The purpose of the article is to study the influence of Nazi experiments on the formation of ideas about the ethos of science in the field of biomedicine. It is shown that the idea of discrediting a value-neutral science was often confronted with the resistance of the scientists themselves, who, in different contexts of condemning Nazi crimes, appealed to the fact that they acted for the good of science, and even of all mankind. The article discusses the strategy of (...) American lawyers adopted at the Nuremberg Trials aimed at demonstrating the perversity of Nazi crimes in the field of biomedicine both ethically and scientifically. In addition, an analysis of individual materials of the Nuremberg process was carried out, which made it possible to give an idea of the scientific and linguistic design of the human body (name correction strategy) as a “correct” scientific object with desired properties. The article considers the influence of the data obtained on Nazi crimes on the formation of the content of the Nuremberg Code and the design of the principle of informed consent in biomedicine. Ethical aspects related to the further use of Nazi scientific data are also considered. In conclusion, the problem of the formation of scientific knowledge in non-violence mode is articulated. (shrink)

Chapter 1 Introduction The man was coughing again. Shocked he was as he discovered that his saliva had a reddish taint. Would he have a lung disease after all? Cancer perhaps? Long ago, relatives of his had died from LC, lung cancer.

The question "Where do we come from?" has fascinated philosophers, scientists, and artists for generations. This book reorients the question of the matrix as a place where everything comes from (_chora_, womb, incubator) by recasting it in terms of acts of "matrixial/maternal hospitality" producing space and matter of and for the other. Irina Aristarkhova theorizes such hospitality with the potential to go beyond tolerance in understanding self/other relations. Building on and critically evaluating a wide range of historical and contemporary scholarship, (...) she applies this theoretical framework to the science, technology, and art of ectogenesis (artificial womb, neonatal incubators, and other types of generation outside of the maternal body) and proves the question "Can the machine nurse?" is critical when approaching and understanding the functional capacities and failures of incubating technologies, such as artificial placenta. Aristarkhova concludes with the science and art of male pregnancy, positioning the condition as a question of the hospitable man and newly defined fatherhood and its challenge to the conception of masculinity as unable to welcome the other. (shrink)

After considering two of Pellegrino’s papers that address the relation between philosophy of medicine and medical ethics, I identify several overarching problems in his account that revolve around his self-described essentialism and the lack of a systematic attempt to relate clinical medicine to biomedicine and public health. I address these from the critical realist position of Bernard Lonergan, who grounds both metaphysics and ethics on the normative structure of human inquiry and seeks to understand historical development, such as (...) we are witnessing in health science and health care, in terms of the dynamic structure of the human good. I conclude that Lonergan’s generalized empirical method and hierarchical account of world order provide a potentially dynamic framework on which to build a more comprehensive philosophy of medicine than one whose foundations rest primarily on a phenomenology of the clinical encounter and the telos of medicine. (shrink)

Philosophical understanding of experimental scientific practice is impeded by disciplinary differences, notably that between philosophy and sociology of science. Severing the two limits the stock of philosophical case studies to narrowly circumscribed experimental episodes, centered on individual scientists or technologies. The complex relations between scientists and society that permeate experimental research are left unexamined. In consequence, experimental fields rich in social interactions have received only patchy attention from philosophers of science. This paper sketches a remedy for both the symptom (...) and its root cause. An empirical study of social interactions in an established field of biomedicine grounds a robust account of success in experimental practice. The core idea is the concept of collaboration, of participants working together on a common project toward a shared goal. The interactive social integument of experimental research is both examined and enacted in a study integrating socio-historical research and philosophical investigation. The two approaches are used in concert to explicate the concept of scientific objectivity. Their joint explication of this contested epistemic ideal demonstrates that philosophical and sociological approaches can work together toward a social epistemology of scientific practice. The explication is in three stages. First, a minimal framework for investigating collaborative activities is established. Social action is understood and evaluated in terms of the connection between shared goals that participants hope to accomplish together, and the coordinated means by which they try to do so. This connection is explicated as participation, a relation mediating between a group and its members, which includes minimal constraints of instrumental rationality. Second, this framework is fleshed out via empirical study of scientific practices. The focal case examines the intersection of immunology and stem cell research in mid-20th century biomedicine, tracing the key social interactions within and among laboratory groups, as the field of blood stem cell research emerged in the 1960s and advanced throughout the next four decades. The study yields a robust empirical result. Participants consistently recognize two aspects of scientific success: construction of improved models of blood cell development, and formation of new boundaries among scientific groups. In the third and final stage, this result is generalized to other experimental episodes and shown to fit with recent accounts of models in scientific practice. The generalized result approximates a familiar normative view of scientific knowledge. An epistemic ideal of scientific objectivity in practice is then derived from this robust general result, using the minimal constraints on rational participation. The derivation is analogous to specification of ends in moral philosophy; given the means taken and assuming some hope of success, what must the goal of scientific inquiry be like? The aim of science so conceived corresponds to a classic conception of scientific objectivity: knowledge independent of epistemic criteria specific to particular persons or groups. This result weaves together sociological and philosophical accounts of science, explicating the epistemic ideal of objectivity in relation to social aspects of scientific practice. This undercuts the entrenched dualism between normative, vs. descriptive approaches to scientific knowledge. Socio-historical study of science does not deflate, but vindicates, scientific objectivity. Philosophy and sociology are recast as collaborating participants in articulating social epistemology of science. (shrink)

