Obesity has generated significant worries amongst health policy makers and has obtained increased attention in health care. Obesity is unanimously defined as a disease in the health care and health policy literature. However, there are pragmatic and not principled reasons for this. This warrants an analysis of obesity according to standard conceptions of disease in the literature of philosophy of medicine. According to theories and definitions of disease referring to internal processes, obesity is not a disease. Obesity undoubtedly can result (...) in disease, making it a risk factor for disease, but not a disease per se. According to several social conceptions of disease, however, obesity clearly is a disease. Obesity can conflict with aesthetic, moral, or other social norms. Making obesity a “social disease” may very well be a wise health policy, assuring and improving population health, especially if we address the social determinants of obesity, such as the food supply and marketing system. However, applying biomedical solutions to social problems may also have severe side effects. It can result in medicalization and enhance stigmatization and discrimination of persons based on appearance or behavior. Approaching social problems with biomedical means may also serve commercial and professionals’ interests more than the health and welfare of individuals; it may make quick fix medical solutions halt more sustainable structural solutions. This urges health insurers, health care professionals, and health policy makers to be cautious. Especially if we want to help and respect persons that we classify and treat as obese. (shrink)

This article draws on Ellul’s analysis of propaganda in understanding propaganda in the helping professions. Key in such an analysis is the interweaving of the psychological and sociological. Contrary to the discourse in mission statements of professional organizations and their codes of ethics calling for informed consent, competence of professionals and taking advantage of research findings, in everyday practice we find a variety of avoidable lapses, including decontextualized problem framing, bogus claims concerning risks, accuracy of assessment measures, and effectiveness of (...) interventions. Perhaps most troubling is obscuring the causes of human problems, for example, framing problems-in-living such as anxiety, alienation, and loneliness that result from living in a technological society as brain disorders, so mystifying the causes of distress. (shrink)

The nosological diagnosis is a particular type of nontheoretical diagnosis consisting of identifying the disease that afflicts the patient without explaining the underlying etiopathological mechanisms. Its origins are within the essentialist point of view on the nature of diseases, which dates back at least to 18th-century taxonomy studies. In this article, we propose a model of nosological diagnosis as a two-phase process composed of the categorization of inductive inferences and argumentations by analogy. In the inductive phase, disease entities are identified (...) by means of typicality-based categorization processes, and meaningful clinical samples are learned ; in the subsequent phase, those samples are used as the bases of argumentations by analogy to obtain a diagnosis for a given patient. This model extends the prototype resemblance theory of disease including also the exemplar theory proposed in cognitive science and, moreover, it frames the clinical activity of nosological diagnosis and how it can be explained within the theory of argumentation. According to it, diagnosis based on the recognition of a typical syndrome is explained in terms of the prototype theory of categorization and the antisymmetrical argumentation by analogy, while diagnosis based on a comparison with a previous clinical case is explained by the exemplar theory of categorization and by the symmetrical argumentation by analogy. (shrink)

This article examines the ethnographic case study in education in the context of policy making with particular emphasis on the practice of research and policy making. The central claim of the article is that it is impossible to establish a transcendental epistemology of the case study on instrumental rationality. Instead it argues for the notion of situated judgement that needs to be made by practitioners in context, practitioners being both researchers and policy makers. In other words, questions about the level (...) of confidence or warrant that can be placed in different sorts of research evidence and findings cannot be answered independently of forming a view about the appropriateness of the policy culture that shapes political decision-making. The article draws a distinction between the general, which is internal to the data as construed by a particular discipline, and the universal, which is the result of embedded human deliberation. This applies to all research findings and not only to case study, although since case study has long had to defend itself against accusations of the lack of generality, it can be a useful starting point for the discussion. This article is not meant to be yet another defence of the case study research genre, although a summary of other defences is offered. Rather it focuses on how use of the case study points to the limits of epistemology as rationality and offers a view of epistemology as ethics. (shrink)

This article examines the ethnographic case study in education in the context of policy making with particular emphasis on the practice of research and policy making. The central claim of the article is that it is impossible to establish a transcendental epistemology of the case study on instrumental rationality. Instead it argues for the notion of situated judgement that needs to be made by practitioners in context, practitioners being both researchers and policy makers. In other words, questions about the level (...) of confidence or warrant that can be placed in different sorts of research evidence and findings cannot be answered independently of forming a view about the appropriateness of the policy culture that shapes political decision-making. The article draws a distinction between the general, which is internal to the data as construed by a particular discipline, and the universal, which is the result of embedded human deliberation. This applies to all research findings and not only to case study, although since case study has long had to defend itself against accusations of the lack of generality, it can be a useful starting point for the discussion. This article is not meant to be yet another defence of the case study research genre, although a summary of other defences is offered. Rather it focuses on how use of the case study points to the limits of epistemology as rationality and offers a view of epistemology as ethics. (shrink)

Correlation analyses of recent back‐propagation neural networks show that network results are due to imbalances in stimulus input. Conclusions concerning the effects of receptive field size, hemispheric specialization, and other issues of relevance to psychology cannot therefore be drawn until the dominating effects of low‐level correlations are removed. Statistical techniques for evaluating the stimulus materials for neural networks are introduced.

What Ivan Illich regarded in his Medical Nemesis as the ‘expropriation of health’ takes place on the surfaces and in the spaces of the screens all around us, including our cell phones but also the patient monitors and (increasingly) the iPads that intervene between nurse and patient. To explore what Illich called the ‘age of the show’, this essay uses film examples, like Creed and the controversial documentary Vaxxed, and the television series Nurse Jackie. Rocky’s cancer in his last film (...) (submitting to chemo to ‘fight’ cancer) highlights what Illich along with Petr Skrabanek called the ‘expropriation of death’. In contrast to what Illich denotes as ‘Umsonstigkeit’ – i.e., a free gift, given undeservedly, i.e., gratuitously – medical science tends to be tempted by what Illich terms scientistic ‘black magic’, taking over (expropriating) the life and the death of the patient in increasingly technological ways, a point underscored in the concluding section on the commercial prospects of xenotransplants using factory farm or mass-produced (and already for some time) human-pig mosaics or chimeras. (shrink)