Elselijn Kingma

Paracetamol, Poison, and Polio: Why Boorse's Account of Function Fails to Distinguish Health and Disease

Christopher Boorses Bio Statistical Theory (BST) defines health as the absence of disease, and disease as the adverse departure from normal species functioning. This paper presents a two-pronged problem for this account. First I demonstrate that, in order to accurately account for dynamic physiological functions, Boorses account of normal function needs to be modified to index functions against situations. I then demonstrate that if functions are indexed against situations, the BST can no longer account for diseases that result from specific environmental factors. The BST is impaled on either horn of this dilemma and therefore must be dismissed. 1. A More Sophisticated Version of the BST 1.1. Normal function1.2. Health as a quantitative normal function1.3. Dispositional function1.4. Situation-specific function1.5. Summary and justification2. An Inescapable Problem 2.1. Harmful environments and situation-specific diseases2.2. A detailed example2.3. Two possible replies refuted2.4. Conclusion of Section 23. Potential Ways out of the Dilemma 3.1. Distinguishing between harmful and normal situations3.2. First solution: Statistically abnormal environments 3.2.1. Rare non-harmful environments3.2.2. Harmful non-rare environments3.3. Second solution: Adverse environments3.4. Third solution: Non-natural environments3.5. Interim conclusion and diagnosis3.6. Abusing the function concept?4. The BST Refuted 4.1. A central tension4.2. Differences with previous arguments4.3. Conclusion A More Sophisticated Version of the BST 1.1. Normal function1.2. Health as a quantitative normal function1.3. Dispositional function1.4. Situation-specific function1.5. Summary and justification Normal function Health as a quantitative normal function Dispositional function Situation-specific function Summary and justification An Inescapable Problem 2.1. Harmful environments and situation-specific diseases2.2. A detailed example2.3. Two possible replies refuted2.4. Conclusion of Section 2 Harmful environments and situation-specific diseases A detailed example Two possible replies refuted Conclusion of Section 2 Potential Ways out of the Dilemma 3.1. Distinguishing between harmful and normal situations3.2. First solution: Statistically abnormal environments 3.2.1. Rare non-harmful environments3.2.2. Harmful non-rare environments3.3. Second solution: Adverse environments3.4. Third solution: Non-natural environments3.5. Interim conclusion and diagnosis3.6. Abusing the function concept? Distinguishing between harmful and normal situations First solution: Statistically abnormal environments 3.2.1. Rare non-harmful environments3.2.2. Harmful non-rare environments Rare non-harmful environments Harmful non-rare environments Second solution: Adverse environments Third solution: Non-natural environments Interim conclusion and diagnosis Abusing the function concept? The BST Refuted 4.1. A central tension4.2. Differences with previous arguments4.3. Conclusion A central tension Differences with previous arguments Conclusion

Perception of emotional facial expressions at different intensities in early-symptomatic Huntington's disease.

Background: While there is abundant evidence that patients with Huntington’s disease (HD) have an impairment in the recognition of the emotional facial expression of disgust, previous studies have only examined emotion perception using full-blown facial expressions. Objective: The current study examines the perception of facial emotional expressions in HD at different levels of intensity to investigate whether more subtle deficits can be detected, possible also in other emotions. Method: We compared early symptomatic HD patients with healthy matched controls on emotion perception, presenting short video clips of a neutral face changing into one of the six basic emotions (happiness, anger, fear, surprise, disgust and sadness) with increasing intensity. Overall face perception ability as well as depressive symptoms were taken into account. Results: A specific impairment in recognizing the emotions disgust and anger was found, which was present even at low emotion intensities. Conclusion: These results extend previous findings and support the use of more sensitive emotion perception paradigms, which enable the detection of subtle neurobehavioral deficits even in the pre- and early symptomatic stages of the disease.

Reason and value: making reasoning fit for practice

Reader in Applied Philosophy, Department of Interdisciplinary Studies, MMU Cheshire, Crewe, UK Assistant Professor, Department of Philosophy and Religious Studies, Old Dominion University, Norfolk, VA, USA Associate Professor, Department of General Practice, University of Auckland, Auckland, New Zealand Director, University of Toronto Joint Centre for Bioethics, Toronto, ON, Canada Assistant Professor, Department of Philosophy, University of Guelph, Guelph, ON, Canada Assistant Professor, Department of Philosophy, Dalhousie University, Halifax, NS, Canada Professor of Values in Health Care, Associate Director, Social Dimensions of Health Institute, University of Dundee, Dundee, UK Research Fellow, King’s College Centre for Humanities and Health/Department of Philosophy; King’s College London, London, UK