This article critically explores the notion of those sociopolitical spaces that are 'disability', 'holism' and 'genetics', arguing from the perspectives of someone who identifies as having a disability. Medical genetics is seen to reflect the ideology and dominant biomedical reductionist thought. In contrast with this, it is proposed that disability and health are inherently social. A nursing approach is seen to recognize the social and holistic nature of the human person and to present a critical reflection on the reductionistic applications (...) of medical genetics. (shrink)

The categories of health and disease/illness are conceptualized from the perspective of the philosophy of medicine. Philosophical contradictions are revealed, which, fueling the debate between naturalism and normativism, prevent biomedicine from developing a single satisfactory understanding of these categories. The theoretical and practical consequences of such biomedicine features as pathocentrism, identification of health with complete well-being, dichotomy of health and disease in the absence of a clear criterion for their differentiation are analyzed. The role of humanistic approaches (...) to the medicine rehumanization is investigated with a focus on their balanced view of health and disease/illness, attentive to the fundamental vulnerability of human nature. (shrink)

Medical practice is practiced morality, and clinical research belongs to normative ethics. The present book elucidates and advances this thesis by: 1. analyzing the structure of medical language, knowledge, and theories; 2. inquiring into the foundations of the clinical encounter; 3. introducing the logic and methodology of clinical decision-making, including artificial intelligence in medicine; 4. suggesting comprehensive theories of organism, life, and psyche; of health, illness, and disease; of etiology, diagnosis, prognosis, prevention, and therapy; and 5. investigating the moral and (...) metaphysical issues central to medical practice and research. Many systems of (classical, modal, non-classical, probability, and fuzzy) logic are introduced and applied. Fuzzy medical deontics, fuzzy medical ontology, fuzzy medical concept formation, fuzzy medical decision-making and biomedicine and many other techniques of fuzzification in medicine are introduced for the first time. -/- . (shrink)

Racial disparities in health outcomes have recently become a flashpoint in the debate about the value of race as a biological concept. What role, if any, race has in the etiology of disease is a philosophically and scientifically contested topic. In this article, I expand on the insights of the new mechanistic philosophy of science to defend a mechanism discovery approach to investigating epidemiological racial disparities. The mechanism discovery approach has explanatory virtues lacking in the populational approach typically employed (...) in the study of race and biomedicine. The explanatory constraints that form an integral part of the new mechanistic approach enable mechanism discovery to avoid the epistemic and normative shortcomings of the populational approach. The methodology of mechanism discovery can fruitfully be extended to the treatment and reversal of epidemiological racial disparities. (shrink)

From the operation of the universe to DNA, the brain and the economy, natural and social frequently describe their activity as being concerned with discovering mechanisms. Despite this fact, for much of the twentieth century philosophical discussions of the nature of mechanisms remained outside philosophy of science. This is an outstanding reference source to the key topics, problems and debates in this exciting subject and is the first collection of its kind. Comprising over thirty chapters by a team of (...) international contributors the Handbook is divided into four parts: Historical Perspectives on Mechanisms; The Nature of Mechanisms; Mechanisms and the Philosophy of Science; Disciplinary Perspectives. Within these sections central topics and problems are examined, including the rise of mechanical philosophy in the seventeenth century; mechanisms as parts and wholes and their interactive powers; mechanisms and laws and regularities; how mechanisms are discovered and explained; dynamical systems theory; and disciplinary perspectives from physics, chemistry, biology, biomedicine, ecology, neuroscience and the social and political sciences. Essential reading for students and researchers in philosophy of science and philosophy the Handbook will also be of interest to those in related fields, such as metaphysics, philosophy of psychology and history of science. (shrink)

