This important work of archaeological theory challenges us to reconsider our ideas about the nature of things, past and present, arguing that objects themselves possess a dynamic presence that we must take into account if we are to understand the world we and they inhabit.

After Discourse is an interdisciplinary response to the recent trend away from linguistic and textual approaches and towards things and their affects. The new millennium brought about serious changes to the intellectual landscape. Favoured approaches associated with the linguistic and the textual lost some of their steam, and were followed by a new curiosity and concern for things and their natures. Gathering contributions from archaeology, heritage studies, history, geography, literature and philosophy, After Discourse offers a range of reflections on what (...) things are, how we become affected by them, and the ethical concerns they give rise to. Through a varied constellation of case studies, it explores ways of dealing with matters which fall outside, become othered from, or simply cannot be grasped through perspectives derived solely from language and writing. After Discourse provides a new perspective for archaeologists, anthropologists and historians interested in the way objects can shed light on areas where textual evidence falls short. (shrink)

Exploring the current clash between the prevailing conceptions of heritage as, on the one hand, something valued and thus worth saving and, on the other, a haunting and unwanted legacy, this book urges a radical reconsideration of our understanding of heritage in line with the notion of an unruly legacy. The fundamental argument is based on a less anthropocentric and more ecologically focussed perspective, where case studies are presented on the following countries: Canada, Iceland, Japan, Norway, Poland, Sweden and the (...) United States. (shrink)

After Discourse is an interdisciplinary response to the recent trend away from linguistic and textual approaches and towards things and their affects. The new millennium brought about serious changes to the intellectual landscape. Favoured approaches associated with the linguistic and the textual lost some of their steam, and were followed by a new curiosity and concern for things and their natures. Gathering contributions from archaeology, heritage studies, history, geography, literature and philosophy, After Discourse offers a range of reflections on what (...) things are, how we become affected by them, and the ethical concerns they give rise to. Through a varied constellation of case studies, it explores ways of dealing with matters which fall outside, become othered from, or simply cannot be grasped through perspectives derived solely from language and writing. After Discourse provides a new perspective for archaeologists, anthropologists and historians interested in the way objects can shed light on areas where textual evidence falls short. (shrink)

In the work of the French thinker René Girard (1923-2015), Christology originates in the view of Jesus as a scapegoat and non-violent role model. Initially, imitation creates the conditions for sacrifice, and sacrifice becomes a way of holding a society together. Mimetic theory localises the problem in rivalistic desires, a process where those who rival each other become more and more preoccupied with outdoing each other. Imitating Christ therefore helps one overcome the desire for otherness and instead identify with the (...) other. A number of theological implications arise from Girard’s theory on divine imitation, and it seems that it is Christ’s perfect imitation of God that makes him divine. Through imitation, Christ becomes both a mediator and a representation of God. Girard seems to replace the notion of following Christ with imitating Christ, as imitating Christ indicates a more common and everyday relationship. (shrink)

