In this paper we focus on some new normativist positions and compare them with traditional ones. In so doing, we claim that if normative judgments are involved in determining whether a condition is a disease only in the sense identified by new normativisms, then disease is normative only in a weak sense, which must be distinguished from the strong sense advocated by traditional normativisms. Specifically, we argue that weak and strong normativity are different to the point that one ‘normativist’ label (...) ceases to be appropriate for the whole range of positions. If values and norms are not explicit components of the concept of disease, but only intervene in other explanatory roles, then the concept of disease is no more value-laden than many other scientific concepts, or even any other scientific concept. We call the newly identified position “value-conscious naturalism” about disease, and point to some of its theoretical and practical advantages. (shrink)

The general concept of mental disorder specified in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders is definitional in character: a mental disorder might be identified with a harmful dysfunction. The manual also contains the explicit claim that each individual mental disorder should meet the requirements posed by the definition. The aim of this article is two-fold. First, we shall analyze the definition of the superordinate concept of mental disorder to better understand what necessary criteria actually (...) characterize such a concept. Second, we shall consider the concepts of some individual mental disorders and show that they are in tension with the definition of the superordinate concept, taking pyromania and narcissistic personality disorder as case studies. Our main point is that an unexplained and not-operationalized dysfunction requirement that is included in the general definition, while being systematically violated by the diagnostic criteria of specific mental disorders, is a logical error. Then, either we unpack and operationalize the dysfunction requirement, and include explicit diagnostic criteria that can actually meet it, or we simply drop it. (shrink)

This paper aims at considering the conceptual status of feeding and eating disorders (FEDs). Now that the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has changed the classification and some relevant criteria of FEDs, it is particularly relevant to evaluate their psychiatric framework and their status as mental disorders. I focus my efforts on addressing only one specific question: Do FEDs fit the DSM-5 general definition of mental disorder? In DSM-5 a mental disorder is defined as a syndrome that (...) reflects adysfunctionand is usually associated with significantdistress or disability. More importantly, there is an explicit statement saying thatallmental disorders listed in the manual must meet the requirements highlighted by the general definition. Thus, I evaluate whether or not FEDs are really meant to reflect a dysfunction and are usually associated with significant distress or disability. (shrink)

The latest edition of the Diagnostic and Statistical Manual of Mental Disorders included the Social Communication Disorder as a new mental disorder characterized by deficits in pragmatic abilities. Although the introduction of SPCD in the psychiatry nosography depended on a variety of reasons—including bridging a nosological gap in the macro-category of Communication Disorders—in the last few years researchers have identified major issues in such revision. For instance, the symptomatology of SPCD is notably close to that of Autism Spectrum Disorder. This (...) opens up the possibility that individuals with very similar symptoms can be diagnosed differently and receive different clinical treatments and social support. The aim of this paper is to review recent debates on SPCD, particularly as regards its independence from ASD. In the first part, we outline the major aspects of the DSM-5 nosological revision involving ASD and SPCD. In the second part, we focus on the validity and reliability of SPCD. First, we analyze literature on three potential validators of SPCD, i.e., etiology, response to treatment, and measurability. Then, we turn to reliability issues connected with the introduction of the grandfather clause and the use of the concepts of spectrum and threshold in the definition of ASD. In the conclusion, we evaluate whether SPCD could play any role in contemporary psychiatry other than that of an independent mental disorder and discuss the role that non-epistemic factors could play in the delineation of the future psychiatry nosography. (shrink)

This paper aims at considering the conceptual status of feeding and eating disorders (FEDs). Now that the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has changed the classification and some relevant criteria of FEDs, it is particularly relevant to evaluate their psychiatric framework and their status as mental disorders. I focus my efforts on address- ing only one specific question: Do FEDs fit the DSM-5 general definition of mental disorder? In DSM-5 a mental disorder is defined as a syndrome (...) that reflects a dysfunction and is usually associated with significant distress or disability. More importantly, there is an explicit statement saying that all mental disorders listed in the manual must meet the requirements highlighted by the general definition. Thus, I evaluate whether or not FEDs are really meant to reflect a dysfunction and are usually associated with significant distress or disability. (shrink)