More and more areas of medicine involve subjects donating tissues to another — blood, organs, bone marrow, sperm, ova and embryos can all be transferred from one person to another. Within the technical frameworks of biomedicine, such fragments are generally treated as detachable things, severed from social identity once they are removed from a particular body. However an abundant anthropological and sociological literature has found that, for donors and patients, human tissues are not impersonal. They retain some of the (...) values of personhood and identity, and their incorporation often has complex effects on embodied identity. This article draws on feminist philosophy of the body to think through the implications of some of these practices. Specifically, it draws on the idea of intercorporeality, wherein the body image is always the effect of embodied social relations. While this approach is highly productive for considering the stakes involved in tissue transfer, it is argued that the concept of body image has been too preoccupied with the register of the visual at the expense of introceptive data and health/illness events. Empirical data around organ transplant and sperm donation are used to demonstrate that the transfer of biological fragments involves a profound kind of intercorporeality, producing identifications and disidentifications between donors and recipients that play out simultaneously at the immunological, psychic and social levels. (shrink)

Increasingly, policymakers within biomedicine argue that “non-financial” interests should be given equal scrutiny to individuals’ financial relationships with industry. Problematized as “non-financial conflicts of interest,” interests, ranging from intellectual commitments to personal beliefs, are managed through disclosure, restrictions on participation, and recusal where necessary. “Non-financial” interests, though vaguely and variably defined, are characterized as important influences on judgment and thus, are considered risks to scientific objectivity. This article explores the ways that “non-financial interests” have been constructed as an ethical (...) problem and the implications for research integrity. I conducted an interpretive, qualitative study, which triangulated two data sources: documents (including published accounts of identifying and managing “non-financial” interests and conflict of interest policies) and in-depth interviews with 16 leaders within evidence-based medicine, responsible for contributing to, directing, or overseeing conflict of interest policy development and implementation. This article outlines how evolutions in the definition of conflict of interest have opened the door to include myriad “non-financial” interests, resulting in the generalisation of a statistical concept—risk of bias—to social contexts. Consequently, biases appear equally pervasive among participants while in reality, a politics of objectivity is at play, with allegations of conflict of interest used as a means to undermine others’ credibility, or even participation. Iterations of the concept of conflict of interest within biomedicine have thus consistently failed to articulate or address questions of accountability including whose interests are able to dominate or distort evidence-led processes and why. Consequently, current policy solutions meant to mitigate bias may instead serve exclusionary purposes under the guise of impartiality while remaining vulnerable to interference from powerful stakeholders. (shrink)

The evidence-based medicine (EBM) movement is touted as a new paradigm in medical education and practice, a description that carries with it an enthusiasm for science that has not been seen since logical positivism flourished (circa 1920–1950). At the same time, the term ‘‘evidence-based medicine’’ has a ring of obviousness to it, as few physicians, one suspects, would claim that they do not attempt to base their clinical decision-making on available evidence. However, the apparent obviousness of EBM can and should (...) be challenged on the grounds of how ‘evidence’ has been problematised in the philosophy of science. EBM enthusiasm, it follows, ought to be tempered. The post-positivist, feminist, and phenomenological philosophies of science that are examined in this paper contest the seemingly unproblematic nature of evidence that underlies EBM by emphasizing different features of the social nature of science. The appeal to the authority of evidence that characterizes evidence-based practices does not increase objectivity but rather obscures the subjective elements that inescapably enter all forms of human inquiry. The seeming common sense of EBM only occurs because of its assumed removal from the social context of medical practice. In the current age where the institutional power of medicine is suspect, a model that represents biomedicine as politically disinterested or merely scientific should give pause. (shrink)

This volume offers interdisciplinary perspectives on contemporary biomedicine as a cultural practice.