In Mensonge romantique et vérité romanesque, René Girard attempts to explain how desire has been depicted in different European novels. According to Girard, the lesser novelists have retracted to some kind of romantic worldview in their description of human relationships. While the “romantic writer” does not see that desires are mediated by other people’s desires, and instead describes desire as object-related, linear, and devoid of any ongoing mimetic contagion, a number of novelists, are, nonetheless, able to reveal the illusion of (...) romantic desire. In Flaubert’s Madame Bovary, the author tries to peer into the desires that govern Emma Bovary's relentless search for a romantic life.... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Imitation, Violence, and ExchangeGirard and MaussPer Bjørnar Grande (bio)RECIPROCAL VIOLENCE AND THE DESIRE FOR WHAT THE OTHER DESIRESIn this article, I would like to draw attention to the potentially violent outcome of exchange interactions between individuals and groups. Both Girard and Mauss examine violence in a wider social and political process.1 According to Mauss, the smallest difference, such as a lack of reciprocity, may evoke a desire for retribution. (...) Understanding reactions when there is a lack of symmetry, real or illusory, can give us an important insight into the generative mechanisms behind violence. This is why traditional societies tried, often very successfully, to protect individuals through prohibitions and taboos. These prohibitions and taboos were directed against any kind of activity that could possibly result in violent rivalries among the population. The killing of adulterers, thieves, and foreigners can be seen as a way of ridding society of people perceived as having undesirable traits and ridding it of the potential imitation of their bad desires. In this way, a society's violence may function in a protective [End Page 221] and anti-mimetic way. The violence against transgressors is a kind of mimetic anti-mimesis, a way of telling people to follow the rules of society so that they will become mimetically immune to the forces that threaten society.Violent victimizing appears to fulfill a generative function by preventing transgressions, moral cleansing, and restoration of peace. At the same time, however, it bears (unconsciously for the participants) a similarity to what one wishes to expel, namely, the feared violence and negative influence of the person or persons who are victimized. Despite attempts to expel violent transgressions, the attempts themselves are quite similar to the violence they are trying to exorcise. Both Freud and Girard argue that those who conduct a rite of sacrifice are projecting onto the sacrificial victim qualities that reflect some of their own innermost concerns.2 Sacrificial violence, seen from a modern, nonsacrificial standpoint, is a kind of suicide. By killing the other, one also kills something in oneself.In demolishing the victim they are symbolically annihilating aspects of themselves. What is destroyed is destructiveness itself: the feelings of violence and hostility that lie behind attempts to carry out violent activities. Such feelings are antithetical to the ties of friendship that bond a community together, and feelings of violence towards one's peers and associates must be banished if a closely knit community—such as a tribal brotherhood, a spiritual fellowship, or a modern nation—is to survive.3Modern societies are full of these projections of one's own desires onto the other, which expose the modern variant of what is sacrifice, and which are often less physically but instead psychologically violent, yet still victimizing in their attitude of projecting. Terms such as "imitation," "identification," and "comparison" do not have to turn out to be violent—even when a great deal of competition is involved. In this respect, I disagree with some Girardians who claim that imitative desire must be violent and who look back to an insight going back to Heraclitus that violence is the source of all.4 The all-decisive factor is the gradual shift from competition to rivalry, from being allies to becoming enemies. The transition from being competitive friends to rivals comes as a result of imitation. Seen in this way, imitative desire is the generative force behind violence, the snake that turns friends and lovers into rivals.This Freudian act of projection resembles an act of doubling, an intense mimesis of the other that creates doubles. From a Girardian perspective, it is the clash of desire that leads to doubling, and later to violence.5 The imitation of each other's desires will sooner or later cause some kind of violence.6 This doubling does not only have to involve two people; it can be groups, even countries. [End Page 222] But the effect is always negative. Raymund Schwager explains it in the following terms:Whoever is desirous has to expect that the others will too. Whoever succumbs to rivalry arouses the same passion in others. Whoever resorts to violence is imitated in his or... (shrink)

This article contains a discussion on René Girard’s understanding of the positive sides of imitation—despite the ambivalent nature of desire. Historically speaking, the discovery of the scapegoat mechanism made a great contribution towards limiting violence. The decomposition of the scapegoat mechanism, and its power to find non-violent alternatives, has paved the way for a culture with numerous opportunities. Even if humans constantly rival one another, one must understand and define the close relationship between competition, cooperation, and rivalry. To be able (...) to see the positive sides of mimesis, one needs to have a robust understanding of human nature as competitive and, thereby, see friendship and competition as closely related. Learning and creativity can actually become optimal when there is a high degree of competition. Fierce competition today is allowed because of the taboo against violence. The decomposition of myth has destroyed archaic societies but, at the same time, created problems of an apocalyptic kind. Increasingly, cultures are now de- veloping without the shelter that sacrificial society previously provided. Positive human development, as is evident in the demystifying of violent myths and the increased concern for victims, cannot stem the power of global terror. Despite greater pessimism in his later works, Girard’s hope is that, through the model of Christ, people will finally learn to love their neighbours as themselves. A change of heart is to a certain degree capable to lead people towards the same kind of non-differentiated love as God. (shrink)

In some jobs, the correlation between effort and output is almost zero. For instance, money managers are primarily paid for luck. Using a controlled lab experiment, we examined under which conditions workers are willing to put in effort even if the output is determined by pure luck. We varied whether the employer could observe the workers’ effort, as well as whether the employer knows that earnings were determined by luck. We find that, workers believed that the employer will reward their (...) effort even if their effort does not affect earnings. Consequently, workers work harder if the employer could observe their effort. Moreover, even when the employer only saw earnings and not effort, workers labored harder if the employer did not know that earnings were determined by luck. (shrink)