Wines with geographical indication can be classified and represented by such features as designations of origin, producers, vintage years, alcoholic strength, and grape varieties; these features allow us to define wines in terms of a set of necessary and/or sufficient conditions. However, wines can also be identified by other characteristics, involving their look, smell, and taste; in this case, it is hard to define wines in terms of necessary and/or sufficient conditions, as wine concepts exhibit typicality effects. This is a (...) setback for the design of computer science ontologies aiming to represent wine concepts, since knowledge representation formalisms commonly adopted in this field do not allow for the representation of concepts in terms of typical traits. To solve this problem, we propose to adopt a hybrid approach in which ontology-oriented formalisms are combined with a geometric representation of knowledge based on conceptual spaces. As in conceptual spaces, concepts are identified in terms of a number of quality dimensions. In order to determine those relevant for wine representation, we use the terminology developed by the Italian Association of Sommeliers to describe wines. This will allow us to understand typicality effects about wines, determine prototypes and better exemplars, and measure the degree of similarity between different wines. (shrink)

In this paper I review how the notion of gender is understood in psychiatry, specifically in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). First, I examine the contraposition between sex and gender, and argue that it is still retained by DSM-5, even though with some caveats. Second, I claim that, even if genderqueer people are not pathologized and gender pluralism is the background assumption, some diagnostic criteria still conceal a residue of gender dualism and (...) essentialism. Third, I consider gender dysphoria, which is characterized by an incongruence between one’s experienced or expressed gender and one’s assigned gender; since this condition pertains to distress and disability, not to the incongruence per se, it does not pathologize transgender people. Still, I contend that it should be removed from DSM-5 for theoretical reasons. (shrink)

1. In her latest book (Jefferson, 2022), “Are Mental Disorders Brain Disorders?”, Anneli Jefferson (AJ) argues that mental disorders can be considered brain disorders when they involve brain dysfun...

The COVID-19 pandemic has made it especially visible that mortality data are a key component of epidemiological models, being a single indicator that provides information about various health aspects, such as disease prevalence and effectiveness of interventions, and thus enabling predictions on many fronts. In this paper we illustrate the interrelation between facts and values in death statistics, by analyzing the rules for death certification issued by the World Health Organization. We show how the notion of the underlying cause of (...) death can change in view of public health goals. This brings us to a general point about how non-epistemic factors, such as values and goals, are reflected in the choice of different measures in epidemiological models. We finally argue that this analysis is not only relevant from a theoretical point of view but also has important practical consequences. (shrink)

In this paper, we discuss the conceptual structure of cocktail recipes. This topic involves engaging questions for philosophers and food theorists due to some peculiar characteristics of cocktail recipes, such as the fact that they are standardised by international associations but, nonetheless, vagueness in some elements of the recipes introduces a degree of variability between cocktails of the same type. Our proposal is that a classical theory of concepts is unable to account for such peculiar features. Thus, only a hybrid (...) theoretical approach, combining definitional and prototypical aspects, can capture how cocktail recipes are usually conceptualised among bartenders and mixologists: while the spirit is usually a necessary (though not sufficient) condition for establishing whether an individual cocktail falls under a specific cocktail concept, all the other ingredients and procedures listed in recipes may vary to a certain extent. In order to assess whether variability in prototypical elements of cocktail recipes has any limitations, we exploit the notion of conceptual scheme applied to cocktail recipes and argue that, as long as the quality dimensions of a specific cocktail are respected, its identity remains unchanged regardless of changes in the ingredients or in its preparation. (shrink)

Ageing is one of the main risk factors for Covid-19. In this paper, we delineate four alternative conceptualisations of ageing, each of which determines different understandings of its causal role to the susceptibility to Covid-19 as well as to the severity of its symptoms and adverse health outcomes.

This book investigates the role of translation processes in the shaping and re-shaping of ideological discourse and their impact on the actors involved in the translation process, focusing on institutional texts and their influence on lifestyle issues both public and personal. The volume employs a unique approach in its focus on "lifestyle politics," examining texts produced by political actors, such as international organizations and national governments, and their translations. The book draws on an interdisciplinary perspective, integrating work from translation studies (...) and linguistics with political science and economics, and applies it to English and French versions of the same documents, calling attention to ideological differences across versions. In light of our increasingly globalized world, Caimotto and Raus demonstrate the ways in which globalized discourse undergoes processes of depoliticization and marketization which produce a trickle-down effect on individuals’ personal identities. This book will be of interest to students and scholars in translation studies, critical discourse analysis, and political science. -/- . (shrink)

After a brief introduction regarding infertility through the ancient ages up to the modern molecular techniques the authors focus on some proposals issued by the Ethics Council in Portugal which were discussed by the medical and scientifically community although there is a lack of legislation regarding medical reproduction and related issues in Portugal.

