Analytic Philosophy of Clinical and Community Medicine

Lucien R Karhausen

Description

I was encouraged to read in the Introduction that it treated philosophy of medicine as part of the philosophy of science. But I was a little sceptical on reading that as such it is comprehensive. Couldn’t a comprehensive account be written only by an amazing polymath? But it turns out that you are that amazing polymath. You seem to have read everything and succeeded in producing an encyclopedia of all the issues. It will establish itself as an essential guide to the field.
Professor Jonathan Glover

Sujets

• Philosophie générale
• Philosophie
• Science
• Lucien
• Medicine
• Analytic
• Philosophy
• Philosophie et théologie
• Movements

Informations

• Publié par: Xlibris US
• Date de parution: 28 juillet 2023
• Nombre de lectures: 0
• EAN13: 9798369404034
• Langue: English

Extrait

ANALYTIC PHILOSOPHY OF CLINICAL AND COMMUNITY MEDICINE
 
 
Scientific Philosophy and Philosophical Medicine
 
 
 
 
 
Third Edition
 
 
 
 
 
LUCIEN KARHAUSEN

 
Copyright © 2023 by Lucien Karhausen.
 
Library of Congress Control Number:
2023913825
ISBN:
Softcover
979-8-3694-0404-1
 
eBook
979-8-3694-0403-4
 
All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright owner.
 
Any people depicted in stock imagery provided by Getty Images are models, and such images are being used for illustrative purposes only.
Certain stock imagery © Getty Images.
 
 
 
 
 
Rev. date: 07/28/2023
 
 
 
 
 
Xlibris
844-714-8691
www.Xlibris.com
854871

 
 
 
 
 
 
 
TO
Micheline Iannuzzelli
1931-2019

CONTENTS
INTRODUCTION
 
ZERO
The Logical Roots of Medicine
The Archê of Medicine and its Logical Genealogy
Not Diseases
First Position and Second Position
The Trajectory from Suffering to Disease.
Summary
 
ONE
Intrinsic Negativities: The Biological Roots of Medicine Suffering, Discomfort and Harm
Physical Pain
Contra Putnam
First Person Privileged Access
The Nature of Pain
Malfunctional Pain
The Reversal of Values and The Symbolic Meaning of Pain.
Mental Suffering: Clinical Anxiety and Clinical Depression
Harm and Detriment
When Harm or Detriment are Dilemmatic
Conclusion
 
TWO
Normalcy or Abnormalcy
Norms
Normal as Natural
Christopher Boorse’s Naturalism:
Biostatistical Theory. Methodological Naturalism
The Homeostatic View of Normalcy
Medical Statements Are Both Prescriptive and Descriptive.
Taking Stock: Defining the Term “Normal”
The Nature of Medical Norms
The Semantic of the Normal/Abnormal Divide
Distinguishing Abnormal from Pathologic
The Logical Priority of the Pathologic.
The Clinical Epistemic Priority of Normality
Specification of Pathologic Boundary: The Case of Hypertension
Harmful and Pathologic
When Being Abnormal is Advantageous
Summary
 
THREE
Explanation
Explanation or Causation?
Two Strategies: Biomedical or Epidemiological
Scientific Explanation: The Hypothetico-Deductive Model
Scientific Explanation: The Inductive-Statistical Model
Epistemic Risk: Inference to the Best Explanation IBE
There Can be No Laws in Biology
The Pragmatics of Explanation
The Contrastive Counterfactual Nature of Medical Explanations
Methodological Reductionism
Hierarchical Systems
The Pivotal Clinical Level
Pathogenesis and Mechanistic Vertical Explanation
Critique of the Hierarchical Model.
The Limits of Reductionism
Emergence
Realization and Supervenience
Causal Versus Non-Causal Supervenience
The Twofold Context of Explanation in Psychiatry
Darwinian Medicine and the Panglossian Fallacy
Conclusion
 
FOUR
Causation and Aetiology
Sufficient and Necessary Causes
Aetiology and Deviation from the Norm.
Are Causes in Medicine External or Internal to their Effects?
Contributing Causes
Causal Role and Causal Capacity
The Concept of Causality
Analytical Epidemiology
Causal Tendencies
Risks and Measures of Effects
Relative Risk and Odds Ratio
Contrast Case
The Causa Vera Fallacy
The Web of Causation: Plurality of Causes and Causal Diversity
Back to Sufficiency and Necessity
Reverse Causality
The Structural Equation Framework
The Unnatural Nature of Causality
Conclusion
 
FIVE
Function and Medicine’s Hybrid Concepts
The Received View
Teleological Explanation vs. Naturalistic Understanding
Function as an Activity, a Biological Role, or a Historical Concept
Teleology: The Naming-Explaining Fallacy
A Semantic View: John Searle
Functions and Their Effects
Functional Role and Functional Capacity
Physiology is False
Functions are Hybrid-Concepts: they are Empirical and Normative, Descriptive and Prescriptive
Are Diseases Malfunctions?
A Naturalistic View: What Malfunctions Are Not About
Malfunctioning
Conclusion:
 