This article begins by addressing a critique of my book Immaterialism by the archaeologists Þóra Pétursdóttirr and Bjørnar Olsen in their 2018 article “Theory Adrift.” As they see it, I restrict myself in Immaterialism to available historical documentation on the Dutch East India Company (VOC), and they wonder how my account might have changed if I had discussed more typical archaeological examples instead: wrecked and sunken ships, released ballast, deserted harbors, distributed goods, and derelict fortresses. In response, I argue that (...) my account was not therefore non-archaeological, since ruins are the topic of archaeology only by accident: the real subject of the discipline is what Marshall McLuhan describes as “cold media,” in the sense that they are low in information. McLuhan’s distinction between hot and cold media is shown to be surprisingly analogous to Aristotle’s difference between continua and discrete substances, and some consequences are drawn from this analogy. (shrink)

This is a comment to Graham Harman’s 2019 response to an article by Þóra Pétursdóttir and Bjørnar Olsen (2018) in which they propose that a materially grounded, archaeological perspective might complement Harman’s historical approach in Immaterialism (2016). Harman responds that his book is indeed already more archaeological than historical, stipulating that history is the study of media with a high density of information, whereas archaeology studies media with a low density of information. History, Harman holds, ends up in too much (...) detail, while archaeology has the advantage of lending itself to the imagination. Hence, his reading of history had the aim of tempering the historical information overload, in effect making the book a work of archaeology. In this comment, I want to do three things: (1) critique the idea that archaeological and historical media are inherently different with regard to their densities of information, (2) discuss how archaeology and history approach their media, and (3) reflect on conceptualisations of “archaeology” outside the discipline itself. (shrink)

This book is an introduction to and interpretation of the philosophy of language devised by Donald Davidson over the past 25 years. The guiding intuition is that Davidson's work is best understood as an ongoing attempt to purge semantics of theoretical reifications. Seen in this light the recent attack on the notion of language itself emerges as a natural development of his Quinian scepticism towards "meanings" and his rejections of reference-based semantic theories. Linguistic understanding is, for Davidson, essentially dynamic, arising (...) only through a continuous process of theory construction and reconstruction. The result is a conception of semantics in which the notion of interpretation and not the notion of knowing a language is fundamental. In the course of his book Bjorn Ramberg provides a critical discussion of reference-based semantic theories, challenging the standard accounts of the principle of charity and elucidating the notion of radical interpretation. The final chapter on incommensurability ties in with the discussions of Kuhn's work in the philosophy of science and suggests certain links between Davidson's analytic semantics and hermeneutic theory. (shrink)

Dieser Beitrag bietet eine umfassende Diskussion des Textes “Humanismus und Christentum” (1950) des dänischen Philosophen und Theologen Knud E. Løgstrup. Er verortet den Text in seinem geistesgeschichtlichen Kontext und analysiert seine wichtigsten Argumente wie auch seine zentrale These, der zufolge Humanismus und Christentum einen entscheidenden Grundsatz teilen, insofern beide die Ethik als “stumm“ oder “unausgesprochen“ verstehen. Darüber hinaus wird dargelegt, wie Løgstrups Text zentrale Überlegungen in dessen späteren Publikationen, besonders in dem Hauptwerk Die ethische Forderung (1956), vorwegnimmt.

The concepts of health and disease are crucial in defining the aim and the limits of modern medicine. Accordingly it is important to understand them and their relationship. However, there appears to be a discrepancy between scholars in philosophy of medicine and health care professionals with regard to these concepts. This article investigates health care professionals’ concepts of health and disease and the relationship between them. In order to do so, four different models are described and analyzed: the ideal model, (...) the holistic model, the medical model and the disjunctive model. The analysis reveals that each model has its pros and cons, and that health care professionals appear to apply more than one models. Furthermore, the models and the way health care professionals’ use them may be helpful for scholars in philosophy of medicine with regard to developing theories and communicating them to health care professionals. (shrink)