En los últimos años se ha incrementado el interés por la narrativa en el campo de la ética. Este hecho es especialmente relevante en el seno del neoaristotelismo. En este artículo se explora el uso que el filósofo hace de la tradición literaria en la Ética a Nicómaco y se analizan los datos extraídos a la luz de la caracterización de los géneros literarios que ofrece la Poética. Se pretende identificar la función que atribuye Aristóteles a la narración en la (...) reflexión ética y justificar la relevancia de la tragedia como expresión más acabada de la condición de la vida humana. (shrink)

Reason and rationality represent crucial elements of the self-image of human beings and have unquestionably been among the most debated issues in Western philosophy, dating from ancient Greece, through the Middle Ages, and to the present day. Many words and thoughts have already been spent trying to define the nature and standards of reason and rationality, what they could or ought to be, and under what conditions something can be said to be rational. This volume focuses instead on the relationships (...) of reason and rationality to some relevant specific topics, i.e., science, knowledge, gender, politics, ethics, religion, aesthetics, language, logic, and metaphysics, trying to uncover and clarify both the connections and differences in their various characterisations and uses. (shrink)

In the ongoing pandemic, death statistics influence people’s feelings and government policy. But when does COVID-19 qualify as the cause of death? As philosophers of medicine interested in conceptual clarification, we address the question by analyzing the World Health Organization’s rules for the certification of death. We show that for COVID-19, WHO rules take into account both facts and values.

The general definition of mental disorder stated in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders seems to identify a mental disorder with a harmful dysfunction. However, the presence of distress or disability, which may be bracketed as the presence of harm, is taken to be merely usual, and thus not a necessary requirement: a mental disorder can be diagnosed as such even if there is no harm at all. In this paper, we focus on the (...) harm requirement. First, we clarify what it means to say that the harm requirement is not necessary for defining the general concept of mental disorder. In this respect, we briefly examine the two components of harm, distress and disability, and then trace a distinction between mental disorder tokens and mental disorder types. Second, we argue that the decision not to regard the harm requirement as a necessary criterion for mental disorder is tenable for a number of practical and theoretical reasons, some pertaining to conceptual issues surrounding the two components of harm and others pertaining to the problem of false negatives and the status of psychiatry vis-à-vis somatic medicine. However, we believe that the harm requirement can be maintained among the specific diagnostic criteria of certain individual mental disorders. More precisely, we argue that insofar as the harm requirement is needed among the specific diagnostic criteria of certain individual mental disorders, it should be unpacked and clarified. (shrink)

Philosophers of medicine have formulated different accounts of the concept of disease. Which concept of disease one assumes has implications for what conditions count as diseases and, by extension, who may be regarded as having a disease and for who may be accorded the social privileges and personal responsibilities associated with being sick. In this article, we consider an ideal diagnostic test for coronavirus disease 2019 infection with respect to four groups of people—positive and asymptomatic; positive and symptomatic; negative; and (...) untested—and show how different concepts of disease impact on the disease and sickness judgements for these groups. The suggestion is that sickness judgements and social measures akin to those experienced during the current COVID-19 outbreak presuppose a concept of disease containing social harm as a component. We indicate the problems that arise when adopting this kind of disease concept beyond a state of emergency. (shrink)

Most of the epidemiological models of the Covid-19 pandemic contain the reproduction number as a parameter. In this article we focus on some shortcomings regarding its role in driving health policies and political decisions. First, we summarize what R is and what it is used for. Second, we introduce a three-question matrix for the evaluation of any construct or parameter within a model. We then review the main literature about R to highlight some of its shortcomings and apply to them (...) our three-question matrix. Finally, we argue that these shortcomings are important for an epistemic and political evaluation of R. (shrink)

This volume breaks new grounds by bringing together a great variety of innovative contributions on triangulation, epistemology, and mind. The notion of triangulation, developed by Donald Davidson during the last two decades of his life, has changed our understanding of the relationship between subjective, intersubjective, and objective, and shed new light on concepts such as externalism, internalism, communication, interpretation, and language. At the same time, however, it has been strongly criticized for several aspects. The papers collected in this volume written (...) by established contributors aim to provide new insights into the contemporary debate on triangulation. The upshot is not only a deeper understanding of Davidson s ideas but also a new appreciation of some central problems of epistemology and the philosophy of mind with regard to adjoining disciplines such as, for instance, cognitive sciences and the philosophy of language.". (shrink)

This article is a book review of: M. C. Amoretti and N. Vassallo (eds.), Reason and Rationality.