SIX
Prudential Objectives Medical Need and Demand
Prudence and the Authority of Medical Judgment
Time Preference
The Structure of Medical Need
Three Types of Needs
The Instrumental Necessity of Health Needs.
Needs are Objective and Demands Subjective
Extensional and Intensional Context
The Grammar of Need and Demand in Health Care.
The Genealogy of Our Prudential Concepts and Practices.
First-Person Indexicalised Account: Naturalistic Inferences
First-Person Indexicalised Account: a Prescriptivist Account
Second-Person Indexicalised Account: The Clinical Encounter
Third-Person De-Indexicalised Inference: From a Prudential to a Moral Account
Conclusion
 
SEVEN
Diagnosis Clinical Epistemology
Signs and Symptoms
The Semantics of Diagnosis
Facts or Events
The Meaning of Clinical Manifestations
The Nature of Diagnosis
The Limits of Diagnosis
Diagnosis as an ampliative procedure
Diagnostic Criteria
Conclusion: Constructing an Epistemology of Medicine
 
EIGHT
Diseases, Injuries, and Impairments
Defining Disease
Syndromes
Diseases Have Causes
Diseases Have a Natural History
Enduring Pathologic States
The Need for Intervention is Constitutive of Our Notion of Diseases.
Illness
Sickness Behaviour and the Sick Role
Two Types of Diseases and a Semantic Digression
Manifestations Diseases
Single-Criterion or Causal Diseases
Causal Disorders and Their Semantics
Moving from Manifestational to Causal Diseases
Grades of “Naturalness”
Are Controversial Diseases Clinical Entities or a Lexical conundrum?
Death
Conclusion
 
NINE
Psychiatric Disorder
Defining Mental Disorder
Fragmentation of the Self
Epistemic Breakdown
Syntactic Breakdown: Deterioration of Coherent Thinking, Perception and Emotion
Semantic Breakdown
Arationality
The Interactive Stance: Breakdown of Interpersonal Relations
Responsibility and the Sick-Role
Breakdown of Autonomy and Enforced Treatment
Are Mental Disorders Natural Kinds?
Interactive Kinds
Psychiatric Nosology
The Spectrum Perspective
The Fragility of Diagnosis
Diagnostic Reliability and Validity
Strawson and the Span of the Concept of Mental Illness.
The two Explanatory Roots of Mental Disease: Hippocrates and Samuel Tuke
Splitting Mental Disorders from Neurological Disorders
Can Mental States be Multiply Realized?
May Mental Disorders be Adaptive?
Is Schizophrenia Adaptive?
Disease Mongering: The Case of Mental Illness
Conclusion
 
TEN
Socially Deviant Behaviour
Social Deviance vs. Mental Disorder
Is Alcohol Abuse a Mere Bad Habit?
Self-Harm
Two Complementary Views
Conclusion
 
ELEVEN
Unexplained Physical Symptoms and Functional Disorders
History of Unexplained Symptoms and Functional Disorders
The Symptom Iceberg.
Unexplained Physical Symptoms and Health Anxiety Observed in the Doctor’s Office
Somatoform Disorders: Symptoms-Only Conditions in the Medical Setting
Medically Unexplained Disorders
Factitious Disorders and Illness Behaviour
Taking Stock
Summary
 
TWELVE
A Critique of the Disease Concept
1. Are Diseases Natural Kinds?
2. Diseases, Type and Token
3. The Ontology of Disease
4. Defining Diseases
 
THIRTEEN
Health
Health Status: Negative or Positive
The Interconnectedness Between Mind and Body
Conclusion
 
FOURTEEN
Preventive, Therapeutic, and Palliative Care
Therapeutic Doctrines
Efficacy and Effectiveness
The Myth of the Magic Bullet and its Return
From Wants to Needs
Defining Treatment
Placebos
The Nature of the Placebo Effect
Placebos in Clinical Trials
Explaining the Placebo Effect
Surgery and Placebos
The Placebo Effect is Sometimes Fictitious
Randomized Control Trials
Evidence-Based Medicine (EBM).
The Double Meaning of “Treatment”
Direct Realism and Instrumentalism in Health Care
Prevention and Health Maintenance
Screening
Scrutiny–Dependent Incidence and Risk Factors of Cancer
Herd Immunity
The Paradox of Health Education
Conclusion
 
FIFTEEN
The Clinical Relationship. The Tale Of Two Stories
Narrative Medicine
The Therapeutic Alliance
The Doctor’s Authority
The Trade-Offs Between Need and Demand: Acceptance and Acceptability
Truth and Truthfulness in the Clinical Transaction
Expectancy
The Fault Lines of the Caring Relationship
Autonomy and Paternalism
The Three Positions
Conclusion
 
SIXTEEN
The Limits of Medicine
Epistemic Limits of Clinical Care
Ethical Limits
Ontological Limits
Con