Cristian Saborido

Our goal in this paper is to articulate a precise concept of at least a certain kind of disease-mongering, showing how pharmaceutical marketing can commercially exploit certain diseases when their best definition is given through the success of a treatment in a clinical trial. We distinguish two types of disease-mongering according to the way they exploit the definition of the trial population for marketing purposes. We argue that behind these two forms of disease-mongering there are two well-known problems in the statistical methodology of clinical trials (the reference class problem and the distinction between statistical and clinical significance). Overcoming them is far from simple

In this paper we articulate a characterization of the concept of disease as a social problem. We argue that, from a social ontology point of view, diseases are problems that are identified and addressed within the framework of concrete social institutions and practices (those that shape medicine). This approach allows us to overcome the classical distinction between naturalist and normativist approaches in the philosophy of medicine, taking into account both the material and the symbolic factors that shape the categories and determine the practices of medicine.

Selected-effects theories provide the most popular account of biological teleology. According to these theories, the purpose of a trait is to do whatever it was selected for. The vast majority of selected-effects theories consider biological teleology to be introduced by natural selection. We want to argue, however, that natural selection is not the only relevant selective process in biology. In particular, our proposal is that biological regulation is a form of biological selection. So, those who accept selected-effects theories should recognize biological regulation as a distinctive source of biological teleology. The purposes derived from biological regulation are of special interest for explaining and predicting the behavior of organisms, given that regulatory mechanisms directly modulate the behavior of the systems they regulate. This explanatory power, added to the fact that regulation is widespread in the biological world, makes the idea that regulation gives rise to its own form of teleology a substantial contribution to the debate on biological teleology.

El proyecto del ‘Darwinismo Formal’ de Alan Grafen propone una formulación matemática de la teoría de Darwin que pretende demostrar que la selección natural moldea los rasgos fenotípicos a través de la maximización de la eficacia. El proyecto de Grafen reposa sobre tres premisas: la selección natural es la única fuerza que moldea los fenotipos; la eficacia es la única medida de le evolución; y el diseño biológico surge como resultado de un proceso de optimización selectiva. En este trabajo argumentamos que estas tres premisas limitan la aplicabilidad del modelo a los hechos evolutivos más simples. Esto se debe a que Grafen implícitamente presupone un concepto de eficacia que es a la vez causa y efecto de las novedades fenotípicas; lo que, por un lado, vacía la teoría de Darwin de poder explicativo y, por el otro, lleva a ignorar la potencial contribución de fuerzas evolutivas no selectivas en la configuración de la complejidad biológica. Para superar estos escollos del proyecto de del Darwinismo Formal - que son además comunes a todos los modelos formales adaptacionistas - proponemos sustituir el concepto causal de eficacia por el de robustez, definiendo así el diseño biológico como forma y función en lugar de como maximización de la eficacia.

Los conceptos de evolución y cambio evolutivo son a la vez laxos y polisémicos: se aplican a fenómenos muy diferentes y no siempre se definen con precisión. La aplicación extendida del paradigma neo-darwinista clásico, además, suele imponer un esquema adaptacionista al análisis de los hechos evolutivos, en el cual las funciones juegan un papel lógicamente anterior a los rasgos y sus formas. En este artículo proponemos, como etapa previa a la formulación de hipótesis sobre las causas del cambio, un modelo de espacio forma-función que pueda responder a preguntas como cuándo se da un cambio en los rasgos de una arquitectura biológica y de qué tipo son estos cambios. Un modelo de este tipo nos permite ver claramente cuándo se da un cambio en la forma o en la función y qué alcance evolutivo tiene.

In the philosophical debate on aging, it is common to raise the question of the theoretical definition of aging in terms of its possible characterization as a disease. Understanding aging as a disease seems to imply its medicalization, which has important practical consequences. In this paper, we analyze the question of whether aging is a disease by appealing to the concept of disease in the philosophy of medicine. As a result of this analysis, we argue that a pragmatist approach to the conception of disease is the best alternative to highlight the relevance of the medicalization of aging. From this pragmatist perspective, it can be seen that the notion of aging is going through a conceptual change, and aging can today be understood as a not radically different process from any other condition that is usually considered a disease.

The definitions and conceptualizations of health, and the management of healthcare have been challenged by the current global scenarios (e.g., new diseases, new geographical distribution of diseases, effects of climate change on health, etc.) and by the ongoing scholarship in humanities and science. In this paper we question the mainstream definition of health adopted by the WHO—‘a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’ (WHO in Preamble to the constitution of the World Health Organization as adopted by the international health conference, The World Health Organization, 1948)—and its role in providing tools to understand what health is in the contemporary context. More specifically, we argue that this context requires to take into account the role of the environment both in medical theory and in the healthcare practice. To do so, we analyse WHO documents dated 1984 and 1986 which define health as ‘coping with the environment’. We develop the idea of ‘coping with the environment’, by focusing on two cardinal concepts: adaptation in public health and adaptivity in philosophy of biology. We argue that the notions of adaptation and adaptivity can be of major benefit for the characterization of health, and have practical implications. We explore some of these implications by discussing two recent case studies of adaptivity in public health, which can be valuable to further develop adaptive strategies in the current pandemic scenario: community-centred care and microbiologically healthier buildings.

