While aging research and policy aim to promote ‘health’ at all ages, there remains no convincing explanation of what this ‘health’ is. In this paper, I investigate whether we can find, implicit within the sciences of aging, a way to know what health is and how to measure it, i.e. a theory of health. To answer this, I start from scientific descriptions of aging and its modulators and then try to develop some generalizations about ‘health’ implicit within this research. After (...) discussing some of the core aspects of aging and the ways in which certain models describe spatial and temporal features specific to both aging and healthy phenotypes, I then extract, explicate, and evaluate one potential construct of health in these models. This suggests a theory of health based on the landscape of optimized phenotypic trajectories. I conclude by considering why it matters for more candidate theories to be proposed and evaluated by philosophers and scientists alike. (shrink)

Several philosophers have recently argued that phenomenology is well-suited to help understand the concepts of health, disease, and illness. The general claim is that by better analysing how illness appears to or is experienced by ill individuals—incorporating the first-person perspective—some limitations of what is seen as the currently dominant third-person or ‘naturalistic’ approaches to understand health and disease can be overcome. In this article, after discussing some of the main insights and benefits of the phenomenological approach, I develop three general (...) critiques of it. First, I show that what is often referred to as naturalism tends to be misunderstood and/or misrepresented, resulting in straw-man arguments. Second, the concept of normality is often problematically employed such that some aspects of naturalism are actually presupposed by many phenomenologists of medicine. Third, several of the key phenomenological insights and concepts, e.g. having vs. being a body, the alienation of illness, the epistemic role of the first-person perspective, and the idea of health within illness, each bring with them new problems that limit their utility. While acknowledging the possible contributions of phenomenology, these criticisms point to some severe limitations of bringing phenomenological insights to bear on the problems facing philosophy of medicine that should be addressed if phenomenology is to add anything substantially new to its debates. (shrink)

Medicalization appears to be an issue that is both ubiquitous and unquestionably problematic as it seems to signal at once a social and existential threat. This perception of medicalization, however, is nothing new. Since the first main writings in the 1960s and 1970s, it has consistently been used to describe inappropriate or abusive instances of medical authority. Yet, while this standard approach claims that medicalization is a growing problem, it assumes that there is simply one “medical model” and that the (...) expanding realm of “the medical” can be more or less clearly delineated. Moreover, while intended to establish the reality of this growing threat, this research often requires making arbitrary or unjustified distinctions between different practices. To better clarify the concept of medicalization, I will focus more on capturing the variety of medical practices than on the sociological aspects of medical discourse. In doing so, I will explore the distinction between medicalization and pathologization, a distinction that is often overlooked and that brings with it many conceptual and practical implications. After defining these terms, I will use some examples to show that while pathologizing is closely tied to medicalizing, both can occur independently. I will then further develop this distinction in terms of the different individual and social effects of these practices. (shrink)

This essay discusses four key criticisms recently leveled against the main attempts to use conceptual analysis to understand health and disease. First, it examines the weaknesses of these attempts and suggests a better way to proceed. Next, it briefly discusses another disease debate concerning pathological mechanisms and suggests that this approach could be more fruitful than that of conceptual analysis. The final section demonstrates how Georges Canguilhem's biological philosophy of disease avoids some of the problems associated with conceptual analysis, and (...) how he can contribute to both debates. Canguilhem's appeal to biological normativity is understood as contributing to a theoretical explanation, and a possible naturalization, of what is specific to healthy and pathological phenomena. (shrink)

Defining the concepts of health and disease has proved rather difficult and many philosophers of medicine have simply concluded that we would be better off giving up on such endeavors. I feel that this view is misguided mainly because it seems to rest on a rather inadequate understanding of how philosophers use biology to clarify medical concepts. While some philosophers appeal to biology so as to clarify what we mean by the concepts of health and disease, others attempt to use (...) biology to develop a theory thathelps to explain what health and disease are. In this dissertation, I examine the work of an often overlooked philosopher of medicine, Georges Canguilhem, who sought to understand medical concepts by starting from the biological properties of variation and variability. In other words, in order to define health and disease, Canguilhem first tried to establish how what is normal can vary between organisms and even within the same organism due to the dynamic relation between the organism and its environment. Simply put: what is normal for one organism could be pathological for another and what is normal in one environment could become pathological in another. Consequently, variation and variability need to be included in our understanding of health and disease. Throughout this dissertation, I explore how Canguilhem goes about developing the implications of these biological properties for medical concepts and this allows me to distinguish his approach from some popular ones in philosophy of medicine, e.g. those trying to develop an objective biological approach (naturalism) and those appealingto evolutionary principles. I establish the plausibility of definingmedical concepts relative to individual organisms and their environments, while showing some of its potential limitations, especially when it comes to human social environments. Ultimately, a more nuanced understanding of how the inseparability of organisms and environments canhelp to clarify health and disease provides an interesting way to get past the apparent stalemate in philosophy of medicine and firmly establishes the relevance of Canguilhem’s philosophy. (shrink)

While philosophers of science have marginally discussed concepts such as ‘nutrient’, ‘naturalness’, ‘food’, or the ‘molecularization’ of nutrition, they have yet to seriously engage with the nutrition sciences. In this paper, I offer one way to begin this engagement by investigating conceptual challenges facing the burgeoning field of nutritional ecology and the question of how organisms construct a ‘balanced’ diet. To provide clarity, I propose the distinction between nutrient balance as a property of foods or dietary patterns and nutrient balancing (...) as an evolved capacity to regulate nutrient intake. This distinction raises conceptual and empirical issues, such as what properties constitute this capacity and whether they are the same in all organisms. Additionally, while scientists use the term ‘balancing’, its intension and extension need further clarification. Based on the literature, the properties of external nutrient detection, internal sensing of nutrient levels, and organismal regulation could provide a basic recipe for nutrient balancing. Next, using an evolutionary lens, I examine nutrient acquisition in some prokaryotes, slime molds, simple multicellular eukaryotes, and in the quirks of multicellular metabolism to raise questions about the origins and universality of balancing. Finally, I build on this explication of balance and balancing by considering how obesity and cancer might respectively elucidate problems of organismal nutrient imbalances versus disrupted cellular nutrient balancing. (shrink)

This essay explores the relation between repetition and thought in Bergson and Deleuze. In Bergson, this relation is seen in the method of intuition by which thought is made to think in time and in the ‘rhythms’ at work in how intuition is a contact with time or life, urging conceptual precision. This framework is used to clarify Deleuze's thought without image as that contingent encounter with the persistent forces of life that demand the perseverance of thought. Far from stressing (...) difference alone, both link the repetition in life to the unsettling persistence required to develop a truly new thought. (shrink)