Skip to main content

Is Boorse’s Biostatistical Theory of Health Naturalistic?

  • Chapter
  • First Online:
Naturalism in the Philosophy of Health

Abstract

Christopher Boorse’s biostatistical theory of health and disease (BST) puts forward a naturalistic definition of these two concepts. Indeed, ‘naturalism’ in the philosophy of medicine was initially defined in terms of the BST, and has often been since. This chapter is an attempt to clarify in what sense Boorse does in fact defend a naturalistic definition of health and disease. We identify different theses that make naturalistic claims regarding health and disease and which help analyze the core claims of Boorse’s naturalism. Some of them have mainly to do with the central role physiology plays in medicine. But, as no physiologist has hitherto proposed a satisfactory scientific definition of ‘disease’ and ‘health’, Boorse’s naturalism must at the same time: (i) propose just such a definition; and (ii) prove that it is central to medicine. Our claim is that even if Boorse’s definition possibly succeeds in (i), it merely assumes (ii). We conclude by examining the necessity that a naturalistic definition of health and disease takes into account not only physiology but also other medical sciences.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Notes

  1. 1.

    The opposition is so important to the definition of naturalism that Boorse felt the need to coin the term ‘normativism’, without referring to its opposite (Boorse 1997): indeed, he accepts ‘non-normativism’ as a more accurate description of the BST (personal communication). This should not, however, undermine the claim that the BST is a genuinely naturalistic theory of health and disease.

  2. 2.

    See Boorse 1975, 57: “The root idea of this account is that the normal is the natural. The state of an organism is theoretically healthy, i.e. free of disease, insofar as its mode of functioning conforms to the natural design of that kind of organism. Philosophers have, of course, grown repugnant to the idea of natural design since its co-optation by natural-purpose ethics and the so-called argument from design. It is undeniable that the term “natural” is often given an evaluative force. Shakespeare as well as Roman Catholicism is full of such usages, and they survive as well in the strictures of state legislatures against “unnatural acts”. But it is no part of biological theory to assume that what is natural is desirable, still less the product of divine artifice. Contemporary biology employs a version of the idea of natural design that seems ideal for the analysis of health”.

  3. 3.

    “Diseases are conditions foreign to the nature of the species” (Boorse 1977, 554).

  4. 4.

    The Harmful Dysfunction Analysis is the claim that for something to be pathological, harm done (according to social standards) and biological dysfunction (according to science) are conjointly required.

  5. 5.

    For another kind of criticism of Boorse’s notion of “reference class”, see (Kingma 2007).

  6. 6.

    According to Wachbroit, it is not statistical, but it is not without link with the statistical: “statistics, for example, may provide important evidence for determining biological normality and biological functions” (Wachbroit 1994).

  7. 7.

    See for example Canguilhem (1991, 123): “The question is whether it is physiology which converts – and how? – descriptive and purely theoretical concepts into biological ideals or whether medicine, in admitting the notion of facts and constant functional coefficients from physiology would not also admit – probably unbeknownst to the physiologists – the notion of norm in the normative sense of the word. And it is a question of whether medicine, in doing this, wouldn’t take back from physiology what it itself had given”.

References

  • Barman, Susan M., Kim E. Barrett, and Pollock D. (2013). Reports of Physiology’s Demise Have Been Greatly Exaggerated. Physiology, 28(6), 360–62.

    Google Scholar 

  • Boorse, C. (1975). On the distinction between disease and illness. Philosophy and Public Affairs, 5, 49–68.

    Google Scholar 

  • Boorse, C. (1977). Health as a theoretical concept. Philosophy of Science, 44, 542–573.

    Article  Google Scholar 

  • Boorse, C. (1997). A rebuttal on health. In J. M. Humber & R. F. Almeder (Eds.), What is disease? (Biomedical ethics reviews 14, pp. 1–134). Totowa: Humana Press.

    Chapter  Google Scholar 

  • Boorse, C. (2011). Concepts of health and disease. In F. Gifford (Ed.), Philosophy of medicine (Handbook of philosophy of science, Vol. 16, pp. 13–64). Amsterdam: Elsevier.

    Chapter  Google Scholar 

  • Boyd, R., Gasper, P., & Trout, J. D. (1991). The philosophy of science. Cambridge, MA: MIT Press.

    Google Scholar 

  • Canguilhem, G. (1991). The normal and the pathological (New ed.). New York: Zone Books.

    Google Scholar 

  • Darden, L., & Maull, N. (1977). Interfield theories. Philosophy of Science, 44(1), 43–64.

    Article  Google Scholar 

  • Daremberg, C. (1870). Histoire des sciences médicales: Comprenant l’anatomie, la physiologie, la médecine, la chirurgie et les doctrines de pathologie générale (2 Vols.). Paris: Baillière.

