How to Proceed in the Disease Concept Debate? A Pragmatic Approach.

In the traditional philosophical debate over different conceptual analyses of "disease," it is often presupposed that "disease" is univocally definable and that there are clear boundaries which distinguish this univocal category "disease" from the category of "nondisease." In this paper, I will argue for a shift in the discussion on the concept of "disease" and propose an alternative, pragmatic approach that is based on the conviction that "disease" is not a theoretical concept but a practical term. I develop a view on which our use of the term "disease" is determined by two interacting factors, namely, value-laden considerations about the (un)desirabilty of certain states and discoveries of cause(s) which is/are explanatorily relevant.

What to expect from reliability and validity claims? A pragmatic conception of psychiatric nosology.

The reliability and validity of psychiatric diagnoses have always been a major concern. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) reliability field trials yielded ambiguous results, with some diagnostic categories scoring well below par. We argue that the emphasis on the reliability of psychiatric diagnoses, which has dominated psychiatric nosology and guided the endeavor of improving the DSM in its consecutive editions, is misguided and lacks in structural validity.

The mycotoxin definition reconsidered towards fungal cyclic depsipeptides.

Currently, next to the major classes, cyclic depsipeptides beauvericin and enniatins are also positioned as mycotoxins. However, as there are hundreds more fungal cyclic depsipeptides already identified, should these not be considered as mycotoxins as well? The current status of the mycotoxin definition revealed a lack of consistency, leading to confusion about what compounds should be called mycotoxins. Because this is of pivotal importance in risk assessment prioritization, a clear and quantitatively expressed mycotoxin definition is proposed, based on data of widely accepted mycotoxins.

Evidence-based medicine and progress in the medical sciences.

The question what scientific progress means for a particular domain such as medicine seems importantly different from the question what scientific progress is in general. While the latter question received ample treatment in the philosophical literature, the former question is hardly discussed. I argue that it is nonetheless important to think about this question in view of the methodological choices we make.

Explanatory pluralism in the medical sciences: theory and practice.

Explanatory pluralism is the view that the best form and level of explanation depends on the kind of question one seeks to answer by the explanation, and that in order to answer all questions in the best way possible, we need more than one form and level of explanation. In the first part of this article, we argue that explanatory pluralism holds for the medical sciences, at least in theory. However, in the second part of the article we show that medical research and practice is actually not fully and truly explanatory pluralist yet.

Epidemiology and causation.

Epidemiologists' discussions on causation are not always very enlightening with regard to the notion of 'cause' in epidemiology. Epidemiologists rightly work from a science-based approach to causation in epidemiology, but largely disagree about the matter. Disagreement may be partly due to confusion of the question of useful concepts for causal inference in epidemiological practice with the question of the metaphysical presuppositions of causal concepts used in epidemiology.

Causal (mis)understanding and the search for scientific explanations: a case study from the history of medicine.

In 1747, James Lind carried out an experiment which proved the usefulness of citrus fruit as a cure for scurvy. Nonetheless, he rejected the earlier hypothesis of Bachstrom that the absence of fresh fruit and vegetables was the only cause of the disease. I explain why it was rational for James Lind not to accept Bachstrom's explanation.