Somogy Varga

In recent years, medical professionals have noted a concerning rise in lawfully available dietary supplements and various other forms of interventions marketed to broad segments of the population. These products are marketed for an increasing number of conditions and are offered by a growing number of large retailers. Discrepancies in the literature regarding what constitutes pseudomedicine indicate a need for a detailed analysis. In this chapter, systematicity is identified as one characteristic that can be used to demarcate medicine from “folk medicine” and pseudomedicine, drawing on work by Paul Hoyningen-Huene and the earlier application of systematicity to medicine. The chapter shows that systematicity not only helps demarcate medicine but also helps offer a better understanding of the proper role of folk medicine.

The moral weight of preferences expressed by people with advanced dementia remains a persistent challenge for clinical ethics, in part because healthcare professionals (HCPs) often treat some such preferences as still deserving respect even while acknowledging that decision-making capacity is compromised. Drawing on dilemmas discussed in a 2023 ethics workshop in a Danish nursing home, we argue that HCPs differential responses are plausibly tracking a distinction between disorder-driven prefer- ences and authentic preferences that remain genuinely expressive of the person. We defend a thin, procedure- externalist conception of authenticity on which pref- erences can be authentic even without higher-order critical reflection, and we argue that such authenticity can ground defeasible normative reasons for compli- ance even without autonomy. We address three chal- lenges and note converging experimental-bioethics findings suggesting that stakeholders’ judgments in dementia cases are sensitive to authenticity consider- ations. Given persistent uncertainty, we propose three defeasible, clinically usable indicators for presuming authenticity: (i) stability and minimal prioritisation in preference patterns, (ii) domain-specific mini- mal ("spherical") comprehension, and (iii) absence of salient distortion or undue influence. We apply these indicators to the workshop cases and illustrate how the framework can guide practice while leaving room for justified override in high-stakes or distorted cases. Overall, the framework extends current debates in neuroethics both rationalises a common source of clinical hesitation about capacity-based decision rules and offers a principled, action-guiding approach to care decisions.

Health is widely treated as multidimensional, yet little is known about how these dimensions are structured in lay thinking or how such structures guide health-related judgments. We used a conceptual scaling approach to derive participant-specific conceptual maps that position the term unhealthy relative to three clusters of related concepts reflecting Disease, Lifestyle, and Functional Ability aspects of health. Participants’ conceptual understanding of unhealthy was most closely aligned with a Lifestyle interpretation of health, followed by Disease, while Functional Ability played a comparatively minor role. We also observed substantial inter-individual differences in pluralism. Dominant alignment in participants’ conceptual maps predicted how they applied the concept in a subsequent vignette task, with higher accuracy among participants expressing stronger beliefs. These findings indicate that lay understandings of unhealthy are not neutral reflections of medical definitions but are typically anchored in lifestyle-related considerations while varying substantially across individuals. Crucially, predicting concept application from conceptual organization alone suggests that the structure of lay concepts meaningfully constrains how they are used in judgment. Accounting for the dominant alignment and heterogeneity may inform psychological theories of health, contribute to philosophical debates about its nature, and support more effective health communication.

In recent years, notable figures within the medical community have expressed concerns about the rate of medical progress, suggesting that the rapid advances of medicine’s ‘golden age’ are now giving way to an ‘age of disappointment’. While these pessimistic pronouncements about medical progress must–implicitly if not explicitly–appeal to some criteria for what medical progress would be, the task of explicitly defining medical progress has been notably neglected. We take up this task, drawing on insights from the philosophy of science concerning both scientific progress and the aims of medicine. Among other things, we differentiate between medical scientific progress and progress in medical practice, and suggest that this distinction helps to evaluate the aforementioned concerns about the current rate of medical progress. While it is not our goal to draw conclusions relating to the state of medicine at the present time, we propose a unifying account of medical scientific progress according to which such progress leads, necessarily, to progress in medical practice, and show how this account both plausibly distinguishes between medical scientific progress and other (non-medical) instances of scientific progress, and does justice to the ‘dual character’ of medicine.