To approach the philosophical anthropology of Donald Davidson is to get ready for an unusually high number of laps around the hermeneutic circle. Apparently a problem-oriented philosopher, Davidson presents his views in a continuing series of dense, tightly focussed papers on narrowly circumscribed topics. The lines of the big picture are mostly implicit. Yet it is the scope and the power of this picture that has made Davidson one of the most significant philosophers of this century. Naturally, this makes Davidson's (...) work an extremely tempting—and extremely treacherous—target for the exegete with synthesizing tendencies. Until now, the sense of danger seems to have won out; secondary expositions have largely confined themselves to particular aspects of his thought. For those seeking to appreciate the cohesion and comprehensiveness of Davidson's vision, there has been no alternative but, as Ted Honderich says, to “struggle and learn,” working their way through Davidson's papers, continually calibrating and recalibrating interpretations of Davidson's detailed philosophical proposals with the emerging pattern of their interrelationships. (shrink)

Fifteen years ago, Ruth Macklin shook the medical community with her claim in the BMJ that dignity is a useless concept. Her essay provoked a storm of reactions. What have we learned from the debate? In this article I analyse the responses to her essay and the following debate to investigate whether she was right that “[d]ignity is a useless concept in medical ethics and can be eliminated without any loss of content.” While some of the commentaries misconstrued her claim (...) and argue against strawmen, others forcefully maintained that the concept of dignity has functions beyond “respect for persons and their autonomy.” One important point that came out of the debate is that dignity is a generic concept that covers more ground than “respect for persons or their autonomy.” In particular, dignity seems to have a wide range of protective functions as well as having reciprocal, relational, and social aspects. Dignity appears more attributional and norm‐formative than respect for persons and autonomy. While the claim that dignity is unclear, vague, and can be used sloganistically seems highly relevant, it is argued that this vagueness fulfils important functions in ethics. Moreover, dismissing dignity because of its lack of clarity has implications for “respect for persons” and “autonomy,” which are also used vaguely and sloganistically. No doubt medical ethics should use as a clear concept as the context requires. Nonetheless, dignity still seems to be a widely used generic concept in ethical debates and doing as much ethical work as “respect for persons” or “respect for autonomy.” Therefore, the death of dignity seems to be greatly exaggerated. (shrink)

Aim of the paper is to present a new logic of technical malfunction. The need for this logic is motivated by a simple-sounding philosophical question: Is a malfunctioning corkscrew, which fails to uncork bottles, nonetheless a corkscrew? Or in general terms, is a malfunctioning F, which fails to do what Fs do, nonetheless an F? We argue that ‘malfunctioning’ denotes the modifier Malfunctioning rather than a property, and that the answer depends on whether Malfunctioning is subsective or privative. If subsective, (...) a malfunctioning F is an F; if privative, a malfunctioning F is not an F. An intensional logic is required to raise and answer the question, because modifiers operate directly on properties and not on sets or individuals. This new logic provides the formal tools to reason about technical malfunction by means of a logical analysis of the sentence “a is a malfunctioning F”. (shrink)

This book is a novel contribution to contemporary research on Simone de Beauvoir, and a defense of the importance of the humanities. It reveals previously unexplored dimensions of Beauvoir's work by exposing her as a significant and inspiring humanist thinker. These essays argue that her works and influence testify to the transformative potential of humanistic research.

This book gives the reader an understanding of what consciousness is about, and of how to make conscious experiences more pleasant. It expands on a new theory that describes the evolutionary trajectory leading to conscious life forms. In short, the evidence suggests that consciousness first evolved some 300 million years ago as a consequence of the introduction of feelings. Feelings offer a strategy for making behavioural decisions. Besides playing a crucial role in the evolution of the human mind, they are (...) a key factor in regard to mental health and quality of life. Fortunately, the human brain is plastic. By exploiting available options for modulating the mind, it is therefore possible to impact on what sort of experiences the brain serves. More specifically, you can strengthen the capacity for positive feelings and reduce the sway of negative feelings. The text covers biological, neurological, psychological, and philosophical aspects of the mind. (shrink)

The concept of disease has been the subject ofa vast, vivid and versatile debate. Categoriessuch as ``realist'', ``nominalist'', ``ontologist'',``physiologist'', ``normativist'' and``descriptivist'' have been applied to classifydisease concepts. These categories refer tounderlying theoretical frameworks of thedebate. The objective of this review is toanalyse these frameworks. It is argued that thecategories applied in the debate refer toprofound philosophical issues, and that thecomplexity of the debate reflects thecomplexity of the concept itself: disease is acomplex concept, and does not easily lenditself to definition.

