Abstract
In this paper we develop a systemic-organizational account of the notion of biological malfunction and present the implications of this theoretical model for the philosophy of medicine. We try to ground the theoretical notion of biological normativity, interpreting it as an inherent feature of biological systems. We then develop a theoretical account of malfunctions, based on the adaptive mechanisms of living systems, which explains the ways in which, and the reasons why, a biological trait is malfunctional in terms of current organization. According to our account, the organizational closure – i.e., the web of mutual constraining actions of the material structures on their boundary conditions that collectively self-maintain the whole organization of the system – provides a naturalistic grounding of the concept of normative functions from a systemic framework and constitutes the causal regime in which biological functions (and malfunctions) appear and can be identified. To illustrate this, we consider some significant medical examples. We claim that our definition of biological malfunction provides the theoretical resources for a naturalization of the notion of biological normativity with relevant implications for a naturalist conception of notions of health and disease.
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Notes
- 1.
There are also some “hybrid” approaches consisting in different combinations of aspects of naturalist and normativist perspectives (Reznek 1987; Caplan 1992; Wakefield 1992). These approaches claim that both biological and value-laden factors play important roles in the conceptualization of health and disease. In this paper, we shall explore the scope and limitations of the naturalist-objectivist project and, since these hybrid approaches defend the necessity of including external values, we shall consider them as “non- naturalist” views and, therefore, we will not focus our analysis on them. The philosophical debate between the so-called “normativist” and “naturalist” approaches is described in Kovacs 1998; Boorse 2002 and Ereshefsky 2009.
- 2.
For a review on BST, its virtues and weak points see Nordenfelt (1987), Kovacs (1998) or Kingma (2010). Boorse himself has offered revisions of his theory and responses to many criticisms in Boorse 1997 and 2002. See also Hausman (2012) and Garson and Piccinini (2014) for recent developments of the bio-statistical approach.
- 3.
This new approach has been introduced as an improvement and an integration of the well-known “etiological” and “systemic-dispositional” approaches (Mossio et al. 2009, 816–821). For a critical survey of these two mainstream perspectives in the philosophical debate on functions, see McLaughlin 2001; Mossio et al. 2009, 816–821, and Saborido 2014.
- 4.
- 5.
Bich et al. (Forthcoming) offers a nice overview of the notion of biological regulation.
- 6.
It is worth noting that there are important similarities between our conception of “functional presupposition” and the conception of this idea proposed in Bickhard 2000 and Christensen and Bickhard 2002. According to these authors, a functional presupposition is a structural property that allows us to conclude the existence of a concrete part or trait of a system and its function by considering the whole set of the remainder of parts or traits. Our interpretation of functional presupposition allows us to postulate, by considering the functional behavior of the whole system and its parts, a range of functioning of a trait that is determined by the regulatory system. Thus, by considering the structure and dynamic components of a system it is possible to postulate the “necessary” existence of a functional trait, the range in which the function of that trait has to be performed, and, therefore, certain aspects of its structure.
- 7.
Functional analysis proposed by the Organizational Approach corresponds to a systemic view that considers that living beings’ dynamical organizations can be decomposed into mechanisms that serve specific functions. As Garson argues, organisms instantiate “functional mechanisms”, i.e., mechanisms that serve functions and whose norms should be characterized in terms of their functional properties: (…) mechanisms serve functions. Moreover, that mechanisms serve functions places substantive restrictions on the kinds of activities ‘for which’ there can be a mechanism. Although the heart is a ‘mechanism for’ circulating blood—or it is part of such a mechanism—it is not a ‘mechanism for’ heart disease. Heart disease is something that happens when this mechanism is disrupted. (Garson 2013, 318)
- 8.
According to Canguilhem, organisms are healthy insofar as they are normative relative to environmental fluctuations. Therefore, health implies the organismic capacity to tolerate variations within what is typical for a given organism, and the living system’s ability to adapt and establish new behavioral patterns in order to meet changing demands (Canguilhem 1991, 132). For an exposition of Canguilhem’s ideas on natural normativity and its implications for the theoretical definition of health and disease, see Sholl (This volume, Chap. 6). As Sholl maintains, Canguilhem’s approach provides an eco-organismic strategy to contextualize a naturalistic account of health and disease. The approach we develop in this paper can be seen as a contribution to this naturalistic project.
References
Amundson, R. (2000). Against normal function. Studies in History and Philosophy of Biological and Biomedical Sciences, 31, 33–53.
Barandiaran, X., Di Paolo, E., & Rohde, M. (2009). Defining agency: Individuality, normativity, asymmetry, and spatio-temporality in action. Adaptive Behavior, 17(5), 367–386.