In this paper, we analyze the debate between the Modern Synthesis and the Extended Evolutionary Synthesis in light of the concept of incommensurability developed by Thomas Kuhn. In order to do so, first we briefly present both the Modern Synthesis and the Extended Evolutionary Synthesis. Then, we clarify the meaning and interpretations of incommensurability throughout Kuhn’s works, concluding that the version of this concept deployed in The Structure of Scientific Revolutions is the best suited to the analysis of scientific disputes. After discussing incommensurability in Kuhn’s works, we address the question of whether the Modern Synthesis and the Extended Evolutionary Synthesis can be considered semantically, methodologically, and ontologically incommensurable, concluding that they can. Finally, we discuss three problems that arise from such a conclusion: firstly, what are the consequences of incommensurability; secondly, which mode of scientific change better explains this current dispute in evolutionary biology; and thirdly, whether rational theory comparison is possible given incommensurability. We suggest that the main consequence of incommensurability is profound disagreement, that the kind of scientific change that better explains the current dispute between the MS and the EES may be scientific specialization, and that incommensurability does not preclude rational theory comparison.

Darwin’s claim that Natural Selection, through optimization of fitness, explains complex biological design has not yet been properly formalized. Alan Grafen’s Formal Darwinism Project aims at providing such a formalization and at demonstrating that fitness maximization is coherent with results from Population Genetics, usually interpreted as denying it. We suggest that Grafen’s proposal suffers from some limitations linked to its concept of design as optimized fitness. In order to overcome these limitations, we propose a classification of evolutionary facts based on a bi-dimensional complexity space, which adds robustness to fitness as measure of the quality of a design. In this space, each point represents an organismic architecture, and movement between two points would be an evolutionary fact. Natural Selection explains movement along the fitness axis, while non-selective mechanisms explain movement on the robustness axis. Moreover, we propose a thermodynamic metaphor to draw parallelisms between notions of fitness and entropy, robustness and energy, and movement in this space and reversible and irreversible cycles. We argue that this metaphor illustrates different evolutionary processes usually overlooked by proposals of formalization of Darwinian theory, such Grafen’s Formal Darwinism Project.

Usually, the organization of living systems is explained by appealing to an intrinsic purpose that is based on the biological survival. However, paradigmatically, it is inevitable to observe that the final destiny of all living organisms is death. In this work, we defend that, from an organizational approach, there is a form of death—Regulated Cell Death—that, far from being a mere «absence of life», is a process of biological regulation and a feature of self-maintenance in multicellular organisms.

The organizational account of biological functions interprets functions as contributions of a trait to the maintenance of the organization that, in turn, maintains the trait. As has been recently argued, however, the account seems unable to provide a unified grounding for both intra- and cross-generation functions, since the latter do not contribute to the maintenance of the same organization which produces them. To face this ‘ontological problem’, a splitting account has been proposed, according to which the two kinds of functions require distinct organizational definitions. In this article, we propose a solution for the ontological problem, by arguing that intra- and cross-generation functions can be said to contribute in the same way to the maintenance of the biological organization, characterized in terms of organizational self-maintenance. As a consequence, we suggest maintaining a unified organizational account of biological functions

Most of current theoretical analyses on biological functions can be classified as etiological or dispositional, depending on how they deal with the teleological dimension. In this paper, we propose a critical survey of these two perspectives, and we argue that some recent studies have set the basis of a new approach which grounds the teleological dimension of functional attributions in the organizational properties of living systems. We outline a new proposal within this new approach, based on an interpretation of living systems as organized self-maintaining systems.

Usually, the organization of living systems is explained by appealing to an intrinsic purpose that is based on the biological survival. However, paradigmatically, it is inevitable to observe that the final destiny of all living organisms is death. In this work, we defend that, from an organizational approach, there is a form of death—Regulatory Cell Death—that, far from being a mere "absence of life", is a process of biological regulation and a feature of self-maintenance in multicellular organisms.

The notion of emergence has accompanied philosophy of science since the late XIX century, claiming that in some systems there are properties in certain levels that cannot be deduced from properties of their components as seen in more fundamental levels. Throughout the XX century, emergence has been characterized by four pillars: unpredictability, novelty, restriction and downward causation. These four pillars have been related to the assumption of a hierarchical order of reality in different levels of organization. In this paper, we show that it is possible to explain the nature of the emergent properties through the nearly-decomposability criterion introduced by Herbert Simon.