Interdisciplinary workshop in the philosophy of medicine: death

PhD Candidate, Centre for the Humanities and Health/Department of Philosophy, King’s College London, London, UK and Visiting Scholar, Department of Philosophy, Princeton University, Princeton, New Jersey, USA Wellcome Research Fellow, Centre for the Humanities and Health/Department of Philosophy, King’s College London, London, UK and Socrates Professor in Philosophy and Ethics of Biotechnology, Technical University Eindhoven, Eindhoven, The Netherlands Professor of Ancient Philosophy, Department of Philosophy, King’s College London, London, UK

Interdisciplinary workshop on health and disease: report

Research Fellow, King’s College Centre for Humanities and Health/Department of Philosophy, King’s College London, London, UK, and Socrates Professor in Philosophy and Ethics of Biotechnology, Technical University Eindhoven, Eindhoven, The Netherlands Centre Manager, King’s College Centre for Humanities and Health, King’s College London, London, UK Professor of Ancient Philosophy, Department of Philosophy, King’s College London, London, UK

Interdisciplinary workshop on concepts of health and disease : report

Research Fellow, King’s College Centre for Humanities and Health/Department of Philosophy, King’s College London, London, UK, and Socrates Professor in Philosophy and Ethics of Biotechnology, Technical University Eindhoven, Eindhoven, The Netherlands Centre Manager, King’s College Centre for Humanities and Health, King’s College London, London, UK Professor of Ancient Philosophy, Department of Philosophy, King’s College London, London, UK

Interdisciplinary workshop in the philosophy of medicine: bodies and minds in medicine.

Postdoctoral Researcher, Finnish Centre of Excellence in Philosophy of the Social Sciences, Department of Politics and Economic Studies, Helsinki University, Helsinki, Finland Research and Teaching Associate, Department of History and Philosophy of Science, University of Cambridge, Cambridge, UK Socrates Professor in Philosophy and Technology and the Humanist Tradition, Technical University Eindhoven, Eindhoven, The Netherlands

Situation-specific disease and dispositional function

In ( Kingma [2010] ), I argued that Boorses ([1977], [1997]) biostatistical theory of health (BST) is unable to accommodate diseases that are the normal result of harmful environments. Hausman ( [2011] ) disagrees: if the BST compares normal dispositional function against the whole population or reference class, rather than against organisms in similar circumstances as I proposed, then my ( [2010] ) challenge can be avoided. In this paper, I argue that Hausmans response fails: his proposal cannot accommodate a series of common physiological processes, such as sleep and those involved in reproduction. In the course of this argument, I also offer a detailed discussion of the concept of functional efficiency ( Hausman [2011] , [2012] ), and reveal a link between the problem of environments ( Kingma [2010] ) and that of reference classes ( Kingma [2007] ). 1   Introduction 2   Kingma on Boorse 3   Hausman on Kingma 4   Response to Hausman 5   Three Possible Replies    5.1   Reference classes    5.2   Temporary pathologies    5.3   Adequacy of function 6   Concluding Discussion 1   Introduction 2   Kingma on Boorse 3   Hausman on Kingma 4   Response to Hausman 5   Three Possible Replies    5.1   Reference classes    5.2   Temporary pathologies    5.3   Adequacy of function    5.1   Reference classes    5.2   Temporary pathologies    5.3   Adequacy of function 6   Concluding Discussion

The Lancet's risky ideas? Rights, interests and home-birth

A recent meta-analysis on home-births reported a small increase in neonatal infant mortality but considerable reduction in maternal morbidity in association with planned home-birth as compared with hospital-birth (1). This caused the editors of the Lancet to proclaim that ‘[w]omen have the right to choose how and where to give birth, but they do not have the right to put their baby at risk. There are competing interests that need to be weighed carefully’ (2).

Interdisciplinary workshop in the philosophy of medicine: medical knowledge, medical duties

On 27 September 2013, the Centre for the Humanities and Health (CHH) at Kings College London hosted a 1-day workshop on ‘Medical knowledge, Medical Duties’. This workshop was the fifth in a series of five workshops whose aim is to provide a new model for high-quality, open interdisciplinary engagement between medical professionals and philosophers. This report identifies the key points of discussion raised throughout the day and the methodology employed.Abstract On 27 September 2013, the Centre for the Humanities and Health (CHH) at Kings College London hosted a 1‐day workshop on ‘Medical knowledge, Medical Duties’. This workshop was the fifth in a series of five workshops whose aim is to provide a new model for high‐quality, open interdisciplinary engagement between medical professionals and philosophers. This report identifies the key points of discussion raised throughout the day and the methodology employed.