Bringing together scholars from philosophy, bioethics, law, sociology, and anthropology, this topical collection explores how innovations in the field of biomedicine and the life sciences are challenging and transforming traditional understandings of human temporality and of the temporal duration, extension and structure of human life. The contributions aim to expand the theoretical debate by highlighting the significance of time and human temporality in different discourses and practical contexts, and developing concrete, empirically informed, and culturally sensitive perspectives. The collection (...) is structured around three main foci: the beginning of life, the middle of life, and later life. This structure facilitates an in-depth examination of specific technological and biographical contexts and at the same time allows an overarching comparison of relevant similarities and differences between life phases and fields of application. (shrink)

The dominant unspoken philosophical basis of medical care in the United States is a form of Cartesian reductionism that views the body as a machine and medical professionals as technicians whose job is to repair that machine. The purpose of this paper is to advocate for an alternative philosophy of medicine based on the concept of healing relationships between clinicians and patients. This is accomplished first by exploring the ethical and philosophical work of Pellegrino and Thomasma and then by (...) connecting Martin Buber's philosophical work on the nature of relationships to an empirically derived model of the medical healing relationship. The Healing Relationship Model was developed by the authors through qualitative analysis of interviews of physicians and patients. Clinician-patient healing relationships are a special form of what Buber calls I-Thou relationships, characterized by dialog and mutuality, but a mutuality limited by the inherent asymmetry of the clinician-patient relationship. The Healing Relationship Model identifies three processes necessary for such relationships to develop and be sustained: Valuing, Appreciating Power and Abiding. We explore in detail how these processes, as well as other components of the model resonate with Buber's concepts of I-Thou and I-It relationships. The resulting combined conceptual model illuminates the wholeness underlying the dual roles of clinicians as healers and providers of technical biomedicine. On the basis of our analysis, we argue that health care should be focused on healing, with I-Thou relationships at its core. (shrink)

Philosopy of medicine focuses inter alia on metaphysics and epistemology that are instantiated in biomedicine as physicalism (or materialism) and empiricism. The Golubchuck case reveals how the clinicans failed to recognize the relation between medical science and medical ethics and made biomedical decsions devoid of medical ethics. That is, they failed to make medical judgments that by defintion include a normative ethical component.

The authors analyze deficiencies and perils of the European Convention on Human Rights and Biomedicine , in particular the concept of human rights as given by natural law and the Conventions stand on germline therapy and its refutation of therapeutic enhancement.

Roberto Esposito, Bíos: Biopolitics and Philosophy, with an intro. and trans. Timothy Campbell. Minneapolis: University of Minnesota Press, 2008; Nikolas Rose, The Politics of Life Itself: Biomedicine, Power, and Subjectivity in the Twenty-first Century. Princeton, NJ: Princeton University Press, 2007.

Putting the ethical tools of philosophy to work, Ellen K. Feder seeks to clarify how we should understand "the problem" of intersex. Adults often report that medical interventions they underwent as children to "correct" atypical sex anatomies caused them physical and psychological harm. Proposing a philosophical framework for the treatment of children with intersex conditions—one that acknowledges the intertwined identities of parents, children, and their doctors—Feder presents a persuasive moral argument for collective responsibility to these children and their families.

How to avoid disease, how to breed successfully, and how to live to a reasonable age are questions that have perplexed humankind throughout history. This book explores our progress in understanding these challenges, and the risks and rewards of devising solutions. A broad range of topics are covered, including reproduction, the development of human progeny from conception to adulthood, staying healthy, ageing, cancer, infection and the burden of our genetic legacy.

From the operation of the universe to DNA, the brain and the economy, natural and social frequently describe their activity as being concerned with discovering mechanisms. Despite this fact, for much of the twentieth century philosophical discussions of the nature of mechanisms remained outside philosophy of science. The Routledge Handbook of Mechanisms and Mechanical Philosophy is an outstanding reference source to the key topics, problems and debates in this exciting subject and is the first collection of its kind. (...) Comprising over thirty chapters by a team of international contributors the _Handbook_ is divided into four parts: Historical Perspectives on Mechanisms The Nature of Mechanisms Mechanisms and the Philosophy of Science Disciplinary Perspectives. Within these sections central topics and problems are examined, including the rise of mechanical philosophy in the seventeenth century; mechanisms as parts and wholes and their interactive powers; mechanisms and laws and regularities; how mechanisms are discovered and explained; dynamical systems theory; and disciplinary perspectives from physics, chemistry, biology, biomedicine, ecology, neuroscience and the social and political sciences. Essential reading for students and researchers in philosophy of science and philosophy the _Handbook _will also be of interest to those in related fields, such as metaphysics, philosophy of psychology and history of science. (shrink)

