63,258 research outputs found
Sulla natura del disturbo mentale
No full textIl capitolo intende esaminare le principali risposte filosofiche alla domanda “che cos’è un disturbo mentale?” Per cominciare, tali risposte sono analizzate in base alla distinzione tra naturalismo e normativismo, quella forse più utilizzata per categorizzare le varie definizioni del concetto di malattia (Amoretti, 2015). In seguito, si prenderà invece in considerazione una diversa dicotomia, quella tra modello medico “debole” e modello medico “forte” in psichiatria. Non si terrà invece conto delle posizioni esplicitamente eliminativiste, come quelle di Michel Foucault e Thomas Szasz, stando alle quali i disturbi mentali non sarebbero altro che miti o strumenti di controllo sociale. Occorre inoltre precisare come la domanda di cui sopra venga investigata esclusivamente al livello teorico (al fine di chiarire quale sia la reale natura, da un punto di vista metafisico, del disturbo mentale e poter così discriminare condizioni patologiche e non patologiche), non al livello pratico (che avrebbe invece lo scopo di orientare decisioni cliniche, di tipo diagnostico e terapeutico)
Gender as a Category of Analysis in Medical Knowledge
No full textFor centuries, the field of medicine operated under the tacit assumption that, apart from genital organs and reproductive systems, human biology was essentially uniform across genders. However, there is currently a growing recognition of gender-specific health conditions that disproportionately affect women, and exhibit different prevalence, severity, distinct causes, manifestations, and varied outcomes or treatments. This underscores the importance of considering the impact of sex and gender on health, as well as the development, clinical features, course, and experience of diseases. From a philosophical perspective, crucial questions emerge about the role of gender in medicine, the relationship between gender and medical research and practice, and the potential biases that hinder the recognition of gender as a relevant category of analysis. To address these questions two opposing trends are examined: "gender blindness," where relevant differences are overlooked, and "gender stereotyping," where nonexistent or insignificant differences are emphasized. Women's diverse biological and physiological aspects have historically been ignored or marginalized. Simultaneously, persistent stereotypes linking women to motherhood and emotional traits hinder accurate diagnoses and effective interventions. Understanding and addressing these two opposite tendencies is crucial for ensuring equitable treatment, and improving health outcomes for all genders
Disturbi mentali e riduzionismi
No full textLa nosologia psichiatrica fornita dal Manuale Diagnostico e Statistico del Disturbi Mentali (DSM) concepisce i disturbi mentali in modo ateorico, descrittivo e operazionale, identificandoli con un insieme di segni e di sintomi, rappresentati dai vari criteri diagnostici. Nonostante la nosologia del DSM sia tuttora lo standard a livello psichiatrico, i progressi delle varie scienze, in particolare della neuroscienza e della biologia molecolare, hanno evidenziato l’opportunità di caratterizzare i disturbi mentali non più come sindromi, bensì come disturbi cerebrali, vale a dire disfunzioni o processi anormali del cervello. Un programma di ricerca che va in questa seconda direzione è l’iniziativa Research Domain Criteria (RDoC), lanciata nel 2009 dal National Institute of Mental Health (NIMH) con lo scopo di favorire la ricerca psichiatrica, apparentemente ostacolata dalle categorie descrittive del DSM. Una ricerca che si basi su tali categorie, infatti, si trova a fronteggiare diversi problemi, legati per esempio al fatto che due individui possono essere diagnosticati con lo stesso disturbo pur avendo sintomatologie diverse (eterogeneità), che pazienti diagnosticati con un disturbo mentale tendono anche a soddisfare i criteri diagnostici di altri disturbi (co-morbilità), o che si possono dare solamente verdetti diagnostici del tipo sì/no, sulla base del conteggio dei sintomi, oscurando la gradualità con cui le psicopatologie possono presentarsi (categoricità vs. dimensionalità) e negando a molti pazienti una vera e propria diagnosi.
