Abstract

Philosophers of science have largely taken little interest in developments in contemporary medicine. There is a familiar, if largely unspoken and undefended, picture of medical research that seems to put it at the periphery of science proper. On this view, medicine is akin to other applied disciplines whose primary aim is to solve particular problems. Scientific research would then be important to medicine only in so far as it sets one kind of constraint on the problem solving process. A second kind of constraint would be set by considerations of value, because the choice, ultimately, is of a course of action, a means to achieving a particular goal. Both the goals that are sought, and the means selected for getting there, are open to evaluation. This normative constraint is, then, added as a kind of second filter, operating on the already given scientific understanding of the parts and processes involved. This view of the relationship between medicine and biology emphasizes a strong discontinuity in explanatory style with the introduction of this separate normative frame. ;A second view might be called an assimilationist view. This view suggests that medical explanations are simply a kind of biological explanation, suggesting that both are value-neutral and that it is a mistake to see a normative frame playing any role in medical explanations. I argue against both of these positions, and defend an account of the relationship between biological explanations and medical explanations that emphasizes their continuity. ;I argue that both medicine and biology rely on a similar understanding of the nature of living creatures. A proper understanding of this underlying picture reveals that medical and biological explanations are extensions of an essentially similar explanatory style. Further, in order for both kinds of explanations to be genuinely explanatory, they require reference to broader contexts that are often unavoidably value-laden