Les personnes présentant des troubles psychiques rencontrent des difficultés à s’insérer sur le marché du travail. Dans cette étude, nous évaluons dans quelle mesure les employeurs se préoccupent de l’accès des jeunes adultes qui présentent des troubles psychiques au travail salarié. Nous mettons l’emphase notamment sur les facteurs contextuels qui influencent les jugements et les comportements des employeurs durant le processus de l’embauche. Les résultats montrent que l’adhésion à l’Accord Norvégien sur la Vie Professionnelle Inclusive et le degré de formalisation (...) des procédures d’embauche vont de pair avec l’adoption de mesures inclusives en matière de recrutement de jeunes adultes qui présentent des troubles psychiques. Cependant, malgré cet accord, peu d’entreprises norvégiennes embauchent de jeunes adultes ainsi classés. De même, seul un petit nombre d’entreprises invitent à un entretien d’embauche un candidat qualifié présentant ces troubles. Notre étude concorde ainsi avec les recherches suggérant que les réticences ou les préjugés des employeurs au recrutement des personnes avec des troubles psychiques contribuent à leurs difficultés sur le marché du travail. (shrink)

Trust can be understood as a precondition for a well-functioning society or as a way to handle complexities of living in a risk society, but also as a fundamental aspect of human morality. Interactions on the Internet pose some new challenges to issues of trust, especially connected to disembodiedness. Mistrust may be an important obstacle to Internet use, which is problematic as the Internet becomes a significant arena for political, social and commercial activities necessary for full participation in a liberal (...) democracy. The Categorical Imperative lifts up trust as a fundamental component of human ethical virtues – first of all, because deception and coercion, the antitheses of trust, cannot be universalized. Mistrust is, according to Kant, a natural component of human nature, as we are social beings dependent on recognition by others but also prone to deceiving others. Only in true friendships can this tendency be overcome and give room for unconditional trust. Still we can argue that Kant must hold that trustworthy behaviour as well as trust in others is obligatory, as expressions of respect for humanity. The Kantian approach integrates political and ethical aspects of trust, showing that protecting the external activities of citizens is required in order to act morally. This means that security measures, combined with specific regulations are important preconditions for building online trust, providing an environment enabling people to act morally and for trust-based relationships. (shrink)

Collaborative interaction pervades everyday practices: work meetings, innovation and product design, education and arts. Previous studies have pointed to the central role of acknowledgement and acceptance for the success of joint action, by creating affiliation and signaling understanding. We argue that various forms of explicit miscommunication are just as critical to challenge, negotiate and integrate individual contributions in collaborative creative activities. Through qualitative microanalysis of spontaneous coordination in collective creative LEGO constructions, we individuate three interactional styles: inclusive, characterized by acknowledgment (...) and praise; instructional, characterized by self-repair; and integrative, characterized by widespread self- and other-repair. We investigate how different interaction styles leave distinct traces in the resulting LEGO models. The inclusive interaction style results in concatenations of individual contributions with little coherence and core narrative. The instructional style produces coherent, but individually driven models. Finally, the integrative style generates more innovative models, synthesizing individual contributions in shared narratives or schemas. (shrink)

The widespread application of technology in health care has imposed a broad range of challenges. The field of health technology assessment (HTA) is developed in order to face some of these challenges. However, this strategy has not been as successful as one could hope. One of the reasons for this is that social and ethical considerations have not been integrated in the HTA process. Nowadays however, such considerations have been included in many HTAs. Still, the conclusions and recommendations of the (...) HTAs are not followed. The reason for this may be that the methods for integrating ethics for HTA are not sufficiently developed, or that they are not adequate. This article presents a supplementary approach to the ethical inquiry in HTA. It is argued that a value analysis is crucial in order to address the ethical issues of health care technology in a fruitful way and to make viable decisions about such technology. (shrink)