In the present paper, we shall discuss the notion of prototype and show its benefits. First, we shall argue that the prototypes of common-sense concepts are necessary for making prompt and reliable categorisations and inferences. However, the features constituting the prototype of a particular concept are neither necessary nor sufficient conditions for determining category membership; in this sense, the prototype might lead to conclusions regarded as wrong from a theoretical perspective. That being said, the prototype remains essential to handling most (...) ordinary situations and helps us to perform important cognitive tasks. To exemplify this point, we shall focus on disease concepts. Our analysis concludes that the prototypical conception of disease is needed to make important inferences from a practical and clinical point of view. Moreover, it can still be compatible with a classical definition of disease, given in terms of necessary and sufficient conditions. In the first section, we shall compare the notion of stereotype, as it has been introduced in philosophy of language by Hilary Putnam, with the notion of prototype, as it has been developed in the cognitive sciences. In the second section, we shall discuss the general role of prototypical information in cognition and stress its centrality. In the third section, we shall apply our previous discussion to the specific case of medical concepts, before briefly summarising our conclusions in section four. (shrink)

Riassunto: In questo contributo analizzeremo il criterio del danno, presente nella definizione generale di disturbo mentale del DSM. La questione ha rilevanza sia da un punto di vista filosofico, perché il danno è una componente normativa e valoriale, non oggettiva, sia da un punto di vista clinico, perché chi ha difeso il criterio del danno ha spesso sostenuto che in sua assenza avremmo troppi falsi positivi. Infine, ha importanza dal punto di vista socio-sanitario in relazione al rapporto tra la psichiatria (...) e la medicina non psichiatrica, nello specifico tra il DSM e l’ICD. Sosterremo che ci sono buone ragioni per non mantenere il danno come criterio necessario nella definizione generale del disturbo mentale. Dopo una breve introduzione, forniremo una panoramica storica sul ruolo del criterio del danno nelle varie edizioni del DSM. Successivamente si illustrerà la principale obiezione contro l’inclusione del criterio del danno nella definizione generale di disturbo mentale, ossia il problema dei falsi negativi, per poi presentare e discutere ulteriori ragioni – medico-pratiche e concettuali – che depongono a sfavore dell’attribuzione di un forte peso al criterio del danno. In sede conclusiva ribadiamo come la decisione presa dalla task force del DSM-5 di escludere il criterio del danno dalla definizione generale di disturbo mentale debba essere sostenuta. Parole chiave: Danno; Disabilità; Disagio; Disturbo mentale; DSM “Harm” as Criterion for the Definition of Mental Disease in DSM. Some Epistemological Reflections: In this paper, we analyse the harm requirement in the general definition of mental disorder in the Diagnostic and Statistical Manual for Mental Disorders. This issue has both philosophical and clinical relevance: on the one hand the harm requirement is a normative, value-laden, non-objective component in the definition of mental disorder; on the other hand, the harm requirement has often been defended on the grounds that it prevents an increase in false positives. The issue is also important in assessing the relationship between psychiatry and somatic medicine, more precisely, between the DSM and the International Classification of Diseases. We argue that there are good reasons not to maintain the harm requirement in the general definition of mental disorder. After a brief introduction, we overview the history of the harm requirement across the various editions of the DSM. Then, we examine the main objection to the inclusion of the harm requirement in the general definition of mental disorder, that is, the problem of false negatives, and also present several other points – both practical and conceptual – that help demonstrate why the harm requirement is inadequate as a definiens of mental disorder. To conclude, we stress that the decision of the DSM-5 task force not to regard the harm requirement as a necessary component of mental disorder should be endorsed. Keywords: Harm; Disability, Distress; Mental Disorder; DSM. (shrink)

La discussione generale sulla filosofia della scienza contemporanea è complicata dal numero e dall’eterogeneità delle scienze, mentre lo studio di temi specifici porta inevitabilmente a dissertazioni specialistiche che mancano nel dare ragione della trama di senso sottostante. Questo Piccolo trattato di epistemologia intende occupare uno spazio vuoto, proponendo alcuni temi chiave per la comprensione dei meccanismi alla base della conoscenza scientifica: i rapporti tra filosofia e scienze, siano esse naturali o umane; la complessa relazione tra fatti e valori; la distinzione (...) tra scoperta e giustificazione; la necessità di un discorso etico sulla ricerca, che chiami in causa categorie come fiducia, empatia, altruismo ed egoismo. Con un approccio chiaro e rigoroso, il volume intende rivolgersi a quell’ampia fascia di pubblico interessata alle tematiche centrali dell’epistemologia, della filosofia e delle scienze. (shrink)