Bioethical research has tended to focus on theoretical discussion of the principles on which the analysis of ethical issues in biomedicine should be based. But this discussion often seems remote from biomedical practice where researchers and physicians confront ethical problems. On the other hand, published empirical research on the ethical reasoning of health care professionals offer only descriptions of how physicians and nurses actually reason ethically. The question remains whether these descriptions have any normative implications for nurses and physicians? (...) In this article, we illustrate an approach that integrates empirical research into the formulation of normative ethical principles using the moral-philosophical method of Wide Reflective Equilibrium (WRE). The research method discussed in this article was developed in connection with the project ‘Bioethics in Theory and Practice’. The purpose of this project is to investigate ethical reasoning in biomedical practice in Denmark empirically. In this article, we take the research method as our point of departure, but we exclusively discuss the theoretical framework of the method, not its empirical results. We argue that the descriptive phenomenological hermeneutical method developed by Lindseth and Norberg (2004) and Pedersen (1999) can be combined with the theory of WRE to arrive at a decision procedure and thus a foundation for the formulation of normative ethical principles. This could provide health care professionals and biomedical researchers with normative principles about how to analyse, reason and act in ethically difficult situations in their practice. We also show how to use existing bioethical principles as inspiration for interpreting the empirical findings of qualitative studies. This may help researchers design their own empirical studies in the field of ethics. (shrink)

The contributions that the philosophy of medicine can make to both the philosophy of science and the practice of science have been obscured in recent years by an overemphasis on personalities rather than critical themes. Two themes have dominated general discussion within contemporary philosophy of science: methodological essentialism and dynamic gradualism. These themes are defined and considered in light of Kenneth Schaffner's argument that theories in biomedicine have a structure and logic unlike that found in theories (...) of the natural sciences. Schaffner's arguments are suggestive but not definitive as a refutation of methodological essentialism. I argue that a primary reason for differences in the logic and structure of theories in biomedicine is not, as some philosophers have suggested, a product of ontological differences, but rather a product of the practical and pragmatic concerns of scientific theorizing in many areas of science, such as medicine. Keywords: philosophy of medicine, philosophy of science, logic of medicine, medical theory, methodological essentialism, dynamic gradualism CiteULike Connotea Del.icio.us What's this? (shrink)

Complexity and integration are longstanding widely debated issues in philosophy of science and recent contributions have largely focused on biology and biomedicine. This paper specifically considers some methodological novelties in cancer research, motivated by various features of tumours as complex diseases, and shows how they encourage some rethinking of philosophical discourses on those topics. In particular, we discuss the integrative-cluster approach, and analyse its potential in the epistemology of cancer. We suggest that, far from being the solution to (...) tame cancer complexity, this approach offers a philosophically interesting new manner of considering integration, and show how it can help addressing the apparent contrast between a pluralistic and a unitary account. (shrink)

BackgroundOur human societies and certainly also (bio) medicine are more and more permeated with technology. There seems to be an increasing awareness among bioethicists that an effective and comprehensive approach to ethically guide these emerging biomedical innovations into society is needed. Such an approach has not been spelled out yet for bioethics, while there are frequent calls for ethical guidance of biomedical innovation, also by biomedical researchers themselves. New and emerging biotechnologies require anticipation of possible effects and implications, meaning the (...) scope is not evaluative after a technology has been fully developed or about hypothetical technologies, but real-time for a real biotechnology.Main textIn this paper we aim to substantiate and discuss six ingredients that we increasingly see adopted by ethicists and that together constitute “ethics parallel research”. This approach allows to fulfil two aims: guiding the development process of technologies in biomedicine and providing input for the normative evaluation of such technologies. The six ingredients of ethics parallel research are: (1) disentangling wicked problems, (2) upstream or midstream ethical analysis, (3) ethics from within, (4) inclusion of empirical research, (5) public participation and (6) mapping societal impacts, including hard and soft impacts. We will draw on gene editing, organoid technology and artificial intelligence as examples to illustrate these six ingredients.ConclusionEthics parallel research brings together these ingredients to ethically analyse and proactively or parallel guide technological development. It widens the roles and judgements from the ethicist to a more anticipatory and constructively guiding role. Ethics parallel research is characterised by a constructive, rather than a purely critical perspective, it focusses on developing best-practices rather than outlining worst practice, and draws on insights from social sciences and philosophy of technology. (shrink)

