Archive for October, 2011

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Value, Dysmenorrhea and the Definition of Disease

October 12, 2011

Lauren Ross

Two main philosophical positions contrast the role of value in the definition of disease. The descriptivist position, championed most influentially by Christopher Boorse’s biostatistical theory (BST), claims that the definition of disease should be value-free, an “objective matter” that can be read, more or less, from the scientific facts of nature. The opposing normativist position asserts instead that this definition should involve value, although many different philosophers have widely different conceptions of how exactly it should.

I argue that the Boorsian theory fails to provide a definition of disease that accounts for dysmenorrhea, a disease of severe pelvic pain with menstruation. According to Boorse’s BST an organism is diseased if and only if it experiences subnormal function, with regard to its species, age-group and sex, which impinges upon the organism’s survival or reproductive fitness. The example dysmenorrhea not only fails to fit the BST’s analysis in that it lacks dysfunction and does not reduce survival or reproductive fitness but it also undermines the rationale for that analysis in that its treatment (hysterectomy) diminishes the patient’s survival and reproductive fitness, and does so far more than the disease itself.

Second, I argue for the normativist position in maintaining that the definition of disease must include at least some value because, as demonstrated by the example of dysmenorrhea, it encompasses the notion of suffering—a subjective experience of the patient. Suffering is value-laden because it depends on the patient’s judgment of her condition (its effects on daily life, severity, etc.) and personal preferences (longevity, quality of life, etc.).

My assessment of “value”, in the definition of disease, refers to a subjective assessment of worth made by an individual or collective, and as such, depends on their judgments or preferences. Values are often juxtaposed to objective or empirical scientific facts which, through detached scientific experimentation, provide descriptions of ourselves and our world. Of course whether there is a sharp fact-value distinction is controversial; my argument requires that only a rough distinction of this sort exists and I will not broach the controversies related to the topic.

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Experiment as a Source and Test of Causal Content in Science

October 7, 2011

Karen Zwier

This presentation explores the history of the idea of experiment as a privileged method for gaining knowledge of causes.  Part of my aim is to argue against any temptation one might have to view manipulationist accounts of causation (a la Woodward) just as a current philosophical fad, as marginalizable, as just one out of several equally valid candidates for fleshing out the meaning of causal claims.  I will show that manipulationist accounts are part of a long tradition of thinking about causation as empirically testable and intimately tied to experiment.  I will also show that the tradition itself—i.e., that of thinking about causation as tied to experiment—was by no means a sideline in history; it is wrapped up in the fundamental ideas of the scientific revolution—the great reconceptualization of human inquiry into nature that resulted in what we call the “New Science”.

I begin by examining the thought of two of the main advocates for experiment during the early stages of the scientific revolution: Galileo and Bacon.  I explore their explicit statements about the connection between experiment and knowledge of causes, and I also examine examples of experiments that they carried out and discussed in their writings. My examination will show that the turn toward experiment during the scientific revolution was marked by a sharp change in what was validly considered to be a cause. The early thinkers of the scientific revolution worked on eliminating or removing emphasis on certain senses of causation prevalent in the academic Aristotelian philosophy of nature, while elevating different sense of cause that was directly linked with the very experimental methodology that they were advocating.

I jump forward in history to show that the narrowed experimental sense of cause that the early modern thinkers sought to characterize is strongly present in the work of John Stuart Mill two centuries later.  Finally, I touch on a few of the main points of the manipulationist account of causation advanced by several philosophers in recent decades, including its understanding of causal claims as referring to the results of actual or hypothetical experiments.

Ultimately, my examination of this historical thread of thought will reveal a great deal of constancy over the past four centuries, in addition to a great deal of progress and increasing sophistication of experimental methods to test causal relationships.