Bich, L., Mossio, M., Ruiz-Mirazo, K., & Moreno, A. (Forthcoming). Biological regulation: Controlling the system from within. Biology and Philosophy.
Bickhard, M. H. (2000). Autonomy, function, and representation. Communication and Cognition – Artificial Intelligence, 17(3–4), 111–131.
Bickhard, M. H. (2004). Process and emergence: Normative function and representation. Axiomathes – An International Journal in Ontology and Cognitive Systems, 14, 121–155.
Birch, J. (2012). Robust processes and teleological language. European Journal for Philosophy of Science, 3(3), 299–312.
Boorse, C. (1977). Health as a theoretical concept. Philosophy of Science, 44(4), 542–573.
Boorse, C. (1997). A rebuttal on health. In J. M. Humber & R. F. Almeder (Eds.), What is disease (pp. 3–134). Totowa: Humana Press.
Boorse, C. (2002). A rebuttal on functions. In A. Ariew, R. Cummins, & M. Perlman (Eds.), Functions (pp. 63–112). Oxford: Oxford University Press.
Canguilhem, G. (1991). The normal and the pathological. Ed. Zone. Original in French 1966.
Caplan, A. (1992). If gene theory is the cure, what is the disease? In G. Annas & S. Elias (Eds.), Gene mapping: Using law and ethics as guides (pp. 128–141). New York: Oxford University Press.
Chandler, J. L. R., & Van De Vijver, G. (Eds.). (2000). Closure: Emergent organizations and their dynamics (Vol. 901). New York: Annals of the New York Academy of Science.
Christensen, W. D. (2012). Natural sources of normativity. Studies in History and Philosophy of Biological and Biomedical Sciences, 43, 104–112.
Christensen, W. D., & Bickhard, M. H. (2002). The process dynamics of normative function. The Monist, 85(1), 3–28.
Collier, J. (2000). Autonomy and process closure as the basis for functionality. Annals of the New York Academy of Sciences, 901, 280–291.
Cummins, R. (2002). Neo-teleology. In A. Ariew, R. Cummins, & M. Perlman (Eds.), Functions (pp. 157–172). Oxford: Oxford University Press.
Davies, P. S. (2001). Norms of nature. Naturalism and the nature of functions. Cambridge: MIT Press.
Delancey, C. (2006). Ontology and teleofunctions: A defense and revision of the systematic account of teleological explanation. Synthese, 150, 69–98.
Di Paolo, E. A. (2005). Autopoiesis, adaptivity, teleology, agency. Phenomenology and the Cognitive Sciences, 4(4), 429–452.
Edin, B. (2008). Assigning biological functions: Making sense of causal chains. Synthese, 161, 203–218.
Ehreshefsky, M. (2009). Defining “health” and “disease”. Studies in the History and Philosophy of Biology and Biomedical Sciences, 40, 221–227.
Engelhardt, T. (1986). The foundations of bioethics. New York: Oxford University Press.
Fulford, K. W. M. (1989). Moral theory and medical practice. New York: Cambridge University Press.
Garson, J. (2013). The functional sense of mechanism. Philosophy of Science, 80(3), 317–333.
Garson, J., & Piccinini, G. (2014). Functions must be performed at appropriate rates in appropriate situations. British Journal for the Philosophy of Science, 65(1), 1–20.
Hardcastle, V. G. (2002). On the normativity of functions. In A. Ariew, R. Cummins, & M. Perlman (Eds.), Functions (pp. 144–156). Oxford: Oxford University Press.
Hausman, D. (2012). Health, naturalism, and functional efficiency. Philosophy of Science, 79, 519–541.
Hofmann, B. (2002). On the triad disease, illness, and sickness. Journal of Medicine and Philosophy, 27(6), 651–673.
Kafri, R., Springer, M., & Pilpel, Y. (2009). Genetic redundancy: New tricks for old genes. Cell, 136(3): 389–392.
Kasper, D. L., Braunwald, E., Fauci, A. S., Hauser, S. L., Longo, D. L., Jameson, J. L., & Loscalzo, J. (2008). Harrison’s principles of internal medicine (17th ed.). New York: McGraw-Hill Medical Publishing Division.
Khushf, G. (2007). An agenda for future debate on concepts of health and disease. Medicine, Health Care and Philosophy, 10(1), 19–27.
Kingma, E. (2010). Paracetamol, poison, and polio: Why Boorse’s account of function fails to distinguish health and disease. British Journal for the Philosophy of Science, 61(2), 241–264.