Many scientific disciplines rely on the construction and use of models: biomedical sciences are no exception. This PhD thesis addresses several aspects of the practice of scientific modeling. First, I discuss the nature of modeling as such, proposing a novel, complementary account of scientific modeling which I term the experimentation-driven modeling account and which drives the construction of mechanistic models in many fields of biological and biomedical research, such as cancer immunology. Second, I scrutinize an objection to the mechanistic account (...) of explanation according to which the account fails to accommodate the common practice of idealizing difference-making factors. I argue that this objection ultimately fails because it is riddled with a number of conceptual inconsistencies. Third, I analyze the roles of similarity judgments in some fields of cancer research which employ a variety of mouse models to learn about the disease mechanisms, arguing that by appreciating the epistemic complexities it is possible to shed new light on more general philosophical debates regarding scientific representation. Fourth, mechanisms can also be studied using more theoretical apparatus in the form of simulations. I investigate an example of an agent-based model used to model the outbreak of SARS-CoV-2... (shrink)

Microbiome research shows that human health is foundationally intertwined with the ecology of microbial communities living on and in our bodies. This challenges the categorical separation of organisms from environments that has been central to biomedicine, and questions the boundaries between them. Biomedicine is left with an empirical problem: how to understand causal pathways between host health, microbiota and environment? We propose a conceptual tool – environmentality – to think through this problem. Environmentality is the state or quality (...) of being an environment for something else in a particular context: a fully perspectival proposition. Its power lies partly in what Isabelle Stengers has called the efficacy of the word itself, contrasting the dominant sense of the word environment as something both external and fixed. Through three case studies, we argue that environmentality can help think about the causality of microbiota vis-a-vis host health in a processual, relational and situated manner, across scales and temporalities. We situate this intervention within historical trajectories of thought in biomedicine, focusing on the challenge microbiome research poses to an aperspectival body. We argue that addressing entanglements between microbial and human lives requires that the environment is brought into the clinic, thus shortening the conceptual gap between medicine and public health. (shrink)

New biotechnologies have propelled the question of what it means to be human - or posthuman - to the forefront of societal and scientific consideration. This volume provides an accessible, critical overview of the main approaches in the debate on posthumanism, and argues that they do not adequately address the question of what it means to be human in an age of biotechnology. Not because they belong to rival political camps, but because they are grounded in a humanist ontology that (...) presupposes a radical separation between human subjects and technological objects. The volume offers a comprehensive mapping of posthumanist discourse divided into four broad approaches-two humanist-based approaches: dystopic and liberal posthumanism, and two non-humanist approaches: radical and methodological posthumanism. The author compares and contrasts these models via an exploration of key issues, from human enhancement, to eugenics, to new configurations of biopower, questioning what role technology plays in defining the boundaries of the human, the subject and nature for each. Building on the contributions and limitations of radical and methodological posthumanism, the author develops a novel perspective, mediated posthumanism, that brings together insights in the philosophy of technology, the sociology of biomedicine, and Michel Foucault's work on ethical subject constitution. In this framework, technology is neither a neutral tool nor a force that alienates humanity from itself, but something that is always already part of the experience of being human, and subjectivity is viewed as an emergent property that is constantly being shaped and transformed by its engagements with biotechnologies. Mediated posthumanism becomes a tool for identifying novel ethical modes of human experience that are richer and more multifaceted than current posthumanist perspectives allow for. The book will be essential reading for students and scholars working on ethics and technology, philosophy of technology, poststructuralism, technology and the body, and medical ethics. (shrink)

