As Dobzhansky wrote, nothing in biology makes sense outside the context of the evolutionary theory, and this truth has not been sufficiently explored yet by medicine. We comment on Shanks and Pyles' recently published paper, Evolution and medicine: the long reach of "Dr. Darwin", and discuss some recent advancements in the application of evolutionary theory to carcinogenesis. However, we disagree with Shanks and Pyles about the usefulness of animal experiments in predicting human hazards. Based on the darwinian observation of inter-species (...) and inter-individual variation in all biological functions, Shanks and Pyles suggest that animal experiments cannot be used to identify hazards to human health. We claim that while the activity of enzymes may vary among individuals and among species, this does not indicate that critical events in disease processes occurring after exposure to hazardous agents differ qualitatively between animal models and humans. In addition, the goal is to avoid human disease whenever possible and with the means that are available at a given point in time. Epidemics of cancer could have been prevented if experimental data had been used to reduce human exposures or ban carcinogenic chemicals. We discuss examples. (shrink)

In the last decades, Systems Biology (including cancer research) has been driven by technology, statistical modelling and bioinformatics. In this paper we try to bring biological and philosophical thinking back. We thus aim at making diferent traditions of thought compatible: (a) causality in epidemiology and in philosophical theorizing—notably, the “sufcient-component-cause framework” and the “mark transmission” approach; (b) new acquisitions about disease pathogenesis, e.g. the “branched model” in cancer, and the role of biomarkers in this process; (c) the burgeoning of omics (...) research, with a large number of “signals” and of associations that need to be interpreted. In the paper we summarize frst the current views on carcinogenesis, and then explore the relevance of current philosophical interpretations of “cancer causes”. We try to ofer a unifying framework to incorporate biomarkers and omic data into causal models, referring to a position called “evidential pluralism”. According to this view, causal reasoning is based on both “evidence of diference-making” (e.g. associations) and on “evidence of underlying biological mechanisms”. We conceptualize the way scientists detect and trace signals in terms of information transmission, which is a generalization of the mark transmission theory developed by philosopher Wesley Salmon. Our approach is capable of helping us conceptualize how heterogeneous factors such as micro and macro-biological and psycho-social—are causally linked. This is important not only to understand cancer etiology, but also to design public health policies that target the right causal factors at the macro-level. (shrink)

Since the microbiological revolution, most infectious diseases have been defined and classified according to an etiologic criterion, i.e. the identification of single, external necessary causes (for example, Mycobacterium for tuberculosis). This is not the case with cancer. Not only external necessary causes of cancer have not been identified, but also the morphological classification cannot be based on univocal criteria. Although neoplasia and anaplasia appear to be universal attributes of cancer, these events are only quantitative. Neoplastic growth can be fast or (...) slow (development may take weeks or years), and tissue pathologies are difficult to detect from normal tissue in some cancers but are obvious in others. Common special properties of anaplasia appear to be concealed in the wide range of morphologies. In the absence of a coherent morphological definition, and of external necessary causes (such as bacteria for infectious diseases), a mechanistic definition could be adopted. However, unless molecular biology discovers specific mechanistic steps in carcinogenesis, which indicate the existence of necessary events in carcinogenesis, we cannot adopt a univocal (monothetic) definition of cancer. The alternative is to use a polythetic definition, according to Wittgenstein's model of a long rope twisted together out of many shorter fibres. (shrink)

In this paper we set out to examine thearguments for and against the claim thatEvidence-Based Medicine (EBM) will improve thequality of care. In particular, we examine thefollowing issues.

