Conceptual and Ethical Challenges of Evolutionary Medicine (Ethics of Science and Technology Assessment, 53)

This book analyses the concept of disease, as defined in the context of evolutionary medicine. Upon introducing the reader to evolutionary medicine in its current form and describing its approach to disease instances, the book leverages thoughts and instruments of knowledge of epistemology, social sciences, and ethics to answer the question: “How can we build a timely and appropriate concept of disease?” At first, it looks at the social concerns of medicalization, for example focusing on the suffering of people who have not been diagnosed, or whose suffering is not caused by certain elements that falls under the definitions of disease. In turn, it merges different, both conceptual and empirical considerations in one comprehensive analysis, with the aim of fostering a multidisciplinary understanding of the phenomenon of disease. This book also highlights certain kinds of epistemic injustices that are taking place in the healthcare system, as this is currently conceived in post-industrial societies, thus offering a timely contribution to the current debate around social justice in healthcare. Foreword Preface Acknowledgments Contents 1 Introduction 1.1 Concepts and Reality 1.2 Starting Point; the Concept of Disease and Evolution 1.3 Setting of the Problem Agenda for the Concept of Disease 1.4 The Motivation 1.5 The Structure of the Book 1.6 Dealing with Concepts of Scientific Research 1.7 Going to the Central Question; Disease 1.8 Caveat for a Conclusion References 2 Finding Value in Concepts 2.1 Introduction 2.1.1 Significance of Thick Concepts 2.2 Evaluative and Descriptive, Why the Distinction is Hard to Grasp and Its Prevalence 2.2.1 Hume’s Guillotine, Naturalistic Fallacy and Non-cognitivists 2.2.2 Disentanglement of the Thick 2.3 The Thin and the Rest 2.3.1 The Thin and Against the Dichotomy 2.3.2 Global Evaluation and Embedded Evaluation 2.3.3 Dimensionality 2.4 Reduction 2.4.1 Reduction as Replacement 2.4.2 Reduction in the Case of Subset of Properties 2.5 Conclusion References 3 Meaning as Definition and Meaning as Use 3.1 Introduction 3.2 Why to Talk About Meaning Within This Context in the Very First Place? 3.3 Meaning Theories 3.3.1 Meaning of What? Concepts, Sentences and Larger Linguistic Representations. A Brief Criticism of the Object of Linguistic Analysis 3.3.2 A Social-Pragmatic Approach as the Critique of Idealist Conception of Concepts 3.3.3 The Meaning of Meaning 3.3.4 Negation and Pragmatics 3.3.5 What Is Real and What Is Representation? 3.4 Conclusion References 4 Locating the Conceptual Change in Scientific Research 4.1 Introduction 4.2 Limits of a Stable Division of Labor and the Steamship of Theseus 4.3 When Is Biological Research Complete? Difficulty Due to the Structure of Research Communities 4.3.1 Difficulty in Research, Someone’s Research Topic, Someone’s Given—Vertically Direction of Change 4.3.2 Sub-fields—Which Part of a Discipline Speaks for the Concept—Horizontal Aspect of Change 4.4 What Kind of Entities Are Concepts in Research?—Is It Simply a Linguistic Problem?—Language and Thought 4.4.1 Contradictions Between the Particular and the Abstract 4.4.2 Grasp and Use (Possessing a Concept)—Scientist Is Back into the Picture 4.5 Conclusion References 5 The Concept of Disease in the Traditional Debates 5.1 Introduction 5.1.1 The Concept of Disease in Short, the Shadow of Logical Positivism 5.1.2 What Kind of Concept is Disease? Positioning Disease in the Context of Philosophy of Science 5.2 The Normativeness Debate—Can It Be Value Free? 5.2.1 A Solution to the Normativeness Debate 5.3 Social and Psychological Aspects; Three Part Division; Disease, Sickness and Illness 5.4 Medical Explanation 5.4.1 What Are We Explaining: What Kind of a Concept is Disease? 5.5 Contextualism and Disability Internal and External 5.6 What to Do When the Concepts Are Changing? 5.7 Individualized and Invented Disease 5.8 Conclusion References 6 Evolution and Evolutionary Medicine in Disease 6.1 The Concept of “Evolution” in Evolutionary Medicine; General Distinctions 6.1.1 The Delphi Study of Evolutionary Medicine 6.1.2 Relevance of Evolution to Medicine 6.2 What is Evolutionary Medicine, Historical and Contemporary Accounts 6.2.1 A Brief History of Evolution and Medicine Together 6.2.2 The Cannon of Evolutionary Medicine 6.3 Are These Simply and Adaptationist Stories? Explanation in Evolutionary Medicine 6.4 How Does EM See Disease; What Can We Expect from It? 6.4.1 What is an Explanation? 6.4.2 The Primary Focus of Modern Synthesis; Genes 6.4.3 We Are not Perfect—Trade-Offs, Constraints and Disease Vulnerability 6.4.4 New Evolutionary Entities—the Units of Selection 6.5 Established—Emergent Structures Versus Continuum (Population Thinking) Mismatch for Environment 6.5.1 Other Developments in Philosophy of Biology that Are Relevant to the Debate; Everything Flows and Everything is Distributed so Shall Disease 6.6 Conclusion References 7 New Developments in Evolutionary Theory and Evolutionary Medicine, New Frontiers for Evolutionary Medicine 7.1 Introduction 7.1.1 Epigenetics 7.1.2 The Structure of Inheritance Dynamics in Epigenetics 7.2 Limitations of Evolutionary Medicine and the Discontents 7.2.1 A Brief History of Evolutionary Theory; Ever Since Darwin 7.3 A Brief History of Inheritance and Inheritance of Inheritance 7.4 Extended Evolutionary Synthesis 7.4.1 Explanations in EES 7.4.2 Ancestral Population Individualized—Inheritance of Different Mechanisms 7.4.3 Structures Fixed and Getting Fixed 7.4.4 Another Kind of History, Individualization and Evolutionary Histories 7.4.5 Emerging Pathogens 7.5 Conclusion References 8 Conclusion 8.1 Introduction 8.2 The Potential Futures of the Concept of Disease 8.3 Different Kinds of Injustices 8.4 The Death of the Non-Clinic 8.5 One Possible Objection—Where Does Disease End 8.6 Conclusion References