Skip to main content
Top
Published in: Medicine, Health Care and Philosophy 2/2021

01-06-2021 | Scientific Contribution

Biological normativity: a new hope for naturalism?

Author: Walter Veit

Published in: Medicine, Health Care and Philosophy | Issue 2/2021

Login to get access

Abstract

Since Boorse [Philos Sci 44(4):542–573, 1977] published his paper “Health as a theoretical concept” one of the most lively debates within philosophy of medicine has been on the question of whether health and disease are in some sense ‘objective’ and ‘value-free’ or ‘subjective’ and ‘value-laden’. Due to the apparent ‘failure’ of pure naturalist, constructivist, or normativist accounts, much in the recent literature has appealed to more conciliatory approaches or so-called ‘hybrid accounts’ of health and disease. A recent paper by Matthewson and Griffiths [J Med Philos 42(4):447–466, 2017], however, may bear the seeds for the revival of purely naturalist approach to health and disease. In this paper, I defend their idea of Biological Normativity against recent criticism by Schwartz [J Med Philos Forum Bioethics Philos Med 42(4):485–502, 2017] and hope to help it flower into a revival of naturalist approaches in the philosophy of medicine.
Footnotes
1
See the Preamble of World Health Organization (2020).
 
2
Though he appears to have changed his mind on this in later publications (Boorse 1997, 2014).
 
3
As she met an unfortunate demise due to a lengthy struggle with cancer in May 2020, I very much dedicate this paper to her and her project for the naturalization of norms. I encourage a reading of Hill and Pavese (2020) for a tribute to and excellent overview of Neander and her work.
 
4
Though I prefer the label anti-naturalists for the latter group. In Veit (2020c), I take this approach further and offer a purely naturalist account of healt, disease, and pathology.
 
5
Canguilhem’s fate in the philosophy of medicine is in many ways an unfortunate one, since many of its current debates have already been discussed by Canguilhem and I may add in a better form than today. Unlike other glorified spearheads for new philosophical disciplines such as David Hull in the philosophy of biology or Daniel Hausman in the philosophy of economics, Canguilhem appears to be continuously underappreciated—a fate that is probably owed to his placement in the continental tradition.
 
6
Recently, philosophers have argued that we can and should explicitly explore the phenomenology or subjective experience of health and suffering in non-human animals which gets us somewhat closer to Canguilhem’s aspirations yet remains fairly within a naturalist framework (see Browning 2018, 2019a, b, c, 2020a, b; Browning and Veit 2020).
 
7
See for instance Millikan (1984, 1989, 1995) and Veit (2019a).
 
8
See Low et al. (2012) and Gluckman et al. (2005)).
 
9
Which is perhaps unsurprising given Griffiths’ previous endorsement of the view (1993, p. 410), in addition to the fact that two of Matthewson’s supervisors have argued for it (Godfrey-Smith 1993, p. 200; Maclaurin and Sterelny 2008, p. 114).
 
10
A naturalist may very well see these different ways of going wrong as useful perspectives or models of a single phenomena in nature, without having to give up on the reality of phenomena, in which case pluralism should face even less resistance (Veit and Browning 2020; Veit 2019b, c, 2020a, b forthcoming).
 
11
In the case of mental disorders such autism we may be more reluctant to admit a naturalist interpretation though there is likewise room for both facts and values to play a role in classification (Chapman 2020; Chapman and Veit 2020a, b).
 
