Jacob P. Neal

This paper advocates for the inclusion of patient perspectives in the diagnosis and treatment of eating disorders (EDs) for ethical, epistemological, and pragmatic reasons. We build upon the ideas of a recent editorial published in this journal. Using EDs as their example, the authors argue against dominant DSM-oriented approaches in favor of an increased focus on understanding patients’ subjective experiences. We argue that their analysis stops too soon for the development of practical—and actionable—insights into how to effect the integration of first-person and third-person accounts of EDs. Methods Contextual analysis was used to make the case for patient perspectives.

The manifest appearance of function and purpose in living systems is responsible for the prevalence of apparently teleological explanations of organismic structure and behavior in biology. Although the attribution of function and purpose to living systems is an ancient practice, teleological notions are largely considered ineliminable from modern biological sciences, such as evolutionary biology, genetics, medicine, ethology, and psychiatry, because they play an important explanatory role. Historical and recent examples of teleological claims include the following: The chief function of the heart is the transmission and pumping of the blood through the arteries to the extremities of the body. (Harvey 1616 [1928: 49]) The Predator Detection hypothesis remains the strongest candidate for the function of stotting [by gazelles]. (Caro 1986: 663) The geographic range of human malaria is much wider than the range of the sickle-cell gene. As it happens, other antimalarial genes take over the protective function of the sickle-cell gene in … other warm parts. (Diamond 1994: 83) Despite the substantial amount of data we now have on theropod dinosaurs, more information is necessary in order to determine the likelihood that early feathers served an adaptive function in visual display as opposed to other proposed adaptive functions such as thermoregulation. (Dimond et al. 2011: 62) The ubiquity of claims such as these raises the question: how should apparently teleological notions in biology be understood? Most post-Darwinian approaches attempt to naturalize teleology in biology, in opposition to nineteenth-century viewpoints which grounded it theologically. Nevertheless, biologists and philosophers have continued to question the legitimacy of teleological notions in biology. For instance, Ernst Mayr (1988), identified four reasons why teleological notions remain controversial in biology, namely that they are: vitalistic (positing some special ‘life-force’); requiring backwards causation (because goal-directed explanations seem to use future outcomes to explain present traits); incompatible with mechanistic explanation (because of 1 and 2); mentalistic (attributing the action of mind where there is none). A fifth complaint is that they are not empirically testable (Allen & Bekoff 1995). The current philosophical literature offers both Darwinian and non-Darwinian accounts of teleology in biology that aim to avoid these concerns. In this article, we hope to bring some clarity to the contemporary debates over the role of teleological notions in biology by sketching a taxonomy of the various accounts of biological function on offer (see Allen & Bekoff 1995 for a more comprehensive taxonomy that forms the basis of this presentation). We primarily focus on naturalistic accounts of biological function, since this is where we see the most lively and productive current debates (see, e.g., Garson 2016 for an extended survey). We also briefly discuss the notion of goal-directedness in section 2.

Philosophers of biology generally agree that causal specificity tracks biological importance: more specific causes are more important. I argue that this correlation does not hold in much research aimed at biomedical intervention. Applying James Woodward’s analysis of causal specificity to the development and design of HIV treatments, I show that drugs that are less causally specific produce better therapeutic outcomes and are more highly valued. Thus, I conclude that the importance of biological causes does not track their specificity but instead varies depending on the biological practice we consider and the goals of that practice.

The origin of human cooperation poses an evolutionary puzzle. In order for cooperation to evolve, our Pleistocene ancestors must have overcome the free rider problem, in which noncooperators reap the benefits of cooperation without paying the costs. Cultural group selection accounts offer a potential solution to this problem. In this article, I evaluate Boyd and Richerson’s influential account. I argue that it cannot explain the evolutionary origins of human cooperation because it presupposes cooperative behaviors among our Pleistocene ancestors. Although Boyd and Richerson’s account may explain the expansion of cooperation in hominin evolution, it cannot explain how cooperative behaviors first emerged.