Reading Marx’s work on central issues such as alienation and class struggle, one is often under the impression that the concept of dignity serves as a normative framework underpinning his diagnosis and criticism—especially in his early work. However, Marx also vehemently opposes concepts like “human dignity,” suggesting that moral terms like dignity are little more than “empty phrases.” To provide a better understanding of this tension, this reflection takes a closer look at the general understanding of morality within historical materialism, and the specific character of the Kantian notion of dignity that fuels Marx’s critical attitude.

The concepts of health and disease are fundamental to medical research, healthcare, and public health, and philosophers have long sought to clarify their meaning and implications. Increasingly, it is suggested that progress in this area could be advanced by integrating empirical methods with philosophical reflection. This Element explores the emerging field of experimental philosophy of medicine (XPhiMed), which takes this approach by applying empirical methods to longstanding philosophical debates. It begins with an overview of the philosophical debates and their methodological challenges, followed by an exploration of experimental findings on health, disease, and disorder, along with their implications for philosophy and other fields.

According to what is sometimes seen as a norm in liberal democratic societies, policy decisions should be founded on well-substantiated factual insights, with science and solid scientific institutions deemed as the authoritative entities on these matters. Call this norm Role of Science in Liberal Democracies (RSLD). We first offer some evidence supporting the presence of a commitment to RSLD and situate it within the foundational traits of liberal democracies. We explore what, if anything, justifies such commitment to RSLD and identify two distinct routes to its justification. RSLD could be _internally justified_ through some unique affinity between science and liberal democracies, or it could be _externally justified_ by some general norm of rationality or morality. We explore and reject both possibilities. Instead, we propose a new hybrid justification of RSLD, according to which deference to science on the part of democratic decision-makers is necessary for realizing a fundamental value of democracy, namely autonomy or self-government.

While difficulties with emotion regulation are widely recognized to be prevalent in individuals with ADHD, researchers disagree on the centrality and explanatory role of dysregulated emotions in ADHD. “Lumpers” comprehend emotion dysregulation as a core symptom alongside inattention, hyperactivity and impulsivity, while “splitters” view the combination as a distinct entity, and “diplomats” hold that they are correlated but ultimately dissociable (Shaw et al. 2014). The literature has predominantly focused on negative emotions such as anger and irritability, often overlooking positive emotional states like curiosity and interest, possibly because these were not traditionally regarded as genuine emotions. We argue that they indeed qualify as epistemic emotions and demonstrate how they can become dysregulated in various ways. By properly acknowledging these emotional dimensions, the core symptoms of ADHD can be understood as manifestations of emotional dysregulation. With this, our account will offer support for “lumpers” and indicates that granting a more prominent explanatory role to emotions and emotional dysregulation could lead to a more unified and integrative model of cognition and behavior in ADHD.

The aim of the paper is to explore how people understand the concepts of health and disease, including the factors that influence their judgments about whether a condition is a disease or a healthy state. The study investigates whether health and disease judgments come apart, and whether they are affected by factors such as typicality, dysfunction, and disvalue. We conclude that the folk concept of health is positive (such that being healthy is consistent with having a disease), while the folk concept of disease is naturalistic (such that value judgments do not play a direct, significant role in determining whether a condition counts as a disease).

With increasing detection of early cancers and precancers, debate over the cancer label has intensified. Although attention focuses on relabeling solid tumors to reduce overtreatment, hematologic precursor conditions remain overlooked. Clonal cytopenia of undetermined significance (CCUS) carries increased risk of progression to myelodysplastic neoplasms and acute myeloid leukemia, with high-risk CCUS having a prognosis similar to that of lower-risk myelodysplastic neoplasms. Because these conditions are managed with surveillance or systemic therapy based on risk, diagnostic labels and linguistic framing may influence decision-making. We investigated whether these factors are associated with changes in risk perceptions and treatment decisions in CCUS.

