Somogy Varga

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.

While medicine is solidly grounded on scientific areas such as biology and chemistry, some argue that it is in its essence not a science at all. With medicine playing a substantial societal role, addressing questions about the scientific nature of medicine is of obvious urgency. This paper takes on such a task and starts by consulting the literature on the “demarcation” problem in the philosophy of science. Learning from failures of earlier approaches, it proposes that we adopt a Deflated Approach, which acknowledges that “science” is a family resemblance concept that admits differences of degrees to nonscientific undertakings. Then, drawing on Paul Hoyningen-Huene’s ; account of systematicity and Alexander Bird’s analysis of examples from the history of medicine, the paper argues that medicine meets the requirement for systematicity on all dimensions and thereby qualifies as a science. The paper then considers and defuses two objections. First, it is shown that nonepistemic differences linked to the distinctive duality of medicine do not warrant thinking that medicine is not science. Second, against some recent criticism, the paper uses homeopathy as an example to show that systematicity can succeed as a demarcation criterion.

The paper engages Christopher Boorse’s Bio-Statistical Theory. In its current form, BST runs into a significant challenge. For BST to account for its central tenet—that lower-level part-dysfunction is sufficient for higher-level pathology—it must provide criteria for how to decide which lower-level parts are the ones to be analyzed for health or pathology. As BST is a naturalistic theory, such choices must be based solely on naturalistic considerations. An argument is provided to show that, if BST is to be preserved, such parthood choices are based on non-naturalistic considerations. We demonstrate that even when parthood choices are based on the best way to preserve BST, there are counterintuitive results which bring the central tenet of BST into question.

Gesellschaftskritik, or social philosophy that aims to provide firm criticism of pathological social practices, requires normatively grounded evaluative principles. In this article, we assess different possibilities for such principles with focus on a model that takes specific patterns of intersubjective interaction as its point of reference. We argue that in order to understand the full significance of this ‘intersubjective turn’ for social philosophy, and to strengthen the normative foundation of social philosophy, we need to distinguish several levels of intersubjectivity and, in particular, focus on the somewhat neglected level of primary intersubjectivity. The article will discuss the account of primary intersubjectivity in Honneth’s work. We show that Honneth’s account runs into difficulties, and drawing on recent findings in developmental psychology, we suggest a rethinking of elementary recognition in terms of ‘affective proximity’. This both renders the account less susceptible to criticism and provides a normative perspective that can effortlessly enter into interdisciplinary collaboration.

While medicine is solidly grounded on scientific areas such as biology and chemistry, some argue that it is in its essence not a science at all. With medicine playing a substantial societal role, addressing questions about the scientific nature of medicine is of obvious urgency. This paper takes on such a task and starts by consulting the literature on the “demarcation” problem in the philosophy of science. Learning from failures of earlier approaches, it proposes that we adopt a Deflated Approach, which acknowledges that “science” is a family resemblance concept that admits differences of degrees to nonscientific undertakings. Then, drawing on Paul Hoyningen-Huene’s (Systematicity: The nature of science, Oxford University Press, Oxford, 2013); (Synthese 196: 907–928, 2019) account of systematicity and Alexander Bird’s (Synthese 196: 863–879, 2019) analysis of examples from the history of medicine, the paper argues that medicine meets the requirement for systematicity on all dimensions and thereby qualifies as a science. The paper then considers and defuses two objections. First, it is shown that nonepistemic differences linked to the distinctive duality of medicine do not warrant thinking that medicine is not science. Second, against some recent criticism (Oreskes in Synthese 196: 881–905, 2019), the paper uses homeopathy as an example to show that (synchronic and diachronic) systematicity can succeed as a demarcation criterion.

Some of our motives that we act on are not only of unconstrained origin, but we also take them to express who we are and, thus, to "speak for us." Harry G. Frankfurt has maintained that it is the formation of a hierarchical structure by means of an act of wholehearted identification that makes a given motive genuinely one's own. I argue that wholehearted identifications fail to live up to this task. Instead, I demonstrate that only a subtype of wholehearted identifications, namely core identifications, genuinely "speak for us." In addition, I argue that core identifications help explain the peculiar phenomenology that characterizes some of our crucial choices.

The Philosophy of Psychiatry is a unique area of research because the nature of the subject matter leads to quite distinct methodological issues. Naturalism, Interpretation, and Mental Disorder is an original new work focusing on the challenges we face when trying to interpret and understand mental illness. The book integrates a hermeneutical perspective, and shows how such an approach can reveal important facts about historical sources in psychiatry and the nature of dialogue in the therapeutic encounter. In addition, the book demonstrates how such an approach can be valuable for understanding the concept of mental disorder itself. Naturalism, Interpretation, and Mental Disorder brings fresh thinking to the philosophy of psychiatry, and will be of interest to students and scholars in the fields of Mental Health and Philosophy.

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

This article suggests that an account of pretence based on the idea of shared intentionality can be of help in understanding autism. In autism, there seems to be a strong link between being able to engage in pretend play, understanding the minds of others and having adequate access to own mental states. Since one of the first behavioral manifestations of autism is the lack of pretend play, it therefore seems natural to investigate pretence in order to identify the nature of the central impairment in question. In mainstream theories, this has been identified as an impaired ‘theory of mind module’ or ‘mentalizing’ capacities. This paper points to some difficulties encountered by such accounts and – by drawing on research by Tomasello and Rakoczy – seeks to develop an alternative account of pretence and social cognition.

This collection of essays provides the first systematic investigation of practical necessity and offers novel perspectives on this intriguing phenomenon. While debates on necessity often take place in the realm of metaphysics, there is a form of necessity that is pertinent to practical philosophy. “Here I stand. I can do no other,” a phrase habitually attributed to Luther, is often interpreted as revealing underlying normative reasons that exhibit a special kind of necessitating force, experienced as an inescapable constraint by the agent. However, one of the features that make this phenomenon so fascinating is that this constraint is often deciphered as stemming from a form of necessitation that articulates the agent’s autonomy or practical identity. Luther’s saying serves as a leitmotif for an exploration of different claims and challenges related to practical necessity.