According to a shared functionalist view in philosophy of mind, a cognitive system, and cognitive function thereof, is based on the components of the organism it is realized by which, indeed, play a causal role in regulating our cognitive processes. This led philosophers to suggest also that, thus, cognition could be seen as an extended process, whose vehicle can extend not only outside the brain but also beyond bodily boundaries, on different kinds of devices. This is what we call (...) the ‘Externally Extended Cognition Thesis.’ This notion has generated a lively debate. Here, we offer a novel notion of extended cognition, according to which cognition can be seen as being realized outside the brain, but still inside the body. This is what we call the ‘Internally Extended Cognition Thesis’. Not only our thesis but also our approach while defending it is innovative. The argument we offer is supported by recent empirical findings in the life sciences and biomedicine, which suggest that the gut microbiota’s activity has a functional role in regulating our cognitive processes and behaviors. In doing so, we embrace the holobiont-perspective, according to which it is possible to claim that what we call biological individuals are not autonomous entities with clear boundaries, but should rather be seen as networks of multiple interactions among species. Thus, by analyzing different sets of evidence in light of the holobiont-perspective, we argue that the gut microbiota could be seen as a component of our organism. On the basis of the philosophical interpretation of this evidence, however, we also suggest that there are no impediments standing the way of considering the gut microbiota also as a functional extension of our cognitive system. If so, this amounts to extending cognition out of ‘our skull’, though still confining it within ‘our body’: to ‘our gut’. This is an instance of the ‘Internally Extended Cognition Thesis,’ whose benefits for an original theory of extended cognition are discussed. (shrink)

Is a theory of identity necessary for bioethics? In this paper I investigate that question starting from an empirical explication of identity based on post-genomics, in particular on epigenetics. After analysing whether the classic problems a theory of identity has to cope with also affect the proposed epigenetic account of identity, I deal with three topics to offer an insight on the relationship between that account and bioethics.

Not only has the philosophical debate on causation been gaining ground in the last few decades, but it has also increasingly addressed the sciences. The biomedical sciences are among the most prominent fields that have been considered, with a number of works tackling the understanding of the notion of cause, the assessment of genuinely causal relations and the use of causal knowledge in applied contexts. Far from denying the merits of the debate on causation and the major theories it comprises, (...) this paper is meant as a stimulus for theorists of causation in the philosophy of biomedicine, with a focus on clinical matters. Without aiming at putting forward an original theory of causation and starting from the narration of two actual but paradigmatic cases at the joints between biomedical research and clinical practice, we want to point out that some pathological situations addressed by molecular medicine actually prove resistant to some of our major epistemological accounts of causal explanation. Given this scenario, which is very frequent in our hospitals, our analysis aims to provide a stimulus for the debate among theorists of causation in biomedicine interested in real cases in science in practice. We believe that this might in turn encourage some more general rethinking of the complex intertwinement of science, philosophy of science and ethics, as well as of the role of philosophy of science for clinical medicine itself. (shrink)

This book contains lectures from the International Conference on Human Rights and Biomedicine, held in Rotterdam, the Netherlands, December 10-12, 2008. The conference was organized by the Institute of Health Policy and Management, Erasmus University Rotterdam and the Erasmus Observatory on Health Law. Eminent scholars from a variety of disciplines - medicine, law, ethics, and philosophy - discuss the meaning of underlying principles of the Convention on Human Rights and Biomedicine (1997) and the fundamental rights in healthcare, (...) contemporary dilemmas in healthcare (policy), and the Convention's impact on national health legislation and daily practice. In particular, the contributions discuss the following topics: human rights and health ethics, equitable access to health care, medical research, human genetics, and organ transplants. (shrink)

Knowledge of Life Today presents the thoughts of Jean Gayon, a major philosopher of science in France who is recognized across the Atlantic, especially for his work in philosophy and the history of life sciences. The book is structured around Gayon's personal answers to questions put forward by Victor Petit. This approach combines scientific rigor and risk-taking in answers that go back to the fundamentals of the subject. As well as the relationship between philosophy and the history of (...) science, Gayon discusses the main questions of the history and philosophy of biology that marked his intellectual journey: Darwin, evolutionary biology, genetics and molecular biology, human evolution, and various aspects of the relationship between biology and society in contemporary times (racism, eugenics, biotechnology, biomedicine, etc.). (shrink)