Kovács, J. (1998). The concept of health and disease. Medicine, Health Care and Philosophy, 1, 31–39.
Krohs, U. (2010). Dys-, Mal- et Non-: L’autre face de la fonctionnalité. In J. Gayon & De Ricqlès. Les fonctions: des organismes aux artefacts (pp. 337–352). Paris: Presses Universitaires de France.
Lennox, J. (1995). Health as an objective value. The Journal of Medicine and Philosophy, 20, 499–511.
Margolis, J. (1976). The concept of disease. The Journal of Medicine and Philosophy, 1, 238–255.
McLaughlin, P. (2001). What functions explain. Functional explanation and self-reproducing systems. Cambridge: Cambridge University Press.
McLaughlin, P. (2009). Functions and norms. In U. Krohs & P. Kroes (Eds.), Functions in biological and artificial worlds. Comparative philosophical perspectives (pp. 93–102). Cambridge: MIT Press.
Mossio, M., & Moreno, A. (2010). Organisational closure in biological organisms. History and Philosophy of the Life Sciences, 32, 269–288.
Mossio, M., Saborido, C., & Moreno, A. (2009). An organizational account for biological functions. British Journal for the Philosophy of Science, 60(4), 813–841.
Mossio, M., Bich, L., & Moreno, A. (2013). Emergence, closure and inter-level causation in biological systems. Synthese, 78(2), 153–178.
Nordenfelt, L. (1987). On the nature of health: An action-theoretic approach. Dordrecht: Reidel.
Pearce, A. C., Senis, Y. A., Billadeau, D. D., Turner, M., Watson, S. P., & Vigorito, E. (2004). Vav1 and vav3 have critical but redundant roles in mediating platelet activation by collagen. Journal of Biological Chemistry, 279(52), 53955–53962.
Powley, T. L. (2003). Central control of autonomic functions: Organization of the autonomic nervous system. In L. R. Squire, F. E. Bloom, S. K. McConnell, J. L. Roberts, N. C. Spitzer, & M. J. Zigmond (Eds.), Fundamental neuroscience (Vol. 2, pp. 913–932). Boston: Elsevier Academic Press.
Price, C. (1995). Functional explanations and natural norms. Ratio (New Series), 7, 143–160.
Price, C. (2001). Functions in mind: A theory of intentional content. Oxford: Oxford University Press.
Reznek, L. (1987). The nature of disease. New York: Routledge.
Saborido, C. (2014). New directions in the philosophy of biology: A new taxonomy of functions. In C. Galavotti, S. Hartmann, M. Weber, W. Gonzalez, D. Dieks, & T. Uebel (Eds.), New directions in the philosophy of science (pp. 235–251). Dordrecht: Springer.
Saborido, C., & Moreno, A. (2015). Biological pathology from an organizational perspective. Theoretical Medicine and Bioethics, 36(1), 83–95.
Saborido, C., Mossio, M., & Moreno, A. (2011). Biological organizational and cross-generation functions. British Journal for the Philosophy of Science, 62, 583–606.
Scadding, J. (1990). The semantic problem of psychiatry. Psychological Medicine, 20, 243–248.
Schlosser, G. (1998). Self-re-production and functionality: A systems-theoretical approach to teleological explanation. Synthese, 116, 303–354.
Schwartz, P. H. (2007). Defining dysfunction: Natural selection. Design, and Drawing a Line, Philosophy of Science, 74, 364–385.
Wakefield, J. C. (1992). The concept of mental disorder: On the boundary between biological facts and social values. American Psychologist, 47, 373–388.
Wouters, A. G. (2005). The function debate in philosophy. Acta Biotheoretica, 53(2), 123–151.
Acknowledgments
This paper is a revised version of a talk prepared for the Conference on Health and Disease Concepts held in Lyon, France, 9/10 November 2012. We are grateful to the audience at that conference, especially to David Teira and Elodie Giroux for their comments on previous versions of this paper. Alvaro Moreno acknowledges aid from the Research Project IT 505-10 of the Gobierno Vasco and FFU2009-12895-CO2-02 and FFI2014-52173-P of the Spanish Ministerio de Economia y Competitividad. Preparation of this manuscript was supported by the UNED grant 20013-029-UNED.
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Saborido, C., Moreno, A., González-Moreno, M., Hernández Clemente, J.C. (2016). Organizational Malfunctions and the Notions of Health and Disease. In: Giroux, É. (eds) Naturalism in the Philosophy of Health. History, Philosophy and Theory of the Life Sciences. Springer, Cham. https://doi.org/10.1007/978-3-319-29091-1_7
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