Analytic Philosophy of Clinical and Community Medicine

Lucien Karhausen

Description

The present volume is about philosophy of medicine and integrates philosophy of medicine as a chapter of philosophy of science. It is neither about bioethics, nor about the history of medicine, but it is comprehensive and encompasses the whole field of medicine including psychiatry. It is grounded on a first-order standpoint, and it strives to stay close to clinical or community medicine: it bestows an epistemological bottom-up account. It is not a review of the literature, and it is not intended to frame the debates, or to analyse and compare the various and substantial number of viewpoints although some authors’ account may form the basis of the book when they fit into the development of its philosophical view of medicine.

Sujets

• Philosophie générale
• Philosophie
• Analytic
• Philosophy
• Philosophie et théologie
• Movements

Informations

• Publié par: Xlibris US
• Date de parution: 06 octobre 2022
• Nombre de lectures: 0
• EAN13: 9781669850571
• Langue: English

Extrait

ANALYTIC PHILOSOPHY OF CLINICAL AND COMMUNITY MEDICINE
LUCIEN KARHAUSEN

Copyright © 2022 by Lucien Karhausen.
 
Library of Congress Control Number:
2022918644
ISBN:
Hardcover
978-1-6698-5058-8

Softcover
978-1-6698-5056-4

eBook
978-1-6698-5057-1
 
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: 10/05/2022
 
 
 
 
 
Xlibris
844-714-8691
www.Xlibris.com
847540
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
Pain is not a brain-state
Malfunctional Pain
The Reversal of Values and The Symbolic Meaning of Pain.
Mental Suffering: Clinical Anxiety and Clinical Depression
Harm and Detriment
When Harm and Detriment are Dilemmatic
Conclusion
TWO
Normal, abnormal, and pathological
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 Pathological
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?
A thirst for generalities
The Quorum of Language: Family Resemblances, (Familienähnlichkeit) or Similarities (Ähnlichkeit)
J Sadegh-Zadeh, Prototypes and Fuzzy Logic.
Two Strategies: Biomedical or Epidemiological
The Hypothetico-Deductive Model
Induction and Abduction: Inference to the Best Explanation
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 292
The meaning and relativity of risk
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
Biological Functions and the Machine Analogy
Teleological Explanation vs. Naturalistic Understanding
Function as an Activity, a Biological Role, or a Historical Concept
Teleology: The Naming-Explaining Fallacy
Getting out of the predicament: 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 Needs and Demand
Prudence and the Authority of Medical Judgment
Time Preference
The Structure of Medical Needs
Three Types of Needs
The Instrumental Necessity of Health Needs.
Needs are Objective and Demands Subjective.
Extensional and Intensional Context
The Grammar of Needs and Demand in Health Care.
The Genealogy of Our Prudential Concepts and Practices.
First-Person Indexicalized Account: Naturalistic Inferences
First-Person Indexicalized Account: A Prescriptivist Account
Second-Person Indexicalized Account: The Clinical Encounter
Third-Person De-Indexicalized Inference: From a Prudential to a Moral Account
Conclusion
SEVEN
Diagnosis Clinical Epistemology
Signs and Symptoms
Are symptoms in medicine private objects?
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 455
Enduring Pathologic States 459
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. 516
Epistemic Breakdown
Syntactic Breakdown: Deterioration of Coherent Thinking, Perception and Emotion
Semantic Breakdown
Arationality 532
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
Diagnostic Validity, Utility and Reliability
The Spectrum Perspective
The Fragility of Diagnosis
Psychiatric Diseases or Syndromes
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
Wittgenstein and the concept of psychosis.
Conclusion
TEN
Socially Deviant Behaviour
Social Deviance vs. Mental Disorder
Two Complementary Views
Is Alcohol Abuse a Mere Bad Habit?
Self-Harm
Medicalization of Criminal Deviance
Conclusion
ELEVEN
Unexplained Physical Symptoms and Functional Disorders
Recent 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
The case of George Canguilhem
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 Needs and Demands: Acceptance and Acceptability
Truth and Truthfulness in the Clinical Transaction
Expectancy
The Fault Lines of the Caring Relationship
Autonomy and Pat