Fact/value holism has become commonplace in philosophy of science, especially in feminist literature. However, that facts are bearers of empirical content, while values are not, remains a firmly-held distinction. I support a more thorough-going holism: both facts and values can function as empirical claims, related in a seamless, semantic web. I address a counterexample from Kourany where facts and values seem importantly discontinuous, namely, the simultaneous support by the Nazis of scientifically sound cancer research and morally unsound political policies. (...) I conclude that even by the criteria available at the time, Nazi cancer research was empirically weak, and the weaknesses in their research are continuous with their moral failures in just the ways predicted by the holism I support. (shrink)

Background Biomedicine, i.e. the application of basic sciences to medicine, has become the cornerstone for the study of etiopathogenesis and treatment of diseases. Biomedicine has enormously contributed to the progress of medicine and healthcare and has become the preferred approach to medical problems in the West. The developments in statistical inference and machine learning techniques have provided the foundation for personalised medicine where clinical management can be fully informed by biomedicine. The deployment of precision medicine may impact (...) the autonomy and self-normativity of the patients. Understanding the relationship between biomedicine and medical practice can help navigate the benefits and challenges offered by precision medicine. Methods Conventional content analysis was applied to “Le Normal and le Pathologique” (Canguilhem G. The Normal and the Pathological. Princeton: Princeton University Press; 1991) and further investigated with respect to its relationship with techne and precision medicine using PubMed and Google Scholar and the Standford Encyclopedia of Philosophy to search for the following keywords singularly or in combination: “Canguilhem”, “techne”, “episteme”, “precision medicine”, “machine learning AND medicine”. Results The Hippocratic concept of techne accounts for many characteristics of medical knowledge and practice. The advances of biomedicine, experimental medicine and, more recently, machine learning offer, in contrast, the model of a medicine based purely on episteme. I argue that Canguilhem medical epistemology establishes a framework where episteme and data-driven medicine is compatible with the promotion of patient’s autonomy and self-normativity. Conclusions Canguilhem’s medical epistemology orders the relationship of applied medicine with experimental sciences, ethics and social sciences. It provides guidance to define the scope of medicine and the boundaries of medicalization of healthy life. Finally, it sets an agenda for a safe implementation of machine learning in medicine. (shrink)

The basic premise of today's scientific medicine is that the ‘book of man’ is written in the language of the biological sciences, ultimately molecular genetics and biochemistry. The patient is a complex biological organism and disease is a deviation from the norm of somatic parameters. At the same time, many major contemporary diseases are reported to have psychosocial and environmental components in their etiology. Hence the challenge: how can a medical model be both scientific and conceptually well-suited to today's disease (...) burden? I argue that certain contemporary "postmodern" sciences support alternative, non-reductionist (self-organizational) premises. So doing, they offer an infrastructure for a medical model at once scientific and responsive to the diseases at hand. Keywords: biomedicine (biological medicine), natural science paradigm, Cartesian dualism, self-organization, postmodern sciences, self-referentiality CiteULike Connotea Del.icio.us What's this? (shrink)

According to N. Goodman, the Carnapian notion of similarity is useless in science and without interest for philosophy. In our paper we suggest that, given the current role that the notion of similarity has in managing biomedical big data, this drastic position should be revised, and similarity should be provided a scientifically useful philosophical interpretation. With the advent of the new sequencing technologies, imaging technologies and with the improvements of health records, the number of genomics, post-genomics and clinical data (...) has exponentially increased. The deluge of data has urged, among others, to devise a new way of stratifying patients. A solution has been found and it is based exactly on the notion of similarity. By discussing two examples focusing on similarity among breast cancer patients, in the paper we illustrate such a use, and analyze it from a philosophical standpoint by resorting to A. Tversky’s features matching approach. We believe that the latter can foster some better understanding of the meaning and current use of similarity in the context of biomedical big data, and that, therefore, be the focus of further reflections in the philosophy of science, in particular in the philosophy of biomedicine. (shrink)

Against the backdrop of the political intrigue in biomedicine’s ascendancy to orthodoxy, this article examines its contemporary rapprochement with Complementary Alternative Medicine (CAM), in the move toward an integrated medical regime. It also identifies and explores factors underlying the rapprochement, as well as different ethical challenges that face integrated medicine. It argues that a major approach to tackling these challenges hinges on devising just and equitable criteria for evaluating the efficacy of plural therapeutic paradigms inherent in CAM models. This (...) is attainable through a policy that encourages creating public health policy and medical personnel deliberately exposed as part of their curriculum to the philosophical and theoretical features of diverse therapeutic traditions. (shrink)