    Google Scholar 

  • Giere, R. N. (1990). Explaining science a cognitive approach. Chicago: University of Chicago Press.

    Google Scholar 

  • Giroux, E. (2015). Epidemiology and the biostatistical theory of disease: a challenging perspective. Theoretical Medicine and Bioethics, 36, 175–195.

    Article  Google Scholar 

  • Gross, F. (2011). What systems biology can tell us about disease. History and Philosophy of the Life Sciences, 33, 477–496.

    Google Scholar 

  • Hausman, D. M. (2012). Health, naturalism, and functional efficiency. Philosophy of Science, 79, 519–541.

    Article  Google Scholar 

  • Hesslow, G. (1993). Do we need a concept of disease? Theoretical Medicine and Bioethics, 14(1), 1–14.

    Article  Google Scholar 

  • Kingma, E. (2007). What is it to be healthy? Analysis, 67, 128–133.

    Article  Google Scholar 

  • Kremer, R. L. (2008). Physiology. In P. J. Bowler, J. V. Pickstone, & C. U. Press (Eds.), The Cambridge history of the modern biological and earth science (pp. 342–366). Cambridge: Cambridge University Press.

    Google Scholar 

  • Lemoine, M. (2015). The naturalization of the concept of disease. In P. Huneman, G. Lambert, & M. Silberstein (Eds.), Classification, disease and evidence (History and philosophy of the life sciences, pp. 19–41). Amsterdam: Springer.

    Google Scholar 

  • Murphy, D. (2006). Psychiatry in the scientific image. Cambridge: MIT Press.

    Google Scholar 

  • Nagel, E. (1961). The structure of science: Problems in the logic of scientific explanation. New York: Harcourt, Brace & World.

    Google Scholar 

  • Nesse, R. M., Williams, G. C., & Brown, J. M. (1996). Why we get sick: The new science of Darwinian medicine. New York: Vintage Books.

    Google Scholar 

  • Nordby, H. (2006). The analytic–synthetic distinction and conceptual analyses of basic health concepts. Medicine, Health Care and Philosophy, 9(2), 169–80.

    Article  Google Scholar 

  • Nordenfelt, L. (1995). On the nature of health: An action-theoretic approach (2nd Revised ed.). Norwell: Kluwer Academic Publishers.

    Google Scholar 

  • Nordenfelt, L. (2001). Health, science, and ordinary language. Amsterdam: Rodopi.

    Google Scholar 

  • Nordenfelt, L., & Lindahl, B. I. B. (1984). Health, disease, and causal explanations in medicine. Dordrecht: Reidel.

    Book  Google Scholar 

  • Papineau, D. (2009, Spring). Naturalism. In Edward N. Zalta (Ed.), The Stanford encyclopedia of philosophy. Papineau: http://plato.stanford.edu/entries/naturalism/.

  • Pinter, G.G., and Pinter V. (1993). Is Physiology a Dying Discipline? Physiology, 8(2), 94–95.

    Google Scholar 

  • Popper, K. (2002). Popper: The logic of scientific discovery. London: Routledge Classics.

    Google Scholar 

  • Schwartz, P. H. (2007). Decision and discovery in defining “disease”. In H. Kincaid & J. McKitrick (Eds.), Establishing medical reality (pp. 47–63). Amsterdam: Springer.

    Chapter  Google Scholar 

  • Sommerhoff, G. (1950). Analytical biology. London: Oxford University Press.

    Google Scholar 

  • Wachbroit, R. (1994). Normality as a biological concept. Philosophy of Science, 61, 579–591.

    Article  Google Scholar 

  • Wakefield, J. (1992). The concept of mental disorder: On the boundary between biological facts and social values. American Psychologist, 47, 373–388.

    Article  Google Scholar 

  • West, J. B., Schoene, R. B., Luks, A. M., & Milledge, J. S. (2012). High altitude medicine and physiology 5E. Boca Raton: CRC Press.

    Book  Google Scholar 

  • Worrall, J., & John, W. (2001). Defining disease: Much Ado about nothing? In T. Anna-Teresa & A. Evandro (Eds.), Life interpretation and the sense of illness within the human condition (Analecta Husserliana 72, pp. 33–55). Dordrecht: Springer.

    Chapter  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Maël Lemoine .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Lemoine, M., Giroux, É. (2016). Is Boorse’s Biostatistical Theory of Health Naturalistic?. In: Giroux, É. (eds) Naturalism in the Philosophy of Health. History, Philosophy and Theory of the Life Sciences. Springer, Cham. https://doi.org/10.1007/978-3-319-29091-1_2

Download citation

Publish with us

Policies and ethics