Akratic action is voluntarily acting against one’s better judgement. Akratic belief is believing against one’s better judgement. We here provide an account of a phenomena that sits somewhere between the two: ‘akratic thinking’. This is where we engage in a thought process against our better judgement. While the idea of akratic thinking has been tentatively considered before, no account has yet been offered of it. This is what we’ll offer here. Our account will seek to show how akratic thinking is possible, the different forms it can take, and the kind of irrationality involved. We’ll also explore how the notion of akratic thinking can provide an alternative explanation for some ostensible cases of akratic belief, and the implications it may have for our understanding of certain mental disorders.

The concept of privacy is both significant and contested, with ongoing philosophical debate about whether it is best understood in terms of non-access or as involving some form of control. This paper advances the discussion by employing experimental philosophy to examine folk intuitions about privacy. Our findings show that these intuitions favor a control-based concept of privacy. Additionally, we show that the type of information at stake influences privacy judgments, indicating that privacy concerns are sensitive to not only access and control but also to informational content. Our results enable us to make progress on the question of how to understand the concept of privacy and calls for a new research agenda that pays closer attention to different informational distinctions.

One significant project within the philosophy of medicine has been to explore the concepts of health and disease and their conceptual relationship—whether health is the absence of disease (negativism) or the presence of a positive state or capacity (positivism). While some contend that this project is hampered by some limitations of traditional philosophical analysis, this paper employs a multi-method approach, incorporating corpus linguistics, semantic feature production tasks, and vignette studies, to investigate the concept of health. Our principal finding is that adherence to healthy behaviors is one of the key criteria for assessing overall health. This finding not only contributes to the philosophical-medical debate but also has implications for health communication and policy development

Two important issues in the philosophy of medicine are the evaluative issue (whether the concept of disease is value-laden) and the neutrality issue (whether the concept of dysfunction is value-laden). The aim of this study was to empirically examine whether a person’s evaluation of their own condition (i.e., patient evaluation) influences whether their condition is considered to be a disease and dysfunction. With respect to the evaluative issue, we observed, consistent with previous research, that patient evaluation does not influence people’s disease judgments, but it does influence their health judgments. Further, with respect to the neutrality issue, we observed that while patient evaluation does not influence people’s dysfunction judgments in physical conditions, it does influence their dysfunction judgments in mental conditions. Depending on exactly how these results are interpreted they might have potentially significant implications for dominant positions in the literature, particularly for those that claim to account for lay judgments. Progress in the philosophy of medicine might benefit from a shift in focus from the concepts of disease and health to a more detailed examination of the concept of dysfunction.

Authenticity has become a widespread ethical ideal that represents a way of dealing with normative gaps in contemporary life. This ideal suggests that one should be true to oneself and lead a life expressive of what one takes oneself to be. However, many contemporary thinkers have pointed out that the ideal of authenticity has increasingly turned into a kind of aestheticism and egoistic self-indulgence. In his book, Varga systematically constructs a critical concept of authenticity that takes into account the reciprocal shaping of capitalism and the ideal of authenticity. Drawing on different traditions in critical social theory, moral philosophy and phenomenology, Varga builds a concept of authenticity that can make intelligible various problematic and potentially exhausting practices of the self.

In contemporary philosophy of the cognitive sciences, proponents of the ‘Hypothesis of Extended Cognition’ (HEC) have focused on demonstrating how cognitive processes at times extend beyond the boundaries of the human body to include external physical devices. In recent years the HEC framework has been put to use in cases of “socially” extended cognition. The guiding intuition in this paper is that exploring the cognitive incorporations of genuinely social elements may advance HEC debates. The paper provides an analysis of emotion regulation in ‘dyadic synchronic interaction’ between infant and caretaker and argues that some ‘socially extended’ cases of cognition cannot be captured with the HEC. Instead, the ‘Hypothesis of Emergent Extended Cognition’ (HEEC) is introduced that complements the HEC and helps in understanding how cognitive properties are sometimes irreducibly emergent, non-programmed properties of coupled social systems. It will be concluded that operating with the HEEC leads to both a more precise grip on the explanandum and to a more robust explanans.