Literature
go back to reference Boorse, C. 1975. On the distinction between disease and illness. Philosophy and Public Affairs 5 (1): 49–68. Boorse, C. 1975. On the distinction between disease and illness. Philosophy and Public Affairs 5 (1): 49–68.
go back to reference Boorse, C. 1977. Health as a theoretical concept. Philosophy of Science 44 (4): 542–573. Boorse, C. 1977. Health as a theoretical concept. Philosophy of Science 44 (4): 542–573.
go back to reference Boorse, C. 1997. A rebuttal on health. In What is disease?, ed. J.M. Humber and R.F. Almeder, 1–134. Totowa: Humana Press. Boorse, C. 1997. A rebuttal on health. In What is disease?, ed. J.M. Humber and R.F. Almeder, 1–134. Totowa: Humana Press.
go back to reference Boorse, C. 2014. A second rebuttal on health. Journal of Medicine and Philosophy 39 (6): 683–724. Boorse, C. 2014. A second rebuttal on health. Journal of Medicine and Philosophy 39 (6): 683–724.
go back to reference Canguilhem, G. 1966/1991. The normal and the pathological (trans: Fawcett, C.R.). New York: Zone Books. Canguilhem, G. 1966/1991. The normal and the pathological (trans: Fawcett, C.R.). New York: Zone Books.
go back to reference Carel, H. 2007. Can I be ill and happy? Philosophia 35 (2): 95–110. Carel, H. 2007. Can I be ill and happy? Philosophia 35 (2): 95–110.
go back to reference Carel, H. 2011. Phenomenology and its application in medicine. Theoretical Medicine and Bioethics 32 (1): 33–46. Carel, H. 2011. Phenomenology and its application in medicine. Theoretical Medicine and Bioethics 32 (1): 33–46.
go back to reference Carel, H. 2018. Illness: The cry of the flesh. London: Routledge. Carel, H. 2018. Illness: The cry of the flesh. London: Routledge.
go back to reference Chapman, R. 2020. The reality of autism: On the metaphysics of disorder and diversity. Philosophical Psychology 33 (6): 1–21. Chapman, R. 2020. The reality of autism: On the metaphysics of disorder and diversity. Philosophical Psychology 33 (6): 1–21.
go back to reference Cooper, R. 2002. Disease. Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences 33 (2): 263–282. Cooper, R. 2002. Disease. Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences 33 (2): 263–282.
go back to reference Garson, J. 2018. How to be a function pluralist. The British Journal for the Philosophy of Science 69 (4): 1101–1122. Garson, J. 2018. How to be a function pluralist. The British Journal for the Philosophy of Science 69 (4): 1101–1122.
go back to reference Garson, J., and G. Piccinini. 2014. Functions must be performed at appropriate rates in appropriate situations. The British Journal for the Philosophy of Science 65 (1): 1–20. Garson, J., and G. Piccinini. 2014. Functions must be performed at appropriate rates in appropriate situations. The British Journal for the Philosophy of Science 65 (1): 1–20.
go back to reference Gluckman, P.D., M.A. Hanson, and H.G. Spencer. 2005. Predictive adaptive responses and human evolution. Trends in Ecology and Evolution 20 (10): 527–533. Gluckman, P.D., M.A. Hanson, and H.G. Spencer. 2005. Predictive adaptive responses and human evolution. Trends in Ecology and Evolution 20 (10): 527–533.
go back to reference Godfrey-Smith, P. 1993. Functions: Consensus without unity. Pacific Philosophical Quarterly 74 (3): 196–208. Godfrey-Smith, P. 1993. Functions: Consensus without unity. Pacific Philosophical Quarterly 74 (3): 196–208.
go back to reference Godfrey-Smith, P. 1994. A modern history theory of functions. Noûs 28 (3): 344–362. Godfrey-Smith, P. 1994. A modern history theory of functions. Noûs 28 (3): 344–362.
go back to reference Goosens, W.K. 1980. Values, health, and medicine. Philosophy of Science 47 (1): 100–115. Goosens, W.K. 1980. Values, health, and medicine. Philosophy of Science 47 (1): 100–115.