Come molti critici hanno evidenziato, uno dei maggiori temi rispetto a cui RDoC è stato criticato – e anche mal interpretato – è il suo (presunto) carattere riduzionistico. Il presente contributo si articola dunque come segue. Nella Sezione 1 illustrerò brevemente l’iniziativa RDoC, mettendola poi in relazione con il riduzionismo ontologico (Sezione 2) e quello epistemologico (Sezione 3). L’intento è quello di operare un lavoro di analisi e chiarificazione concettuale che, come ha sottolineato Pagnini, può essere fondamentale per aiutare a compiere “scelte e pronunciamenti che siano il più possibile responsabili”, nello specifico rispetto a RDoC
Sul complesso rapporto tra teorie normative e scienze empiriche
No full textIl presente contributo prende in esame due questioni che, seppure in modo diverso, riguardano i rapporti quanto mai complessi che intercorrono tra teorie normative, in particolare quelle sviluppate dalla filosofia morale, e scienze empiriche: in primo luogo, l’eventualità che le scienze empiriche possano contribuire a corroborare o falsificare particolare tesi normative e, in secondo luogo, il rapporto tra i diversi livelli che contraddistinguono teorie normative e descrittive.This comment analyzes two issues regarding the complex relationship between normative theories, particularly those developed by moral philosophy, and empirical sciences: first, the possibility that empirical sciences help corroborate or falsify normative theories and, second, the different levels that characterize normative theories and descriptive hypotheses
Conversation with Pieranna Garavaso
No full textPieranna Garavaso is Emerita Professor of Philosophy at the University of Minnesota, Morris. Her research areas include epistemological and metaphysical issues in the philosophy of mathematics, philosophy of language, personal identity, and feminist epistemologies. She received her doctorate in philosophy from the University of Nebraska Lincoln in 1985. She has published Filosofia della matematica. Numeri e strutture (Guerini 1998), Filosofia delle donne (Laterza 2007, coauthored with N. Vassallo), and Frege on Thinking and its Epistemic Significance (Lexington Books 2014, coauthored with N. Vassallo). She edited Philip Hugly and Charles Sayward, Arithmetic and Ontology: A Non-Realist Philosophy of Mathematics (Rodopi 2006), a monographic issue of Paradigmi devoted to Contemporary Perspectives on Frege (2013), and The Bloomsbury Companion to Analytic Feminism (Bloomsbury 2018). She has published articles in English and Italian journals and in edited collections. The University of Minnesota has recognized her teaching and research with three awards: the University of Minnesota, Morris Alumni Association Teaching Award in 2003, the Horace T. Morse University of Minnesota Alumni Association Award for Outstanding Contribution to Undergraduate Education in 2004, and the University of Minnesota Morris Faculty Distinguished Research Award in 2017. In this interview, she explains what led her to leave Italy in the early 1980’s to study philosophy in the US. She also illustrates how her ontological anti-realism in the philosophy of mathematics has influenced her work in feminist epistemology and metaphysics. She defends analytic philosophy from the accusation of being less friendly than continental philosophy towards feminist philosophy
Do Feeding and Eating Disorders Fit the General Definition of Mental Disorder?
No full textThis paper aims at considering the conceptual status of feeding and eating disorders (FEDs). Now that the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has changed the classification and some relevant criteria of FEDs, it is particularly relevant to evaluate their psychiatric framework and their status as mental disorders. I focus my efforts on addressing only one specific question: Do FEDs fit the DSM-5 general definition of mental disorder? In DSM-5 a mental disorder is defined as a syndrome that reflects a dysfunction and is usually associated with significant distress or disability. More importantly, there is an explicit statement saying that all mental disorders listed in the manual must meet the requirements highlighted by the general definition. Thus, I evaluate whether or not FEDs are really meant to reflect a dysfunction and are usually associated with significant distress or disability
EVIDENZA, VALORI, RAZIONALITÀ: TRE CASI DI COVID-SCIENCE Evidence, values, rationality: Three examples of Covid-science
No full textLa nostra ricerca (Amoretti, Lalumera, 2021a, 2021b, 2022, manuscript) ha indagato come in alcuni casi elementi non epistemici – considerazioni valoriali e scopi pragmatici – entrino in gioco nella defini- zione dei concetti teorici e nella valutazione dei risultati nella scienza pandemica. In questo contributo illustriamo brevemente tre casi di scienza pandemica in cui abbiamo individuato e discusso il ruolo dei valori non epistemici: la definizione di morte causata da Covid-19, la scelta dei parametri nei modelli epidemiologici, con particolare attenzione al fatidico “numero R” di riproduzione del virus, e la questione del fallimento comunicativo del cosiddetto vaccino AstraZeneca.The so-called Covid-science – the research, especially the biomedical research on the biological, clinical, epidemiological, pharmacological, and psycho-sociological aspects of Covid-19 - can be considered an important case study for the philosophy of science and the philosophy of medicine. In this contribution, we briefly illustrate three cases of Covid-science in which we have identified and discussed the role of values, particularly non epistemic values: the definition of death caused by Covid-19, the choice of parameters in epidemiological models,
with particular attention to the “magic” reproduction number R, and the issue of the communicative failure of the AstraZeneca vaccine. The purpose of this analysis is to show that admitting that biomedical science includes non-epistemic elements is not to deny or diminish its objectivity. Rather, detecting the role of values in specific contexts allows them to be subjected to public discussion and thus, prospectively, allows for providing shared reasons for them
Wherein is the concept of disease normative? From weak normativity to value-conscious naturalism
No full textIn this paper we focus on some new normativist positions and compare them with traditional ones. In so doing, we claim that if normative judgments are involved in determining whether a condition is a disease only in the sense identified by new normativisms, then disease is normative only in a weak sense, which must be distinguished from the strong sense advocated by traditional normativisms. Specifically, we argue that weak and strong normativity are different to the point that one ‘normativist’ label ceases to be appropriate for the whole range of positions. If values and norms are not explicit components of the concept of disease, but only intervene in other explanatory roles, then the concept of disease is no more value-laden than many other scientific concepts, or even any other scientific concept. We call the newly identified position “value-conscious naturalism” about disease, and point to some of its theoretical and practical advantages
The Notion of Gender in Psychiatry: A Focus on DSM-5
No full textIn this paper I review how the notion of gender is understood in psychiatry, specifically in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). First, I examine the contraposition between sex and gender, and argue that it is still retained by DSM-5, even though with some caveats. Second, I claim that, even if genderqueer people are not pathologized and gender pluralism is the background assumption, some diagnostic criteria still conceal a residue of gender dualism and essentialism. Third, I consider gender dysphoria, which is characterized by an incongruence between one’s experienced or expressed gender and one’s assigned gender; since this condition pertains to distress and disability, not to the incongruence per se, it does not pathologize transgender people. Still, I contend that it should be removed from DSM-5 for theoretical reasons
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