The concept of health has long been debated in philosophy and medicine, with discussions often centering on whether health is merely the absence of disease (negativism) or requires the presence of some positive state or ability (positivism). Empirical studies on the folk concept remain scarce and inconclusive. This paper investigates the folk concept of health through implication and contradiction tests. Our findings reveal that while people often infer that health entails both a disease-free state and lifestyle-related factors, interpretations of ‘health’ vary significantly depending on context, with participants associating health primarily with the absence of disease in medical settings while emphasizing lifestyle factors like diet and activity in personal training scenarios. These results suggest that the meaning of the folk concept of health is strongly context-dependent.

The meaning of being healthy is widely debated, with many suggesting it is a multidimensional concept encompassing key dimensions such as the absence of disease, the presence of well-being, and a healthy lifestyle. While recent studies indicate that lifestyle may be a dominant dimension, it remains unclear whether this holds true across populations or if significant differences exist, particularly between laypeople and healthcare professionals. Our studies reveal a difference, but surprisingly, in the opposite direction of what the literature would predict: medical professionals are substantially more likely than laypeople to frame discussions of “healthy” and “unhealthy” in lifestyle contexts. This result challenges prevailing assumptions about the biomedical focus of healthcare professionals and has implications for improving health communication.

Using experimental philosophy methodologies, this paper explores standing to blame and praise, specifically within respect to health and health advice. Our primary aim is to contribute insights to the literature on standing, while also addressing work in medical ethics on the appropriate roles of doctors. Two main principles regarding standing emerge from these areas: the Differential Relationship Principle and the Hypocrisy Principle. To propel the debates and test these principles, we investigate whether standing judgments are affected by factors such as relationship (whether the person giving health advice is a friend or a doctor), advisor consistency (whether the advisor themselves follow the health advice they offer), and advisee consistency (whether the advice-recipient follows the advice). Moreover, we explore how participants perceive the degree of blame or praise individuals deserve for following health advice or for their health outcome. Our main findings indicate that, surprisingly, doctors are judged to have a higher standing compared to friends, and that hypocritical behavior does not significantly reduce the perceived standing of either doctors or friends. We conclude by discussing the significance of our findings and outlining potential directions for future research.

Prior research has unveiled a pathologization effect where individuals perceived as having bad moral character are more likely to have their conditions labeled as diseases and are less often considered healthy compared to those viewed as having a good moral character. Moreover, these individuals are perceived as less unlucky in their affliction and more deserving of it. This study explores the broader impacts of moral character on such judgments, hypothesizing that these effects reach deeper and extend to both negative and positive moral evaluations. The pathologization effect also raises concerns about potential discrimination and the overmedicalization of normal health variations, so we also examine whether providing more detailed descriptions of conditions mitigates the influence of judgments of moral character. The methodology and broader implications of our findings are discussed, emphasizing the need for a deeper understanding of how moral judgments might influence patient care.

Debates about the genuine disease status of controversial diseases rely on intuitions about a range of factors. Adopting tools from experimental philosophy, this paper explores some of the factors that influence judgments about whether low sexual desire should be considered a disease and whether it should be medically treated. Drawing in part on some assumptions underpinning a divide in the literature between viewing low sexual desire as a genuine disease and seeing it as improperly medicalized, we investigate whether health and disease judgments are affected by factors such as an individual’s gender, the cause of the low desire, whether the desire is high or low, and both personal and societal valuations of the condition. Our main findings indicate that (a) the cause of a condition influences whether it is judged a disorder, (b) how the individual values the condition influences whether the condition is seen as a proper target of medical intervention, and (c) perceived dysfunction influences judgments regarding health, disorder classification, medicalization, and medical intervention. Our findings help further illuminate the intricate interplay of factors that influence judgments about health and disease in controversial conditions.

