Medicine and Society, New Perspectives in Continental Philosophy (Philosophy and Medicine Book 120)

This volume addresses some of the most prominent questions in contemporary bioethics and philosophy of medicine: ‘liberal’ eugenics, enhancement, the normal and the pathological, the classification of mental illness, the relation between genetics, disease and the political sphere, the experience of illness and disability, and the sense of the subject of bioethical inquiry itself. All of these issues are addressed from a “continental” perspective, drawing on a rich tradition of inquiry into these questions in the fields of phenomenology, philosophical hermeneutics, French epistemology, critical theory and post-structuralism. At the same time, the contributions engage with the Anglo-American debate, resulting in a fruitful and constructive conversation that not only shows the depth and breadth of continental perspectives in bioethics and medicine, but also opens new avenues of discussion and exploration. For decades European philosophers have offered important insights into the relation between the practices of medicine, the concept of illness, and society more broadly understood. These interventions have generally striven to be both historically nuanced and accessible to non-experts. From Georges Canguilhem’s seminal __The Normal and the Pathological__, Michel Foucault’s lectures on madness, sexuality, and biopolitics, Hans Jonas’s deeply thoughtful essays on the right to die, life extension, and ethics in a technological age, Hans-Georg Gadamer’s lectures on __The Enigma of Health__, and more recently Jürgen Habermas’s carefully nuanced interventions on the question of liberal eugenics, these thinkers have sought to engage the wider public as much as their fellow philosophers on questions of paramount importance to current bioethical and social-political debate. The essays contained here continue this tradition of engagement and accessibility. In the best practices of European philosophy, the contributions in this volume aim to engage with and stimulate a broad spectrum of readers, not just experts. In doing so the volume offers a showcase of the richness and rigor of continental perspectives on medicine and society. Acknowledgments 6 Contents 7 1 Introduction 9 Part I Figures and Grounds 20 2 Defining Bioethics: Back to the Sources 21 1 Introduction: What Is Defining? 21 2 Bioethics According to Its Inventor 24 2.1 ``Global Bioethics'' 30 2.2 A Last Call 33 3 A Personal Journey 34 3.1 Techno (-) Science and (Bio) Ethics 35 3.1.1 The Philosophical Context: Response to an Outdated Image of Science Conveyed by a Resigned Philosophy 35 3.1.2 Characterizations of Techno-science and Its Ethically Problematic Scope 36 3.2 Evolution 39 4 Two Bioethical Approaches 41 References 44 3 The Ontological Ethics of Hans Jonas 45 1 Introduction 45 2 The Nature of Life 48 3 Human Responsibility and the Elemental Ought 52 4 Human Enhancement and the Imperative to Protect Human Nature 54 5 The Burden and Blessing of Mortality 57 References 60 4 On the Origins of Illness and the Hiddenness of Health: A Hermeneutic Approach to the History of a Problem 62 1 Nature and Health: The Classical View 62 2 The Modern Response: Reason and Nature 65 3 Back to Antiquity 67 4 Gadamer's Graecophilia: The Recovery of Plato 68 5 The Proper Measure: Nature as a Ground Rule 70 6 Body and Soul: The Person as a Unified Whole 71 References 77 5 The Ethical Self After Genetics 78 1 Introduction 78 2 Habermas, Genetics and Rational Reconstruction 79 3 Derrida and the Already Technical Self 83 References 88 Part II The Experience of Illness: Phenomenological Approaches 89 6 An Ethics of Embodiment: The Body as Object and Subject 90 1 Introduction 90 2 The Body as Object 91 3 The Body as Subject 93 4 The Body as Subject and Object 96 5 Bodily Integrity and Bodily Intentionality 99 6 Bodily Integrity and Self-identification 101 7 Concluding Remarks 104 References 105 7 Conspicuous, Obtrusive and Obstinate: A Phenomenology of the Ill