go back to reference Griffiths, P.E. 1993. Functional analysis and proper functions. The British Journal for the Philosophy of Science 44 (3): 409–422. Griffiths, P.E. 1993. Functional analysis and proper functions. The British Journal for the Philosophy of Science 44 (3): 409–422.
go back to reference Griffiths, P.E., and J. Matthewson. 2018. Evolution, dysfunction, and disease: A reappraisal. The British Journal for the Philosophy of Science 69 (2): 301–327. Griffiths, P.E., and J. Matthewson. 2018. Evolution, dysfunction, and disease: A reappraisal. The British Journal for the Philosophy of Science 69 (2): 301–327.
go back to reference Griffiths, P.E., and J. Matthewson. 2020. Diseases are not adaptations and neither are their causes. Biological Theory 15: 136–142. Griffiths, P.E., and J. Matthewson. 2020. Diseases are not adaptations and neither are their causes. Biological Theory 15: 136–142.
go back to reference Hausman, D.M. 2012. Health, naturalism, and functional efficiency. Philosophy of Science 79 (4): 519–541. Hausman, D.M. 2012. Health, naturalism, and functional efficiency. Philosophy of Science 79 (4): 519–541.
go back to reference Kendell, R.E. 1986. What are mental disorders? In Issues in psychiatric classification: Science, practice and social policy, ed. A.M. Freedman, R. Brotman, I. Silverman, and D. Hutson, 23–45. New York: Human Sciences Press. Kendell, R.E. 1986. What are mental disorders? In Issues in psychiatric classification: Science, practice and social policy, ed. A.M. Freedman, R. Brotman, I. Silverman, and D. Hutson, 23–45. New York: Human Sciences Press.
go back to reference Kingma, E. 2010. Paracetamol, poison, and polio: Why Boorse’s account of function fails to distinguish health and disease. The British Journal for the Philosophy of Science 61 (2): 241–264. Kingma, E. 2010. Paracetamol, poison, and polio: Why Boorse’s account of function fails to distinguish health and disease. The British Journal for the Philosophy of Science 61 (2): 241–264.
go back to reference Kingma, E. 2013. Naturalist accounts of mental disorder. In The Oxford handbook of philosophy and psychiatry, 363–384. Oxford: Oxford University Press. Kingma, E. 2013. Naturalist accounts of mental disorder. In The Oxford handbook of philosophy and psychiatry, 363–384. Oxford: Oxford University Press.
go back to reference Kingma, E. 2017. Disease as scientific and as value-laden concept. In Handbook of the philosophy of medicine, 45–63. Dordrecht: Springer. Kingma, E. 2017. Disease as scientific and as value-laden concept. In Handbook of the philosophy of medicine, 45–63. Dordrecht: Springer.
go back to reference Kukla, R. 2014. Medicalization, “normal function,” and the definition of health. In The Routledge companion to bioethics, 539–554. New York: Routledge. Kukla, R. 2014. Medicalization, “normal function,” and the definition of health. In The Routledge companion to bioethics, 539–554. New York: Routledge.
go back to reference Low, F.M., P.D. Gluckman, and M.A. Hanson. 2012. Developmental plasticity, epigenetics and human health. Evolutionary Biology 39 (4): 650–665. Low, F.M., P.D. Gluckman, and M.A. Hanson. 2012. Developmental plasticity, epigenetics and human health. Evolutionary Biology 39 (4): 650–665.
go back to reference Maclaurin, J., and K. Sterelny. 2008. What is biodiversity? Chicago: University of Chicago Press. Maclaurin, J., and K. Sterelny. 2008. What is biodiversity? Chicago: University of Chicago Press.
go back to reference Matthewson, J., and P.E. Griffiths. 2017. Biological criteria of disease: Four ways of going wrong. Journal of Medicine and Philosophy 42 (4): 447–466. Matthewson, J., and P.E. Griffiths. 2017. Biological criteria of disease: Four ways of going wrong. Journal of Medicine and Philosophy 42 (4): 447–466.
go back to reference Millikan, R.G. 1984. Language, thought, and other biological categories. Cambridge: MIT Press. Millikan, R.G. 1984. Language, thought, and other biological categories. Cambridge: MIT Press.