New technologies facilitate the enhancement of a wide range of human dispositions, capacities, or abilities. While it is argued that we need to set limits to human enhancement, it is unclear where we should find resources to set such limits. Traditional routes for setting limits, such as referring to nature, the therapy-enhancement distinction, and the health-disease distinction, turn out to have some shortcomings. However, upon closer scrutiny the concept of enhancement is based on vague conceptions of what is to be (...) enhanced. Explaining why it is better to become older, stronger, and more intelligent presupposes a clear conception of goodness, which is seldom provided. In particular, the qualitative better is frequently confused with the quantitative more. We may therefore not need “external” measures for setting its limits – they are available in the concept of enhancement itself. While there may be shortcomings in traditional sources of limit setting to human enhancement, such as nature, therapy, and disease, such approaches may not be necessary. The specification-of-betterment problem inherent in the conception of human enhancement itself provides means to restrict its unwarranted proliferation. We only need to demand clear, sustainable, obtainable goals for enhancement that are based on evidence, and not on lofty speculations, hypes, analogies, or weak associations. Human enhancements that specify what will become better, and provide adequate evidence, are good and should be pursued. Others should not be accepted. (shrink)

With Contingency, Irony, and Solidarity Richard Rorty tries to persuade us that a case for liberalism is better served by historical narrative than by philosophical theory. The liberal ironist is the complex protagonist of Rorty’s anti-foundationalist story. Why does Rorty think irony serves—rather than undermines—commitments to liberal democracy? I distinguish political from existential dimensions of irony, consider criticisms of Rorty’s ironist, and then draw on recent work by Lear to argue that Rorty’s ironist character nevertheless can be recast as an (...) image useful to the self-understanding of contemporary liberal democrats. (shrink)

The point of departure for this article is a review of the discussion between Twaddle and Nordenfelt on the concepts of disease, illness, and sickness, and the objective is to investigate the fruitfulness of these concepts. It is argued that disease, illness, and sickness represent different perspectives on human ailment and that they can be applied to analyze both epistemic and normative challenges to modern medicine. In particular the analysis reveals epistemic and normative differences between the concepts. Furthermore, the article (...) demonstrates, against Nordenfelt's claim, that the concepts of disease, illness, and sickness can exist without a general theory of health. Additionally, the complexity of different perspectives on human ailment also explains why it is so difficult to give strict definitions of basic concepts within modern health care. (shrink)

_This article presents an experiment in using Socratic dialogue as a methodological approach to Responsible Research and Innovation (RRI) in an interdisciplinary life sciences research project. The approach seeks to avoid imposing a set of predetermined substantive norms by engaging the researchers in knowledge-seeking group discussions. We adapted Svend Brinkmann’s method of epistemic interviewing, in order to facilitate reflection on normative issues concerning responsibility in research and innovation in two research group sessions. Two elements characterize this approach, relating it to (...) empirical ethics methodologies: (1) the aim is not to map and analyse opinions, but to develop knowledge based on the dialogue; and (2) the facilitators of the discussion are also active participants in the dialogue rather than mere “spectators”. Through a description of the approach and discussion of some key challenges, we __show the method’s potential as a supplement to the catalogue of RRI approaches and argue that it serves a dual purpose of contributing to knowledge production and reflexivity._ _Keywords_: Epistemic interviewing, bioethics, responsibility, reflexivity. (shrink)

Medicalization is frequently defined as a process by which some non-medical aspects of human life become to be considered as medical problems. Overdiagnosis, on the other hand, is most often defined as diagnosing a biomedical condition that in the absence of testing would not cause symptoms or death in the person’s lifetime. Medicalization and overdiagnosis are related concepts as both expand the extension of the concept of disease. They are both often used normatively to critique unwarranted or contested expansion of (...) medicine and to address health services that are considered to be unnecessary, futile, or even harmful. However, there are important differences between the concepts, as not all cases of overdiagnosis are medicalizations and not all cases of medicalizations are overdiagnosis. The objective of this article is to clarify the differences between medicalization and overdiagnosis. It will demonstrate how the subject matter of medicalization traditionally has been non-medical (social or cultural everyday life) phenomena, while the subject matter of overdiagnosis has been biological or biomolecular conditions or processes acknowledged being potentially harmful. They also refer to different types of uncertainty: medicalization is concerned with indeterminacy, while overdiagnosis is concerned with lack of prognostic knowledge. Medicalization is dealing with sickness (sick role) while overdiagnosis with disease. Despite these differences, medicalization and overdiagnosis are becoming more alike. Medicalization is expanding, encompassing the more “technical” aspects of overdiagnosis, while overdiagnosis is becoming more ideologized. Moreover, with new trends in modern medicine, such as P4 (preventive, predictive, personal, and participatory) medicine, medicalization will become all-encompassing, while overdiagnosis more or less may dissolve. In the end they may converge in some total “iatrogenization.” In doing so, the concepts may lose their precision and critical sting. (shrink)

