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)

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.

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)

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)

The philosophical analysis of mathematical explanations concerns itself with two different, although connected, areas of investigation. The first area addresses the problem of whether mathematics can play an explanatory role in the natural and social sciences. The second deals with the problem of whether mathematical explanations occur within mathematics itself. Accordingly, this entry surveys the contributions to both areas, it shows their relevance to the history of philosophy and science, it articulates their connection, and points to the philosophical pay-offs to (...) be expected by deepening our understanding of the topic. (shrink)

The temporality of intentions and actions in situations of social interaction can sometimes be paradoxical. I argue that in these situations it may sometimes be possible to conceive of individual acts that can, in a strong sense, be intended retroactively. This could happen when the relational patterns in social interaction literally alter the virtual structure of a participant's past corporeal intentions resulting in an odd experience of having intended something all along without knowing it. I propose that this possibility should (...) be interpreted as more than just a narrowly epistemic phenomenon. Examining this claim involves clarifying the enactive perspective on intentionality, which I do here. The enactive approach rejects the model of a causal relation between intention and action for one of an intrinsic qualitative relation between the two as facets of sense-making. I develop this idea and compare it with Merleau-Ponty's Fundierung model of the mutual relation between corporeal and reflexive intentionality to show that co-regulated moves/affections during social interaction may modulate both arcs of this relation, creating the possibility of a re-signification that alters not the actuality but the virtual tendencies that preceded the social act. (shrink)

This paper explores the epistemology of extrapolation from model organisms to humans in molecular medicine. We take into account two common views on the issue, the homology view and the disanalogy view. In response to both interpretations, we argue that the foundational basis of extrapolations cannot simply be provided by homology and that relevant disanalogies can, thanks to the techniques of molecular biology, be experimentally controlled and exploited to allow useful and reliable extrapolations. The case of "humanised mice" in the (...) context of cancer stem cell research provides evidence of how animal models can be construed to approximate bona fide causal analogue models of human diseases. To supplement this view we show how the epistemology of model organisms needs to take into account the engineering side of molecular medicine. Model organisms are often manipulated to create analogies or remove disanalogies with the target system. We maintain that highlighting this feature is fundamental to explain what warrants extrapolation in the search for the molecular causes of disease. (shrink)

A novel theoretical framework for an embodied, non-representational approach to language that extends and deepens enactive theory, bridging the gap between sensorimotor skills and language. -/- Linguistic Bodies offers a fully embodied and fully social treatment of human language without positing mental representations. The authors present the first coherent, overarching theory that connects dynamical explanations of action and perception with language. Arguing from the assumption of a deep continuity between life and mind, they show that this continuity extends to language. (...) Expanding and deepening enactive theory, they offer a constitutive account of language and the co-emergent phenomena of personhood, reflexivity, social normativity, and ideality. Language, they argue, is not something we add to a range of existing cognitive capacities but a new way of being embodied. Each of us is a linguistic body in a community of other linguistic bodies. The book describes three distinct yet entangled kinds of human embodiment, organic, sensorimotor, and intersubjective; it traces the emergence of linguistic sensitivities and introduces the novel concept of linguistic bodies; and it explores the implications of living as linguistic bodies in perpetual becoming, applying the concept of linguistic bodies to questions of language acquisition, parenting, autism, grammar, symbol, narrative, and gesture, and to such ethical concerns as microaggression, institutional speech, and pedagogy. (shrink)

Christ as symbol in Kant¿s religion -- Hegel's conception of God -- The reality of religion in Hegel's idealist metaphysics -- Hegel's version of the ontological argument for the existence of God -- The trinity and the I -- The death of God and recognition of the self -- Beyond subjectivism -- The relevance of Hegel's philosophy of religion today.

The objective of the article is to examine the extensions of a clinical measure of efficacy, the Number Needed to Treat (NNT), in different settings including screening, scanning, genetic testing and primary prevention, and the associated ethical implications. We examine several situations in which the use of the NNT or NNS (Number Needed to Screen) has been suggested, such as Prostate-Specific Antigen for prostate cancer, Magnetic Resonance Imaging scans, genetic testing and banning of smoking. For each application, we explore the (...) ethical implications of the relevant measure. We have found that the different measures have different ethical implications. For example, the Number Needed to Prevent is the only measure that can be lower than one, indicating with a numerical example that prevention is better than cure. Conversely, we raise questions about the acceptability of genetic screening. In a realistic example, we show that primary prevention of the effects of arsenic in drinking water, targeted to the most susceptible, would require to genetically screen a large number of subjects, whereas giving rise to ethical concerns. We warn against the abuse of testing, in particular genetic testing, we show that different measures are associated with different ethical issues and that prevention tends to be better than cure. (shrink)

Summary This article presents three hitherto unpublished letters by Frank Plumpton Ramsey on the foundations of mathematics with commentary. One of the letters was sent to Abraham Fraenkel and the other two letters to Heinrich Behmann. The transcription of the letters is preceded by an account that details the extent of Ramsey's known contacts with mathematical logicians on the Continent.

The literature on indicative conditionals contains two appealing views. The first is the selectional view: on this view, conditionals operate by selecting a single possibility, which is used to evaluate the consequent. The second is the informational view: on this view, conditionals don’t express propositions, but rather impose constraints on information states of speakers. Both views are supported by strong arguments, but they are incompatible on their standard formulations. Hence it appears that we have to choose between mutually exclusive options. (...) But the options are not exclusive. This paper develops a theory of the semantics and assertability of conditionals that is both selectional and informational. The theory vindicates the signature inferences of both selectional and informational theories, including so-called Conditionals Excluded Middle and principles about the interplay between conditionals and ‘might’. It also predicts some interesting and puzzling facts about the assertion of conditionals. (shrink)

Heinrich Behmann (1891-1970) obtained his Habilitation under David Hilbert in Göttingen in 1921 with a thesis on the decision problem. In his thesis, he solved - independently of Löwenheim and Skolem's earlier work - the decision problem for monadic second-order logic in a framework that combined elements of the algebra of logic and the newer axiomatic approach to logic then being developed in Göttingen. In a talk given in 1921, he outlined this solution, but also presented important programmatic remarks on (...) the significance of the decision problem and of decision procedures more generally. The text of this talk as well as a partial English translation are included. (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)