go back to reference Millikan, R.G. 1989. In defense of proper functions. Philosophy of Science 56 (2): 288–302. Millikan, R.G. 1989. In defense of proper functions. Philosophy of Science 56 (2): 288–302.
go back to reference Millikan, R.G. 1995. White queen psychology and other essays for Alice. Cambridge: MIT Press. Millikan, R.G. 1995. White queen psychology and other essays for Alice. Cambridge: MIT Press.
go back to reference Murphy, D., and R.L. Woolfolk. 2000. The harmful dysfunction analysis of mental disorder. Philosophy, Psychiatry, and Psychology 7 (4): 241–252. Murphy, D., and R.L. Woolfolk. 2000. The harmful dysfunction analysis of mental disorder. Philosophy, Psychiatry, and Psychology 7 (4): 241–252.
go back to reference Neander, K. 1983. Abnormal psychobiology. PhD Thesis, Unpublished Doctoral Dissertation. La Trobe University, Bundoora. Neander, K. 1983. Abnormal psychobiology. PhD Thesis, Unpublished Doctoral Dissertation. La Trobe University, Bundoora.
go back to reference Neander, K. 1991. Functions as selected effects: The conceptual analyst’s defense. Philosophy of Science 58 (2): 168–184. Neander, K. 1991. Functions as selected effects: The conceptual analyst’s defense. Philosophy of Science 58 (2): 168–184.
go back to reference Nordenfelt, L. 1993. Quality of life, health and happiness. Aldershot: Ashgate Publishing. Nordenfelt, L. 1993. Quality of life, health and happiness. Aldershot: Ashgate Publishing.
go back to reference Nordenfelt, L. 1995. On the nature of health: An action-theoretic approach. Dordrecht: Kluwer. Nordenfelt, L. 1995. On the nature of health: An action-theoretic approach. Dordrecht: Kluwer.
go back to reference Quine, W.V., and W.V.O. Quine. 1981. Theories and things. Cambridge: Harvard University Press. Quine, W.V., and W.V.O. Quine. 1981. Theories and things. Cambridge: Harvard University Press.
go back to reference Reznek, L. 1987. The nature of disease. London: Routledge. Reznek, L. 1987. The nature of disease. London: Routledge.
go back to reference Saborido, C., and A. Moreno. 2015. Biological pathology from an organizational perspective. Theoretical Medicine and Bioethics 36 (1): 83–95. Saborido, C., and A. Moreno. 2015. Biological pathology from an organizational perspective. Theoretical Medicine and Bioethics 36 (1): 83–95.
go back to reference Saborido, C., A. Moreno, M. González-Moreno, and J.C.H. Clemente. 2016. Organizational malfunctions and the notions of health and disease. In Naturalism in the philosophy of health, 101–120. Cham: Springer. Saborido, C., A. Moreno, M. González-Moreno, and J.C.H. Clemente. 2016. Organizational malfunctions and the notions of health and disease. In Naturalism in the philosophy of health, 101–120. Cham: Springer.
go back to reference Savulescu, J., R. Ter Meulen, and G. Kahane (eds.). 2011. Enhancing human capacities. Wiley. Savulescu, J., R. Ter Meulen, and G. Kahane (eds.). 2011. Enhancing human capacities. Wiley.
go back to reference Schwartz, P.H. 2007. Decision and discovery in defining ‘disease.’ In Establishing medical reality: Essays in the metaphysics and epistemology of biomedical science, ed. H. Kincaid and J. McKitrick, 47–64. Dordrecht: Springer. Schwartz, P.H. 2007. Decision and discovery in defining ‘disease.’ In Establishing medical reality: Essays in the metaphysics and epistemology of biomedical science, ed. H. Kincaid and J. McKitrick, 47–64. Dordrecht: Springer.
go back to reference Schwartz, P.H. 2007. Defining dysfunction: Natural selection, design, and drawing a line. Philosophy of Science 74 (3): 364–385. Schwartz, P.H. 2007. Defining dysfunction: Natural selection, design, and drawing a line. Philosophy of Science 74 (3): 364–385.