Body 108 1 Introduction 108 2 The Eidetic Features of Illness 109 3 The Objective Body and the Body as Lived 112 4 Sartre's Three Orders of the Body 115 5 The Transparency of the Body 118 6 The Body as Tool 122 7 Conclusion 124 References 125 8 The Body Between Pathology and the Everyday 127 1 Whose Body Is This? 127 2 The Mystery of the Phantom Limb 129 3 Pathology and the Loss of Reflection 132 4 Body and Language 136 5 Conclusion: Pathology at the Limits of Phenomenology 138 References 139 Part III The Normal and the Pathological 141 9 Towards a Critique of Normalization: Canguilhem and Boorse 142 1 Introduction 142 2 Three Problems of Normalization 143 3 Boorse's Naturalism as an Example of Normalization 146 4 The Problem of the Abnormal and the Anomalous 151 5 From Environmental to Social Relativity? 156 References 158 10 Are Paraphilias Mental Disorders? The Case of the DSM 160 1 Introduction 160 2 Revolutionizing Sexual Deviance 162 3 The Early DSM and the Paraphilias (1952--1980) 163 4 Homosexuality: A Crucial Controversy 165 5 On Being Consistent: Defining the Paraphilias in DSM-III and DSM-IV (1980--2012) 169 6 DSM-5, Paraphilias, and Paraphilic Disorders 173 7 Arguing Against the DSM 174 8 Conclusion 176 References 177 11 Liberal Eugenics, Human Enhancement and the Concept of the Normal 180 1 Introduction 180 2 Shaping People: Human Enhancement and Normality 181 3 Rethinking Normality 191 References 194 Part IV Life Itself: From Bio to Political 196 12 Was Canguilhem a Biochauvinist? Goldstein, Canguilhem and the Project of Biophilosophy 197 1 Introduction 197 Acknowledgments 209 References 209 13 Of (Auto-)Immune Life: Derrida, Esposito, Agamben 213 1 The Political Life 213 2 Immunity and Identity: The Philosophical Importance of Immunity 214 3 Auto-Immunity 216 4 Derrida on Autoimmunity 216 5 Roberto Esposito: Legal and Biological Immunity 220 6 The Two Interpretations of Biological Immunity 222 7 The Community 225 8 Esposito and Derrida: History and Community 226 9 Conclusion. Agamben: Of a Possible Survival Beyond Immunity 227 References 230 14 The Psychopathology of Space: A Phenomenological Critique of Solitary Confinement 232 1 The Rise of the Supermax Prison 232 2 Outline for a Phenomenology of Solitary Confinement 236 3 Bodies in Depth 240 4 Pure Depth and Psychopathology 243 5 Pathology and Resistance 246 References 248 Part V Eugenics and Enhancements 250 15 The Right to Be Impaired and the Legacy of Eugenics: A Critical Reading of the UN Convention on ``Disability'' Rights 251 1 Introduction 251 2 Becoming `Disabled': Experiencing the Legacies of Eugenics 253 3 Legacies of Eugenics---Lived Experience During the Nazi-Period and Now 256 4 Models of Disability Underpinning the Disability Rights Convention: Eugenics or Inclusion? 261 5 Implications of Inclusion for Disability Rights 264 6 Conclusion 266 References 266 16 Being Machine: Two Competing Models for Neuroprosthesis 269 1 Introduction 269 2 Extending Minds and Bodies 270 3 Medical Prosthesis 278 4 Merleau-Ponty and Prosthetic Embodiment 280 5 Machinic Embodiment 283 6 Conclusion 288 References 290 17 From ``Enhancement Medicine'' to ``Anthropotechnology'' 293 1 Introduction 293 1.1 Using Science Speculation to Do Philosophy 294 2 First Objection to the Concept of Enhancement Medicine 295 2.1 Medicine and Norms 295 2.2 Classes of Medical Action 297 2.2.1 First Class: Return to the Individual Norm 297 2.2.2 Second Class: Establishment of a New Individual Norm 297 2.2.3 Third Class: Impossibility of Establishing a New Individual Norm 298 2.2.4 Fourth Class: Reestablishment of the Species Norm (or Whatever Is Thought to Be Such in a Certain Social and Historical Context) 298 2.3 From Curative Medicine to Enhancement Medicine 299 2.3.1 First Set of Problems: Corrections that Actually Enhance 299 2.3.2 Second Set of Problems: The Norm of What? 300 2.4 Critique of the Notion of Enhancement Medicine 302 3 Second Objection and Transition to the Concepts of Anthropotechny and Anthropotechnology 303 3.1 Problems Raised by the Very Concept of Enhancement 303 3.1.1 What Makes a Modification an Enhancement, and Who Decides? 