Dissertation, Ku Leuven (
2014)
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Abstract
Defining the concepts of health and disease has proved rather difficult
and many philosophers of medicine have simply concluded that we would be better
off giving up on such endeavors. I feel that this view is misguided mainly
because it seems to rest on a rather inadequate understanding of how
philosophers use biology to clarify medical concepts. While some philosophers
appeal to biology so as to clarify what we mean by the concepts of health and
disease, others attempt to use biology to develop a theory thathelps to
explain what health and disease are. In this dissertation, I examine the work
of an often overlooked philosopher of medicine, Georges Canguilhem, who sought
to understand medical concepts by starting from the biological properties of
variation and variability. In other words, in order to define health and
disease, Canguilhem first tried to establish how what is normal can vary
between organisms and even within the same organism due to the dynamic relation
between the organism and its environment. Simply put: what is normal for one
organism could be pathological for another and what is normal in one
environment could become pathological in another. Consequently, variation and
variability need to be included in our understanding of health and disease.
Throughout this dissertation, I explore how Canguilhem goes about developing
the implications of these biological properties for medical concepts and this
allows me to distinguish his approach from some popular ones in philosophy of
medicine, e.g. those trying to develop an objective biological approach
(naturalism) and those appealingto evolutionary principles. I establish the plausibility
of definingmedical concepts relative to individual organisms and their
environments, while showing some of its potential limitations, especially when
it comes to human social environments. Ultimately, a more nuanced understanding
of how the inseparability of organisms and environments canhelp to clarify
health and disease provides an interesting way to get past the apparent
stalemate in philosophy of medicine and firmly establishes the relevance of
Canguilhems philosophy.