitly conceptualized as displaying distinct individualities and being embedded in caring interpersonal relations. By comprehending the dehumanized as deindividuated entities to which moral norms and considerations of fairness do not apply (Opotow 1990), dehumanizers are able to disengage from moral restrictions and self-sanctions (Bandura 1999). (shrink)

From Minkowski and Jaspers to Blankenburg, phenomenological psychopathology has assumed that lost or diminished experience of ‘realness’ is related to an impairment of tacit level intersubjectivity. This paper develops a theoretical framework for this hypothesis by drawing mainly on the phenomenological tradition and the works of Wittgenstein. The argument, in return, contributes to recent discussions regarding depersonalization and intersubjectivity. In addition, the approach suggests some interesting implications for psychopathology.

Often drawing on the phenomenological tradition, a number of philosophers and cognitive scientists working in the field of “embodied cognition” subscribe to the general view that cognition is grounded in aspects of its sensorimotor embodiment and should be comprehended as the result of a dynamic interaction of nonneural and neural processes. After a brief introduction, the paper critically engages Lakoff and Johnson’s “conceptual metaphor theory”, and provides a review of recent empirical evidence that appears to support it. Subsequently, the paper (...) underscores some of the limitations of CMT, points to some philosophical problems that require further attention, and explores possible implications for understanding and treating of mental disorders. (shrink)

Psychotic and prodromal states are characterized by distortions of intersubjectivity, and a number of psychopathologists see in the concrete I-You frame of the clinical encounter the manifestation of such impairment. Rümke has coined the term of ‘praecox-feeling’, designated to describe a feeling of unease emanating in the interviewer that reflects the detachment of the patient and the failure of an ‘affective exchange.’ While the reliability of the praecox-feeling as a diagnostic tool has since been established, the explanation and theoretical framing (...) of the phenomena is still lacking. By drawing on enactivist approaches to social cognition, the paper will attempt to provide such an explanation. This is relevant, since such an explanation could contribute to a more precise understanding of the phenomena in question and possibly add to our knowledge regarding the link between experiential vulnerability to psychosis and disturbed I-Thou intersubjectivity. (shrink)

Christopher Boorse’s Health care ethics: an introduction, Temple University Press, Philadelphia, pp 359–393, 1987; in Humber, Almeder, Totowa What is disease?, Humana Press, New York City, pp 1–134, 1997; J Med Philos, 39:683–724, 2014) Bio-Statistical Theory comprehends diseases in terms of departures from natural norms, which involve an objectively describable deviation from the proper physiological or psychological functioning of parts of the human organism. I argue that while recent revisions and additional considerations shield the BST from a number of issues (...) raised by critics, they give rise to significant new challenges. These are related to the attribution of epistemic authority, the possibility of multiple concepts in the authoritative literature, and the framing of BST as “philosophical explication.” The conclusion is that, in its current form, the BST is unable to provide a robust framework for a naturalist classification. (shrink)

The paper engages Christopher Boorse’s Bio-Statistical Theory. In its current form, BST runs into a significant challenge. For BST to account for its central tenet—that lower-level part-dysfunction is sufficient for higher-level pathology—it must provide criteria for how to decide which lower-level parts are the ones to be analyzed for health or pathology. As BST is a naturalistic theory, such choices must be based solely on naturalistic considerations. An argument is provided to show that, if BST is to be preserved, such (...) parthood choices are based on non-naturalistic considerations. We demonstrate that even when parthood choices are based on the best way to preserve BST, there are counterintuitive results which bring the central tenet of BST into question. (shrink)

While medicine is solidly grounded on scientific areas such as biology and chemistry, some argue that it is in its essence not a science at all. With medicine playing a substantial societal role, addressing questions about the scientific nature of medicine is of obvious urgency. This paper takes on such a task and starts by consulting the literature on the “demarcation” problem in the philosophy of science. Learning from failures of earlier approaches, it proposes that we adopt a Deflated Approach, (...) which acknowledges that “science” is a family resemblance concept that admits differences of degrees to nonscientific undertakings. Then, drawing on Paul Hoyningen-Huene’s ; account of systematicity and Alexander Bird’s analysis of examples from the history of medicine, the paper argues that medicine meets the requirement for systematicity on all dimensions and thereby qualifies as a science. The paper then considers and defuses two objections. First, it is shown that nonepistemic differences linked to the distinctive duality of medicine do not warrant thinking that medicine is not science. Second, against some recent criticism, the paper uses homeopathy as an example to show that systematicity can succeed as a demarcation criterion. (shrink)

Worries about the potential medicalization of social and moral problems has propelled the debate on the nature of mental disorder, with normativists insisting that psychiatric classification is inherently value-laden and naturalists maintaining that a purely descriptive account of disease is possible. In recent work, some authors take a different path, accepting that the concepts of disease and mental disorder are value-laden but maintaining that this does not prevent objective truths regarding mental disorder attribution. This paper explores two such accounts and (...) the important steps they provide toward rethinking the nature and metaphysical status of mental disorder. The challenges raised in this paper are meant to contribute to the further development of this stimulating work. (shrink)

Some of our motives that we act on are not only of unconstrained origin, but we also take them to express who we are and, thus, to "speak for us." Harry G. Frankfurt has maintained that it is the formation of a hierarchical structure by means of an act of wholehearted identification that makes a given motive genuinely one's own. I argue that wholehearted identifications fail to live up to this task. Instead, I demonstrate that only a subtype of wholehearted (...) identifications, namely core identifications, genuinely "speak for us." In addition, I argue that core identifications help explain the peculiar phenomenology that characterizes some of our crucial choices. (shrink)

After some preliminary distinctions, this paper will discuss the merits of higher-order representational theory and same-order theory. A distinction will be introduced between a intrinsic conception of consciousness and a representational variant . It will be argued that the SOIT account of 'non-reflective self-awareness' can be applied to understanding aspects of psychopathology. However, a closer look at specific aspects of schizophrenic experience reveals that we might need to widen the scope of and 'situate' the SOIT of non-reflective selfawareness.

Cognitive theory (CT) is currently the most widely acknowledged framework used to describe the psychological processes in affective disorders like depression. The purpose of this paper is to assess the philosophical assumptions upon which CT rests. It is argued that CT must be revised due to significant flaws in many of these philosophical assumptions. The paper contains suggestions as to how these problems could be overcome in a manner that would secure philosophical accuracy, while also providing an account that is (...) better suited to explaining some of the cognitive, emotional, and bodily manifestations of affective disorders. (shrink)