303 3.1.2 An Enhancement Relative to What Context? 304 3.2 Anthropotechny, Anthropotechnics, Anthropotechnology 306 3.2.1 Construction of the Three Concepts 306 3.2.2 Why Differentiate Between ``Anthropotechnics'' and ``Anthropotechnology''? 307 3.3 Is It Ethically Acceptable to Unconceal the Concept of Anthropotechny? 309 4 Conclusion 310 References 311 Index 314 This Volume Addresses Some Of The Most Prominent Questions In Contemporary Bioethics And Philosophy Of Medicine: ‘liberal’ Eugenics, Enhancement, The Normal And The Pathological, The Classification Of Mental Illness, The Relation Between Genetics, Disease And The Political Sphere, The Experience Of Illness And Disability, And The Sense Of The Subject Of Bioethical Inquiry Itself. All Of These Issues Are Addressed From A “continental” Perspective, Drawing On A Rich Tradition Of Inquiry Into These Questions In The Fields Of Phenomenology, Philosophical Hermeneutics, French Epistemology, Critical Theory And Post-structuralism. At The Same Time, The Contributions Engage With The Anglo-american Debate, Resulting In A Fruitful And Constructive Conversation That Not Only Shows The Depth And Breadth Of Continental Perspectives In Bioethics And Medicine, But Also Opens New Avenues Of Discussion And Exploration. For Decades European Philosophers Have Offered Important Insights Into The Relation Between The Practices Of Medicine, The Concept Of Illness, And Society More Broadly Understood. These Interventions Have Generally Striven To Be Both Historically Nuanced And Accessible To Non-experts. From Georges Canguilhem’s Seminal The Normal And The Pathological, Michel Foucault’s Lectures On Madness, Sexuality, And Biopolitics, Hans Jonas’s Deeply Thoughtful Essays On The Right To Die, Life Extension, And Ethics In A Technological Age, Hans-georg Gadamer’s Lectures On The Enigma Of Health, And More Recently Jürgen Habermas’s Carefully Nuanced Interventions On The Question Of Liberal Eugenics, These Thinkers Have Sought To Engage The Wider Public As Much As Their Fellow Philosophers On Questions Of Paramount Importance To Current Bioethical And Social-political Debate. The Essays Contained Here Continue This Tradition Of Engagement And Accessibility. In The Best Practices Of European Philosophy, The Contributions In This Volume Aim To Engage With And Stimulate A Broad Spectrum Of Readers, Not Just Experts. In Doing So The Volume Offers A Showcase Of The Richness And Rigor Of Continental Perspectives On Medicine And Society. . Table Of Contents -- Acknowledgements -- Preface -- Part I: Figures And Grounds: Continental Approaches To Bioethics And Medicine -- Chapter 1, Gilbert Hottois; “defining Bioethics” -- Chapter 2, Niall Keane; “on The Origins Of Illness And The Hiddenness Of Health: A Hermeneutic Approach To The History Of A Problem” -- Chapter 3; Michael Hauskeller; “the Ontological Ethics Of Hans Jonas” -- Part Ii: The Experience Of Illness: Phenomenological Approaches -- Chapter 4, Jenny Slatman And Guy Widdershoven; “an Ethics Of Embodiment: The Body As Subject And Object” -- Chapter 5, Havi Carel; “conspicuous, Obtrusive, Obstinate: a Phenomenology Of The Ill Body” -- Chapter 6, Eran Dorfman; “the Body Between Pathology And The Everyday” -- Part Iii: The Normal And The Pathological -- Chapter 7, Andreas De Block And Jonathan Sholl; “towards A Critique Of Normalization: Canguilhem And Boorse” -- Chapter 8, Pieter Adrians ; “are Paraphilias Mental Illnesses?” -- Chapter 9, Catherine Mills; “liberal Eugenics, Human Enhancement And The Concept Of The Normal” -- Part Iv: Life Itself: From Bio To Political -- Chapter 10, Charles Wolfe; “was Canguilhem A Biochauvanist” -- Chapter 11, Michael Lewis; “on (auto)immune Life: Derrida, Esposito And Agamben -- Chapter 12, Lisa Guenther; “the Psychopathology Of Space: A Phenomenological Critique Of Solitary Confinement” -- Part V: The Horizons Of Medicine: Eugenics, Enhancement And Anthropotechics -- Chapter 13, Christien Van Den Anker; “the Right To Be Impaired And The Legacy Of Eugenics: A Critical Reading Of The Un Convention On ‘disability’ Rights” -- Chapter 14, Sylvie Allouche; “from Enhancement Medicine To Anthropotechnology” -- Chapter 15, Corry Shores; “being Machine, Two Competing Model Of Neuroprosthesis”. . Darian Meacham, Editor. Includes Bibliographical References And Index. This volume addresses some of the most prominent questions in contemporary bioethics and philosophy of medicine: ĺlliberalĺl eugenics, enhancement, the normal and the pathological, the classification of mental illness, the relation between genetics, disease and the political sphere, the experience of illness and disability, and the sense of the subject of bioethical inquiry itself. All of these issues are addressed from a ĺlcontinentalĺl perspective, drawing on a rich tradition of inquiry into these questions in the fields of phenomenology, philosophical hermeneutics, French epistemology, critical theory and post-structuralism. At the same time, the contributions engage with the Anglo-American debate, resulting in a fruitful and constructive conversation that not only shows the depth and breadth of continental perspectives in bioethics and medicine, but also opens new avenues of discussion and exploration. ℗l For decades European philosophers have offered important insights into the relation between the practices of medicine, the concept of illness, and society more broadly understood. These interventions have generally striven to be both historically nuanced and accessible to non-experts. From Georges Canguilhemĺls seminal The Normal and the Pathological, Michel Foucaultĺls lectures on madness, sexuality, and biopolitics, Hans Jonasĺls deeply thoughtful essays on the right to die, life extension, and ethics in a technological age, Hans-Georg Gadamerĺls lectures on The Enigma of Health, and more recently J©ơrgen Habermasĺls carefully nuanced interventions on the question of liberal eugenics, these thinkers have sought to engage the wider public as much as their fellow philosophers on questions of paramount importance to current bioethical and social-political debate. The essays contained here continue this tradition of engagement and accessibility. In the best practices of European philosophy, the contributions in this volume aim to engage with and stimulate a broad spectrum of readers, not just experts. In doing so the volume offers a showcase of the richness and rigor of continental perspectives on medicine and society.℗l Front Matter....Pages i-viii Introduction....Pages 1-11 Front Matter....Pages 13-13 Defining Bioethics: Back to the Sources....Pages 15-38 The Ontological Ethics of Hans Jonas....Pages 39-55 On the Origins of Illness and the Hiddenness of Health: A Hermeneutic Approach to the History of a Problem....Pages 57-72 The Ethical Self After Genetics....Pages 73-83 Front Matter....Pages 85-85 An Ethics of Embodiment: The Body as Object and Subject....Pages 87-104 Conspicuous, Obtrusive and Obstinate: A Phenomenology of the Ill Body....Pages 105-123 The Body Between Pathology and the Everyday....Pages 125-138 Front Matter....Pages 139-139 Towards a Critique of Normalization: Canguilhem and Boorse....Pages 141-158 Are Paraphilias Mental Disorders? The Case of the DSM....Pages 159-178 Liberal Eugenics, Human Enhancement and the Concept of the Normal....Pages 179-194 Front Matter....Pages 195-195 Was Canguilhem a Biochauvinist? Goldstein, Canguilhem and the Project of Biophilosophy....Pages 197-212 Of (Auto-)Immune Life: Derrida, Esposito, Agamben....Pages 213-231 The Psychopathology of Space: A Phenomenological Critique of Solitary Confinement....Pages 233-250 Front Matter....Pages 251-251 The Right to Be Impaired and the Legacy of Eugenics: A Critical Reading of the UN Convention on “Disability” Rights....Pages 253-270 Being Machine: Two Competing Models for Neuroprosthesis....Pages 271-294 From “Enhancement Medicine” to “Anthropotechnology”....Pages 295-315 Back Matter....Pages 317-323