go back to reference Schwartz, P.H. 2017. Progress in defining disease: Improved approaches and increased impact. The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 42 (4): 485–502. Schwartz, P.H. 2017. Progress in defining disease: Improved approaches and increased impact. The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 42 (4): 485–502.
go back to reference Veit, W. 2019. Model pluralism. Philosophy of the Social Sciences 50 (2): 91–114. Veit, W. 2019. Model pluralism. Philosophy of the Social Sciences 50 (2): 91–114.
go back to reference Veit, W. (2020c). Health, agency, and the evolution of consciousness. Ph.D. thesis, University of Sydney. Manuscript in preparation. Veit, W. (2020c). Health, agency, and the evolution of consciousness. Ph.D. thesis, University of Sydney. Manuscript in preparation.
go back to reference Veit, W. (forthcoming). Experimental philosophy of medicine and the concepts of health and disease. Theoretical Medicine and Bioethics. Veit, W. (forthcoming). Experimental philosophy of medicine and the concepts of health and disease. Theoretical Medicine and Bioethics.
go back to reference Veit, W., and H. Browning. 2020. Perspectival pluralism for animal welfare. European Journal for Philosophy of Science 11 (1): 9. Veit, W., and H. Browning. 2020. Perspectival pluralism for animal welfare. European Journal for Philosophy of Science 11 (1): 9.
go back to reference Wakefield, J.C. 1992. The concept of mental disorder: On the boundary between biological facts and social values. American Psychologist 47 (3): 373. Wakefield, J.C. 1992. The concept of mental disorder: On the boundary between biological facts and social values. American Psychologist 47 (3): 373.
go back to reference Wakefield, J.C. 1999. The concept of disorder as a foundation for the DSM’s theory-neutral nosology: Response to Follette and Houts, Part 2. Behaviour Research and Therapy 37 (10): 1001–1027. Wakefield, J.C. 1999. The concept of disorder as a foundation for the DSM’s theory-neutral nosology: Response to Follette and Houts, Part 2. Behaviour Research and Therapy 37 (10): 1001–1027.
go back to reference Wakefield, J.C. 2000. Spandrels, vestigial organs, and such: Reply to Murphy and Woolfolk’s “The harmful dysfunction analysis of mental disorder.” Philosophy, Psychiatry, and Psychology 7 (4): 253–269. Wakefield, J.C. 2000. Spandrels, vestigial organs, and such: Reply to Murphy and Woolfolk’s “The harmful dysfunction analysis of mental disorder.” Philosophy, Psychiatry, and Psychology 7 (4): 253–269.
go back to reference Wakefield, J.C. 2001. Evolutionary history versus current causal role in the definition of disorder: Reply to McNally. Behaviour Research and Therapy 39 (3): 347–366. Wakefield, J.C. 2001. Evolutionary history versus current causal role in the definition of disorder: Reply to McNally. Behaviour Research and Therapy 39 (3): 347–366.
go back to reference Wakefield, J.C. 2007. The concept of mental disorder: Diagnostic implications of the harmful dysfunction analysis. World Psychiatry 6 (3): 149–156. Wakefield, J.C. 2007. The concept of mental disorder: Diagnostic implications of the harmful dysfunction analysis. World Psychiatry 6 (3): 149–156.
go back to reference World Health Organization. 2020. Constitution of the World Health Organization 49th edition. Basic Documents of the World Health Organization. World Health Organization. 2020. Constitution of the World Health Organization 49th edition. Basic Documents of the World Health Organization.
Metadata
Title
Biological normativity: a new hope for naturalism?
Author
Walter Veit
Publication date
01-06-2021
Publisher
Springer Netherlands
Published in
Medicine, Health Care and Philosophy / Issue 2/2021
Print ISSN: 1386-7423
Electronic ISSN: 1572-8633
DOI
https://doi.org/10.1007/s11019-020-09993-w

Other articles of this Issue 2/2021

Medicine, Health Care and Philosophy 2/2021 Go to the issue