Bioethics and the Hypothesis of Extended Health

Nicolae Morar
University of Oregon
Dominant views about the nature of health and disease in bioethics and the philosophy of medicine have presumed the existence of a fixed, stable, individual organism as the bearer of health and disease states, and as such, the appropriate target of medical therapy and ethical concern. However, recent developments in microbial biology (Turnbaugh & al 2007; Gordon & Klaenhammer 2011; The Human Microbiome Project Consortium 2012; Grice & Segre 2012; Blaser 2014; Knight 2015; Relman 2015), neuroscience (Kim & Johnson 2010; Maravita & Iriki 2004), the philosophy of cognitive science (Clark & Chalmers 1998; Clark 2007a, 2007b; Sterelny 2010; Hutchins 2010), and social and personality psychology (Ickes, Snyder, & Garcia 1997; Drigotas, Rusbult, Wieselquist, & Whitton 1999; Fitzsimmons, Finkel, & van Dellen, 2015), have produced a novel understanding of the individual and its fluid boundaries. Drawing on converging evidence from these disciplines, and following recent research in public health (Atlas 2012; Mackenzie & al. 2013; Horton & al. 2014), we argue that certain features of our biological and social environment can be so tightly integrated as to constitute a unit of care extending beyond the intuitive boundaries of skin and skull. This paper lays the groundwork for a research program in extended health. Drawing from work in microbiology and social and personality psychology, we develop and defend the Hypothesis of Extended Health (HEH), which denies the claim that health and disease states are predicated solely on the internal functioning of an organism. We contend that this view has profound and wide-ranging clinical implications. Namely, that the targets of medical invention and ethical concern are wider and more diverse than usually assumed.
Keywords bioethics  extended mind  human microbiome  social psychology  One Health  extended health
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