This paper aims to clarify the nature of understanding in medicine. The first part describes in more detail what it means to understand something and links a type of understanding (i.e., objectual understanding) to explanations. The second part proceeds to investigate what objectual understanding of a disease (i.e., biomedical understanding) requires by considering the case of scurvy from the history of medicine. The main hypothesis is that grasping a mechanistic explanation of a condition is necessary for a biomedical understanding of that condition. The third part of the paper argues that biomedical understanding is necessary, but not sufficient for understanding in a clinical context (i.e., clinical understanding). The hypothesis is that clinical understanding combines biomedical understanding of a _disease_ or pathological condition with understanding _illness,_ which involves some degree of personal understanding of the patient. It is argued that, in many cases, clinical understanding necessitates adopting a particular second-personal stance and using cognitive resources _in addition_ to those involved in biomedical understanding.

The apparent downsides of opaque algorithms has led to a demand for explainable AI (XAI) methods by which a user might come to understand why an algorithm produced the particular output it did, given its inputs. Patients, for example, might find that the lack of explanation of the process underlying the algorithmic recommendations for diagnosis and treatment hinders their ability to provide informed consent. This paper examines the impact of two factors on user perceptions of explanations for AI systems in medical contexts. The factors considered were the stakes of the decision—high versus low—and the decision source—human versus AI. 484 participants were presented with vignettes in which medical diagnosis and treatment plan recommendations were made by humans or by AI. Separate vignettes were used for high stakes scenarios involving life-threatening diseases, and low stakes scenarios involving mild diseases. In each vignette, an explanation for the decision was given. Four explanation types were tested across separate vignettes: no explanation, counterfactual, causal and a novel ‘narrative-based’ explanation, not previously considered. This yielded a total of 16 conditions, of which each participant saw only one. Individuals were asked to evaluate the explanations they received based on helpfulness, understanding, consent, reliability, trust, interests and likelihood of undergoing treatment. We observed a main effect for stakes on all factors and a main effect for decision source on all factors except for helpfulness and likelihood to undergo treatment. While we observed effects for explanation on helpfulness, understanding, consent, reliability, trust and interests, we by and large did not see any differences between the effects of explanation types. This suggests that the effectiveness of explanations may not depend on type of explanation but instead, on the stakes and decision source.

There is growing attention towards atypical brain-body interactions and interoceptive processes and their potential role in psychiatric conditions, including affective and anxiety disorders. This paper aims to synthesize recent developments in this field. We present emerging explanatory models and focus on brain-body coupling and modulations of the underlying neurocircuitry that support the concept of a continuum of affective disorders. Grounded in theoretical frameworks like peripheral theories of emotion and predictive processing, we propose that altered interoceptive processes might represent transdiagnostic mechanisms that confer common vulnerability traits across multiple disorders. A deeper understanding of the interplay between bodily states and neural processing is essential for a holistic conceptualization of mental disorders.

Nation Branding is broadly conceived of as an apolitical marketing strategy that targets external markets to establish and communicate a specific image of national identity. However, in this article it is argued that Nation Branding displays characteristics that make it constructive to analyse in terms of an implicit cultural policy. The main point is that Nation Branding is essentially an inner-oriented, cultural- political measure that targets the citizens of the national state, characterized by conservative, transformative and transferring political agendas. On the background of an analysis of these characteristics, it will be argued that Nation Branding may work in a self-defeating manner and endanger democratic processes.

Motivated by a recent trend that advocates a reassessment of the aim of medical science and clinical practice, this paper investigates the epistemic aims of biomedical research. Drawing on contemporary discussions in epistemology and the philosophy of science, along with a recent study on scurvy, this paper (1) explores the concept of understanding as the aim of scientific inquiry and (2) establishes a framework that will guide the examination of its forms in biomedical research. Using the case of Tuberculosis (TB), (3) it is argued that grasping a mechanistic explanation is crucial for reaching a threshold of understanding at which we may speak of an objectual, biomedical understanding of TB.