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Mechanisms, malfunctions and explanation in medicine

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Abstract

Mechanisms are a way of explaining how biological phenomena work rather than why single elements of biological systems are there. However, mechanisms are usually described as physiological entities, and little or no attention is paid to malfunction as an independent theoretical concept. On the other hand, malfunction is the main focus of interest of applied sciences such as medicine. In this paper I argue that malfunctions are parts of pathological mechanisms, which should be considered separate theoretical entities, conceptually having a priority over physiological sequences. While pathological mechanisms can be described in terms of a Cummins-like mechanistic explanation, they show some unnoticed peculiarities when compared to physiological ones. Some features of pathological mechanisms are considered, such as outcome variability, ambivalence and dependence on a range.

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Notes

  1. Davies (2000) has the merit of describing malfunction as an independent question, but deals almost exclusively with its evolutionary implications. Neander (1995) argues about malfunction from a purely logical point of view, which is not very relevant to my point.

  2. Neander (1995) clearly expresses this point of view: “The primary physiological analysis necessarily abstracts away from maladaptive environments […] Descriptions of what happens when things are maladaptive or malfunctioning are given against this background. That is medical descriptions of disease processes tend to assume normal functioning of the body, except where abnormalities are explicitly described or are inferable from those explicitly described” (p. 118).

  3. Note that blood transfusion reaction and the graft-versus-host reaction have conceptually the same mechanism.

  4. This is most clearly the case in anaphylaxis.

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Acknowledgments

I would like to thank Carmen Dell’Aversano for many insightful remarks on earlier drafts, Guglielmo Tamburrini for his friendly encouragement to the study of scientific explanation, and a referee of this journal who helped to significantly improve the readability of this paper.

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  1. University of Pisa, Pisa, Italy

    Mauro Nervi

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  1. Mauro Nervi
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Correspondence to Mauro Nervi.

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Nervi, M. Mechanisms, malfunctions and explanation in medicine. Biol Philos 25, 215–228 (2010). https://doi.org/10.1007/s10539-009-9190-x

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