Epidemiology relies upon a broad interpretation of determinism. This paper discusses analogies with the evolution of the concept of cause in physics, and analyzes the classical nine criteria proposed by Sir Austin Bradford Hill for causal assessment. Such criteria fall into the categories of enumerative induction, eliminative induction, deduction and analogy. All of these four categories are necessary for causal assessment and there is no natural hierarchy among them, although a deductive analysis of the study design is preliminary to any (...) assessment. (shrink)

Using the example of air pollution, I criticize a restricted utilitarian view of environmental risks. It is likely that damage to health due to environmental pollution in Western countries is relatively modest in quantitative terms (especially when considering cancer and comparing such damage to the effects of some life-style exposures). However, a strictly quantitative approach, which ranks priorities according to the burden of disease attributable to single causes, is questionable because it does not consider such aspects as inequalities in the (...) distribution of risks. Secondly, the ability of epidemiological research to identify some health effects is limited. Third, the environment has symbolic and aesthetic components that overcome a strict evaluation of damage based on the impairment of human health. It is not acceptable that priorities be set just balancing the burden of disease caused by pollution in the environment against economic constraints. As an example of a computation that inherently includes economic analysis, I refer to the proposal of an estimator of mortality in coal mining, i.e., a rate which puts deaths in the numerator and tons of coal extracted in the denominator. According to this estimator, mortality due to accidents decreased from 1.15 to 0.42 in the period 1950–1970 in the United States, for each million tons of coal extracted. However, considering the steep decline in the workforce in the same period, the traditional mortality rate (deaths over persons-time) actually increased. The proposal of a measure of mortality based on the amount of coal extracted is just one example of the attempts to influence decisions by including an economic element (productivity) in risk assessment. This paper has three purposes: One, to describe empirical research concerning the health effects of environmental pollutants; two, to discuss the scientific principles and methods used in the identification of environmental hazards; and three, to critically discuss some of the ethical principles which are applied in medicine and in the assessment and management of risk. (shrink)

The clinical decision is supposed to be based on evidence. In fact, what counts as evidence is far from being established. Some definition of "proof" is needed to distinguish between scientific medicine and charlatanism. My thesis is that unfortunately a clear-cut boundary between evidence and lack of evidence cannot be found, for several reasons that I summarise in the paper. Evidence in medicine very often has fuzzy boundaries, and dichotomising fuzziness and uncertainty can have serious consequences. Physicians and patients should (...) accept the irreducible fuzziness of many of the concepts they use when dealing with health and disease. (shrink)

Italian political thinker Paolo Virno argues that the category of "multitude" is a far better tool to analyze contemporary issues than the Hobbesian concept of "people." Globalization is forcing us to rethink some of the categories—such as "the people"—that traditionally have been associated with the now eroding state. Italian political thinker Paolo Virno argues that the category of "multitude," elaborated by Spinoza and for the most part left fallow since the seventeenth century, is a far better tool to (...) analyze contemporary issues than the Hobbesian concept of "people," favored by classical political philosophy. Hobbes, who detested the notion of multitude, defined it as shunning political unity, resisting authority, and never entering into lasting agreements. "When they rebel against the state," Hobbes wrote, "the citizens are the multitude against the people." But the multitude isn't just a negative notion, it is a rich concept that allows us to examine anew plural experiences and forms of nonrepresentative democracy. Drawing from philosophy of language, political economics, and ethics, Virno shows that being foreign, "not-feeling-at-home-anywhere," is a condition that forces the multitude to place its trust in the intellect. In conclusion, Virno suggests that the metamorphosis of the social systems in the West during the last twenty years is leading to a paradoxical "Communism of the Capital.". (shrink)

Bringing together contributors from philosophy, international relations, security studies, and strategic studies, New Wars and New Soldiers offers a truly interdisciplinary analysis reflective of the nature of modern warfare. This comprehensive approach allows the reader to see the broad scope of modern military ethics, and to understand the numerous questions about modern conflict that require critical scrutiny. Aimed at both military and academic audiences, this paperback will be of significant interest to researchers and students in philosophy, sociology, military and strategic (...) studies, international relations, politics, and security studies, acting as an ideal course text or as supplementary reading. (shrink)