As it emerged from philosophical analyses and cognitive research, most concepts exhibit typicality effects, and resist to the efforts of defining them in terms of necessary and sufficient conditions. This holds also in the case of many medical concepts. This is a problem for the design of computer science ontologies, since knowledge representation formalisms commonly adopted in this field do not allow for the representation of concepts in terms of typical traits. However, the need of representing concepts in terms of (...) typical traits concerns almost every domain of real world knowledge, including medical domains. In particular, in this article we take into account the domain of mental disorders, starting from the DSM-5 descriptions of some specific mental disorders. On this respect, we favor a hybrid approach to the representation of psychiatric concepts, in which ontology oriented formalisms are combined to a geometric representation of knowledge based on conceptual spaces. (shrink)

This volume offers a meta-philosophical reflection on feminist philosophies of science. It emphasizes and discusses both the connections and differences between "traditional" philosophies of science and feminist philosophies of science. The collection systematically analyses feminist contributions to the various philosophies of specific sciences. Each chapter is devoted to a specific area of philosophy of science: general philosophy of science, philosophy of biology, philosophy of climate sciences, philosophy of cognitive sciences and neurosciences, philosophy of economics, philosophy of history and archaeology, philosophy (...) of logic and mathematics, philosophy of medicine, philosophy of psychology, philosophy of physics, and philosophy of social sciences. Since some of these areas have so far rarely been addressed by feminist philosophers, this new collection provides new angels and stimulates the debate on pivotal issues that are part and parcel of both "traditional" philosophies of science and feminist philosophies of science. Using a range of different methodologies and styles, the essays all show great clarity in both arguments and contents. (shrink)

As it emerged from philosophical analyses and cognitive research, most concepts exhibit typicality effects, and resist to the efforts of defining them in terms of necessary and sufficient conditions. This holds also in the case of many medical concepts. This is a problem for the design of computer science ontologies, since knowledge representation formalisms commonly adopted in this field (such as, in the first place, the Web Ontology Language - OWL) do not allow for the representation of concepts in terms (...) of typical traits. The need of representing concepts in terms of typical traits concerns almost every domain of real world knowledge, including medical domains. In particular, in this article we take into account the domain of mental disorders, starting from the DSM-5 descriptions of some specific disorders. We favour a hybrid approach to concept representation, in which ontology oriented formalisms are combined to a geometric representation of knowledge based on conceptual space. As a preliminary step to apply our proposal to mental disorder concepts, we started to develop an OWL ontology of the schizophrenia spectrum, which is as close as possible to the DSM-5 descriptions. (shrink)

Patient-centred Care should be the golden thread that runs through all healthcare education and continuing Professional/educational professional/inter-professional/development development nowadays. However, the values and attitudes supposed to be part of healthcare professions, such as compassion, address an important gap in training today. As compassion is a Complex/Complexity, culturally-based value, the challenge for healthcare educators consists in providing and evaluating compassionate care practice in a global society within contexts with different social and cultural value systems.Developing an educational culture specific for European health (...) professions that promotes improvement as a core value within the health education programmes and connecting compassion as the baseline was the Purpose of the ISTEW Project funded by the European Commission. Its main contributions were a consensus definition of Healthcare Improvement Science, four accredited HIS educational modules and a HIS Evaluation Framework. Since July 2016 an annual international summer programme named as “Immersion to Healthcare Improvement Science” takes place in the Faculty of Health Sciences at University of Alicante. This summer course has the potential to introduce students as future professionals in healthcare into improvement science and critical thinking with the scope of compassionate Care by using the ISTEW outcomes. All this body of work and knowledge generated aims to improve patient outcomes, health system performance and population health. (shrink)

Come è emerso dall’analisi filosofica e dalla ricerca nelle scienze cogni- tive, la maggior parte dei concetti, tra cui molti concetti medici, esibisce degli “effetti prototipici” e non riesce ad essere definita nei termini di condizioni necessarie e sufficienti. Questo aspetto rappresenta un problema per la pro- gettazione di ontologie in informatica, poiché i formalismi adottati per la rap- presentazione della conoscenza (a partire da OWL – Web Ontology Langua- ge) non sono in grado di rendere conto dei concetti nei (...) termini dei loro tratti prototipici. Nel presente articolo ci concentriamo sulla classe dei disordini mentali facendo riferimento alle descrizioni che ne vengono date nel DSM-5. L’idea è quella di proporre un approccio ibrido, in cui i formalismi delle ontologie sono combinati a una rappresentazione geometrica della conoscenza basata sugli spazi concettuali. (shrink)