How can we draw the line between health and disease? This crucial question of demarcation has immense practical implications and has troubled scholars for ages. The question will be addressed in three steps. First, I will present an important contribution by Rogers and Walker who argue forcefully that no line can be drawn between health and disease. However, a closer analysis of their argument reveals that a line-drawing problem for disease-related features does not necessarily imply a line-drawing problem for disease (...) as such. The second step analyzes some alternative approaches to drawing the line between health and disease. While these approaches do not provide full answers to the question, they indicate that the line-drawing question should not be dismissed too hastily. The third step investigates whether the line-drawing problem can find its solution in the concept of suffering. In particular, I investigate whether returning to the origin of medicine, with the primary and ultimate goal of reducing suffering, may provide sources of demarcation between health and disease. In fact, the reason why we pay attention to particular phenomena as characteristics of disease, consider certain processes to be relevant, and specific functions are classified as dys-functions, is that they are related to suffering. Accordingly, using suffering as a criterion of demarcation between health and disease may hinder a wide range of challenges with modern medicine, such as unwarranted expansion of disease, overdiagnosis, overtreatment, and medicalization. (shrink)

This article presents and evaluates arguments supporting that an approval procedure for genome-edited organisms for food or feed should include a broad assessment of societal, ethical and environmental concerns; so-called non-safety assessment. The core of analysis is the requirement of the Norwegian Gene Technology Act that the sustainability, ethical and societal impacts of a genetically modified organism should be assessed prior to regulatory approval of the novel products. The article gives an overview how this requirement has been implemented in the (...) regulatory practice, demonstrating that such assessment is feasible and justified. Even in situations where genome-edited organisms are considered comparable to non-modified organisms in terms of risk, the technology may have—in addition to social benefits—negative impacts that warrant assessments of the kind required in the Act. The main reason is the disruptive character of the genome editing technologies due to their potential for novel, ground-breaking solutions in agriculture and aquaculture combined with the economic framework shaped by the patent system. Food is fundamental for a good life, biologically and culturally, which warrants stricter assessment procedures than what is required for other industries, at least in countries like Norway with a strong tradition for national control over agricultural markets and breeding programs. (shrink)

Theories of structured meanings are designed to generate fine-grained meanings, but they are also liable to overgenerate structures, thus drawing structural distinctions without a semantic difference. I recommend the proliferation of very fine-grained structures, so that we are able to draw any semantic distinctions we think we might need. But, in order to contain overgeneration, I argue we should insert some degree of individuation between logical equivalence and structural identity based on structural isomorphism. The idea amounts to forming an equivalence (...) class of different structures according to one or more formal criteria and designating a privileged element as a representative of all the elements, i.e., a first among equals. The proposed method helps us to a cluster of notions of co-hyperintensionality. As a test case, I consider a recent objection levelled against the act theory of structured propositions. I also respond to an objection against my methodology. (shrink)

Overdiagnosis and disease are related concepts. Widened conceptions of disease increase overdiagnosis and vice versa. This is partly because there is a close and complex relationship between disease and overdiagnosis. In order to address the problems with overdiagnosis, we may benefit from a closer understanding this relationship. Accordingly, the objective of this article is to elucidate the relationship between disease and overdiagnosis. To do so, the article starts with scrutinizing how overdiagnosis can explain the expansion of the concept of disease. (...) Then it investigates how definitions of disease address various challenges of overdiagnosis. The article specifically investigates recent attempts to clarify the relationship between the concepts of disease and overdiagnosis. Several shortcomings are identified and lead to a closer analysis of overdiagnosis in the diagnostic process. Contrary to recent contributions to the field, it is argued that cases of overdiagnosis are not cases of disease. They are non-verified labelling of disease. It is revealed how overdiagnosis establishes an unwarranted link between indicative phenomena, such as polyps or cell changes, and harm, and thereby generates a link to disease. One implication of this study is that we should stop attributing disease language to indicative phenomena. That is, we should stop calling it “cancer screening” when we are actually searching for polyps. Another implications is that we should strive for scientific progress in differentiating phenomena that are of negative value to us from those that are not. In overdiagnosis we diagnose something that is not disease: it is over-diagnosis. (shrink)