We reply to Artiga and Martinez’s claim according to which the organizational account of cross-generation functions implies a backward looking interpretation of etiology, just as standard etiological theories of function do. We argue that Artiga and Martinez’s claim stems from a fundamental misunderstanding about the notion of “closure”, on which the organizational account relies. In particular, they incorrectly assume that the system, which is relevant for ascribing cross-generation organizational function, is the lineage. In contrast, we recall that organizational closure refers to a relational description of a network of mutual dependencies, abstracted from time, in which production relations are irrelevant. From an organizational perspective, ascribing a function to an entity means locating it in the abstract system that realizes closure. In particular, the position of each entity within the relational system conveys an etiological explanation of its existence, because of its dependence on the effects exerted by other entities subject to closure. Because of the abstract relational nature of closure, we maintain that the organizational account of functions does not endorse a backward looking interpretation of etiology. As a consequence, it does not fall prey of epiphenomenalism.

En este trabajo analizamos críticamente el enfoque mecanicista de explicación científica centrándonos principalmente en la forma en la que este da cuenta de los fenómenos biológicos. Nos proponemos complementar esta perspectiva con una concepción de nivel como intervalo de cuasi-descomponibilidad que nos permite fundamentar metafísicamente las propuestas mecanicistas clásicas en las propiedades sistémicas características de las entidades biológicas. A través del análisis de ejemplos concretos, demostraremos cómo nuestra propuesta permite superar algunas de las limitaciones de los enfoques predominantes de explicación mecanística.

La noción de emergencia acompaña a la Filosofía de la Biología desde finales del siglo XIX, afirmando que las propiedades de los sistemas biológicos no pueden deducirse de las de sus componentes. A lo largo del siglo XX las caracterizaciones de este concepto se han apoyado en cuatro pilares, impredecibilidad, novedad, restricción y causación descendente, pilares ligados a la asunción de una jerarquización de la realidad en niveles de organización. En este trabajo intento demostrar que puede explicarse la naturaleza de las propiedades biológicas sin hacer referencia a la emergencia utilizando como herramienta la noción de cuasi-descomponibilidad propuesta originariamente por Herbert Simon.

Most of current theoretical analyses on biological functions can be classified as etiological or dispositional, depending on how they deal with the teleological dimension. In this paper, we propose a critical survey of these two perspectives, and we argue that some recent studies have set the basis of a new approach which grounds the teleological dimension of functional attributions in the organizational properties of living systems. We outline a new proposal within this new approach, based on an interpretation of living systems as organized self-maintaining systems.

In contrast to the “normativist” view, “naturalist” theorists claim that the concept of health refers to natural or normal states and propose different characterizations of healthy and diseased conditions that are meant to be objectivist and biologically grounded. In this article, we examine the core concept of these naturalist accounts of disease, i.e., the concept of biological malfunction, and develop a new formulation of the notion of malfunction following the recent organizational approach to functions in the philosophy of biology. We focus on the notions of adaptive regulation and functional presupposition to develop a new conceptual framework that justifies the ascription of malfunctional behaviors to biological systems according to the embodied normativity of biological organizations

In this paper, we develop an organizational account that defines biological functions as causal relations subject to closure in living systems, interpreted as the most typical example of organizationally closed and differentiated self-maintaining systems. We argue that this account adequately grounds the teleological and normative dimensions of functions in the current organization of a system, insofar as it provides an explanation for the existence of the function bearer and, at the same time, identifies in a non-arbitrary way the norms that functions are supposed to obey. Accordingly, we suggest that the organizational account combines the etiological and dispositional perspectives in an integrated theoretical framework. IntroductionDispositional ApproachesEtiological TheoriesBiological Self-maintenance Closure, teleology, and normativityOrganizational differentiationFunctions C1: Contributing to the maintenance of the organization C2: Producing the functional trait Implications and Objections Functional versus useful Dysfunctions, side effects, and accidental contributionsProper functions and selected effectsReproductionRelation with other ‘unitarian’ approachesConclusions

En la intersección entre la ética aplicada y los estudios sobre divulgación científica en los medios, este trabajo propone un concepto de «cultura bioética» y lo aplica a la exitosa serie de televisión House. Nuestro análisis de la serie muestra la relación existente entre la tensión entre autonomía del paciente y paternalismo médico presente en la teoría bioética y la práctica asistencial, por un lado, con el debate abierto en filosofía de la medicina entre posiciones naturalistas y normativistas sobre los conceptos de salud y enfermedad, por el otro. Se propone también una ampliación del concepto de autonomía que permita avanzar en la resolución de esta tensión, tanto a nivel teórico como práctico