According to public health data, the US Hispanic population is far healthier than would be expected for a population with low socioeconomic status. Ever since Kyriakos Markides and Jeannine Coreil highlighted this in a seminal 1986 article, public health researchers have sought to explain the so-called “Hispanic paradox.” Several candidate explanations have been offered over the years, but the debate goes on. This article offers a philosophical analysis that clarifies how two sets of obstacles make it particularly difficult to explain (...) the Hispanic paradox. First, different research projects define the Hispanic paradox phenomenon in substantially different ways. Moreover, using Bas van Fraassen’s pragmatic theory of explanation and Sean Valles’s extension of it with the concept of “phenomenon choice,” it also becomes clear that there are also multiple ways of explaining each individual definition of the phenomenon. A second set of philosophical and methodological challenges arises during any attempt to study “Hispanic” phenomena, with one key challenge being that the “Hispanic” panethnic concept was intentionally made vague as it was developed and popularized during the 1960s–1970s. After comparing this case with similar cases in the philosophical literature, the article concludes with observations on what makes this problem unique, particularly its ethical features. (shrink)

Two decades ago, the eminent evolutionary biologist George C. Williams and his physician coauthor, Randolph Nesse, formulated the evolutionary medicine research program. Williams and Nesse explicitly made adaptationism a core component of the new program, which has served to undermine the program ever since, distorting its practitioners’ perceptions of evidentiary burdens and in extreme cases has served to warp practitioner’s understandings of the relationship between evolutionary benefits/detriments and medical ones. I show that the Williams and Nesse program more particularly embraces (...) the panselectionist variety of adaptationism (the empirical assumption that non-adaptive evolutionary processes are causally unimportant compared to natural selection), and argue that this has harmed the field. Panselectionism serves to conceal the enormous evidentiary hurdles that evolutionary medicine hypotheses face, making them appear stronger than they are. I use two examples of evolutionary medicine texts, on neonatal jaundice and on asthma, to show that some evolutionary medicine practitioners have allowed their fervent panselectionism to directly shape their recommendations for clinical practice. I argue that this escalation of panselectionism’s influence is inappropriate under Williams’ and Nesse original stated standards, despite being inspired by their program. I also show that the examples’ conflation of clinical and evolutionary considerations is inappropriate even under Christopher Boorse’s controversial evolution-rooted concepts of disease and health. (shrink)

Randolph Nesse argues that evolutionary theory is the key element in elaborating a valid criterion demarcating the normal from the pathological in psychiatry. By focusing on the application of Nesse’s criterion on the demarcation of normal low mood from pathological depression, I argue – contrary to Nesse’s claims – that evolutionary theory cannot generate a valid criterion from the differentiation of normal low mood states from pathological depression. Indeed, expression in conformity to evolved functions cannot constitute a sufficient condition for (...) normality, as Nesse’s project should imply. Moreover, grounding normality in evolved functions presupposes a kind of fixity of our emotional states, which seems unwarranted in the light of a constantly changing environment. As a result of these limitations, I suggest that the relevant distinction in psychiatry should not be “normality” versus “abnormality”, but, rather, “that which requires intervention” versus “that which does not”. (shrink)