From November 5 to November 22, 2019, the University of Milan hosts an exhibition in which philosophy and its problems are staged in playful and interactive forms. Like any catalog, this volume also intends to document the objects and themes proposed to the visitor. But it also has a more ambitious goal: to imagine and design the spaces of that Museum of Philosophy which, we are sure, will be created here in Milan, starting from the experience of this exhibition--Translated, via (...) Google, from page 2 of cover. (shrink)

While the governance of human existence is organised ever-increasingly around life and its potential to proliferate beyond all limits, much critical reflection on the phenomenon is underpinned by considerations about the very negation of life, death. The challenge is to construct an alternative understanding of human existence that is truer to the complexity of the present, biopolitical moment. Palladino responds to the challenge by drawing upon philosophical, historical and sociological modes of inquiry to examine key developments in the history of (...) biomedical understanding of ageing and death. He combines this genealogy with close reflection upon its implications for a critical and effective reading of Foucault's and Deleuze's foundational work on the relationship between life, death and embodied existence. Biopolitics and the Philosophy of Death proposes that the central task of contemporary critical thought is to find ways of coordinating different ways of thinking about molecules, populations and the mortality of the human organism without transforming the notion of life itself into the new transcendent truth that would take the place once occupied by God and Man. (shrink)

Le but de cet ouvrage est de montrer la teneur philosophique unitaire de la pensée critique de Diderot par delà le caractère éclaté et dispersé de son œuvre. Diderot philosophe est présenté comme un penseur critique et systématique, c'est-à-dire un philosophe dont la réflexion, d'une part, s'inscrit dans le cadre du courant de pensée moderne qui vise à dépasser les perspectives du « premier regard géomètre de la raison », celui de Descartes, de Malebranche et des post-cartésiens. D'autre part, elle (...) atteint un « second regard critique », plus profond, jeté sur le monde de la nature et surtout, sur lui-même (une philosophie de l'aperception : Spinoza, Wolff, les Moralistes anglais et Kant), qui se rattache intimement à un matérialisme biologique tout à fait original, issu de la confrontation de Diderot avec les naturalistes et les médecins de son temps. C'est ce matérialisme élaboré dans l'usine encyclopédique qui met en cause la notion clé d'« individualité naturelle » (jouée en couplet avec une « communauté du désir ») - néologisme dont Le Neveu de Rameau et Le Rêve de D'Alembert développeront les tenants et les aboutissants philosophiques -, et qui témoigne de la nouveauté d'approche propre à cette philosophie, à l'intérieur de la pensée des Lumières européennes. Avec Diderot, c'est une nouvelle figure historique de la philosophie elle-même - celle de la subjectivité individuelle complexe, uni-totalité de penser-sentir-agir - qui monte sur la scène de la modernité, comme étant la substance première, incontournable et insaisissable, de la pensée critique de nos jours. (shrink)

Il libro ricostruisce la vita e il pensiero di Jean Guitton (1901-1999), il grande amico di Paolo VI, a quasi ventʼanni dalla sua morte. La vicenda umana di questo scrittore e filosofo cristiano ha attraversato quasi integralmente il XX secolo quale testimone diretto di eventi epocali: i primi tentativi ecumenici, le due guerre mondiali, le radicalizzazioni ideologiche del secondo dopoguerra, lʼera atomica e il Concilio Vaticano II. Il primo capitolo del volume è dedicato alla ricostruzione della vita di Guitton (...) e alle sue prime sintesi accademiche; ed esso fanno seguito altri due capitoli che trattano della sua antropologia (il tempo, il pudore, l'amore umano) e della sua cristologia filosofica (le condizioni di possibilità della rivelazione, la filosofia della risurrezione, la sua innovativa mariologia). Ne viene il ritratto di un pensiero di impronta umanista, ben radicato nella tradizione francese e che forse, come già lamentava Yves Congar nel 1963, non ha avuto, fino ad oggi, quellʼattenzione e quellʼaccoglienza che sembra meritare. (shrink)