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1990 (12) Heft 1

Gesundheit, Krankheit und Rationalität

 


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Markus Pawelzik
Krankheit als Funktionsgestörtheit. Eine Kritik an C. Boorses 'objektiver' Krankheitstheorie
5-45

Abstract: Contrary to the bio-medical sciences most philosophers of medicine regard disease as an evaluative concept. C. Boorse's well-known naturalist attempt to conceptualize disease exclusively on the basis of physiological fact seems highly plausible at first sight, since on this supposition it is possible to make use of the impressive explanatory knowledge of modern medicine. But critical examination of his meta-physiological notion of "disease" as subnormal functioning shows that it does not conform to licensed medical disease-judgements. Furthermore his doctrine seems unjustified since it's empirical implementability is highly questionable. This suggests that medicine is a naturalist enterprise that is guided by evaluation. An alternative conception of disease is advanced that tries to make the ,nexus, of physiological fact and evaluation intelligible: Disease is (extensionally) the class of physiological processes that (actually or prospectively) undermine the physiological conditions of human well-being.

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Bernard Gert
Irrationality and the DSM-III-R Definition of Mental Disorder
34-46

Abstract: I provide an account of irrationality that takes the concept of an irrational action as more basic than that of an irrational belief. While explaining the various elements of the DSM-III-R definition of mental disorders, I show that even though (I) not all mental disorders involve irrational beliefs or delusions, (2) not all irrational actions are due to mental disorders, and (3) not all mental disorders lead to irrational actions, there is a close conceptual connection between irrationality and mental disorders because both involve suffering or an increased risk of suffering an evil or harm, independent of the circumstances one is in.

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Martin Löw-Beer
Ist "zwanghaftes Handeln" ein paradoxer Begriff? Ein Versuch der Beschreibung von Zwangssymptomen
47-66

Abstract: What does it mean that a person is psychologically forced to do certain things? It is argued that there are, strictly speaking, no compulsive actions. Talking of compulsive actions people refer to intentional actions that are means of avoiding irrational panic attacks. People know that certain situations will cause them irrational fears and that is the reason why they avoid these situations. These irrational fears are either mediated by wrong perceptions or by emotional delusions. In the former case the people believe wrongly that they are in danger, while in the latter case they know that they "feel wrong", but cannot help it. The compulsive elements cannot be found in the actions but in the irrational fears and the obsessions that are part of them.

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Matthias Kettner
Wahn, Sinn, Sprache und Analyse. Kritische Notizen zu Wolfgang Tress, "Vorklärungen zu einer psychologischen Medizin der Person"
67-88

Abstract: I discuss Wolfgang Tress, attempt to apply analytic philosophy to the field of psychiatry and psychological medicine. According to Tress the concept of a person as a rational intentional system is fundamental for psychological medicine and irreducible to concepts of the natural sciences. But the rationality assumptions that are crucial for the concept of a person need much more clarification than Tress provides. Furthermore, Tress, concept of schizophrenia as a disorder of 'semantic coherence of the person, is seriously flawed empirically. Pragmatics rather than semantics should provide the methodological framework for the reconstruction of psychopathological concepts, such as "schizophrenia" and "delusion".

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Wolfgang R. Köhler
Können Personen ein Gegenstand des Verstehens sein? Ein Beitrag zur Hermeneutik der Person
89-110

Abstract: Is it possible to understand not only linguistic expressions and actions but also persons? According to common sense it surely is. Here it is argued that to understand a person a fourfold knowledge is required, although this knowledge is not identical with the understanding of a person. The understanding of a person is cognitive, but neither complete nor scientific.

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