Externalist Medicine and Externalist Biology

Authors

  • Shane Glackin Department of Social and Political Sciences, Philosophy, and Anthropology, University of Exeter, Exeter, United Kingdom https://orcid.org/0000-0002-8346-8666

DOI:

https://doi.org/10.5195/pom.2025.237

Keywords:

Disease, Externalism, Extended Evolutionary Synthesis, Degeneracy

Abstract

This paper assesses the prospects for an externalist perspective for somatic medicine—the view that health and disease of the body might sometimes be constitutively dependent on factors external to the organism. After briefly reviewing the grounds for psychiatric externalism, I argue that similar considerations are already implicit in somatic medical practice, particularly in immunology, public/population health, and occupational therapy. I then argue that the interactionist and population-minded externalist approach to biomedicine represents an important practical application of more general trends in biological theory; namely, the growing rejection of individualistic and reductionistic thinking.

References

Arah, Onyebuchi A. 2009. “On the Relationship Between Individual and Population Health.” Medicine, Healthcare, and Philosophy 12 (3): 235–244. https://doi.org/10.1007/s11019-008-9173-8.

Brumm, Joe. 2020. “Baby Race.” Bluey episode. Australian Broadcasting Corporation, November 17. https://www.youtube.com/watch?v=xmkCmJtK6X8.

Burnet, Frank M. 1969. Cellular Immunology: Self and Not-Self. Cambridge University Press.

Clark, Andy. 2012. “Embodied, Embedded, and Extended Cognition.” In The Cambridge Handbook of Cognitive Science, edited by Keith Frankish and William Ramsey, 275–291. Cambridge University Press.

Clark, Andy, and David Chalmers. 1998. “The Extended Mind.” Analysis 58 (1): 7–19. https://doi.org/10.1093/analys/58.1.7.

Conley, Brandon A., and Shane N. Glackin. 2021. “How to be a Naturalist and a Social Constructivist About Diseases.” Philosophy of Medicine 2 (1): 1–21. https://doi.org/10.5195/pom.2021.18.

Davies, Will. 2016. “Externalist Psychiatry.” Analysis 76 (3): 290–296. https://doi.org/10.1093/analys/anw038.

De Carvalho, Felipe Nogueira, and Joel Krueger. 2023. “Biases in Niche Construction.” Philosophical Psychology 37 (6): 1297–1327. https://doi.org/10.1080/09515089.2023.2237065.

De Haan, Sanneke. 2020. Enactive Psychiatry. Cambridge University Press.

Diez Roux, Ana V. 2016. “On the Distinction—or Lack of Distinction—Between Population Health and Public Health.” American Journal of Public Health 106 (4): 619–620. https://doi.org/10.2105/AJPH.2016.303097.

Drayson, Zoe. 2009. “Embodied Cognitive Science and Its Implications for Psychopathology.” Philosophy, Psychiatry, and Psychology 16 (4): 329–334. https://doi.org/10.1353/ppp.0.0261.

Dupré, John. 1995. The Disorder of Things: Metaphysical Foundations of the Disunity of Science. Harvard University Press.

Edelman, Gerald M., and Joseph A. Gally. 2001. “Degeneracy and Complexity in Biological Systems.” Proceedings of the National Academy of Sciences of the United States of America 98 (24): 13763–13768. https://doi.org/10.1073/pnas.231499798.

EES Consortium (Extended Evolutionary Synthesis Consortium). n.d. “What Is the Extended Evolutionary Synthesis?” https://extendedevolutionarysynthesis.com/about-the-ees/.

Eijsermans, M.J.C., I.C. van Haastert, V.A.M. Gulmans, and P.J.M. Helders. 1999. “Motor Performance After Bottom-Shuffling in Early Childhood.” Physiotherapy 86 (2): 81–84. https://doi.org/10.1016/S0031-9406(05)61209-6.

Ferreira Ruiz, María, and Jon Umerez. 2021. “Interactionism, Post-Interactionism, and Causal Complexity: Lessons From the Philosophy of Causation.” Frontiers in Psychology 12: article 590533. https://doi.org/10.3389/fpsyg.2021.590533.

Frege, Gottlob. 1948. “Sense and Reference.” The Philosophical Review 5 (3): 209–230. https://doi.org/10.2307/2181485.

Glackin, Shane. 2017. “Individualism and the Medical: What About Somatic Externalism?” Analysis 77 (2): 287–293. https://doi.org/10.1093/analys/anx073.

———. 2021. “Infinity, Technology, Degeneracy: A Note on Werkhoven’s Dispositional Theory of Health.” British Journal for the Philosophy of Science 72 (3): 797–806. https://doi.org/10.1093/bjps/axz033.

———. 2025. “Disease Externalism.” In The Oxford Handbook of Philosophy of Medicine, edited by Alex Broadbent. Oxford University Press.

———. Forthcoming. “Stakeholding and Social Construction in Medicine.” Journal of Medicine and Philosophy.

Griffiths, Paul E., and Richard D. Gray. 1997. “Replicator II: Judgment Day.” Biology and Philosophy 12 (4): 471–492. https://doi.org/10.1023/A:1006551516090.

Griffiths, Paul E., and Robin D. Knight. 1998. “What Is the Developmentalist Challenge?” Philosophy of Science 65 (2): 253–258. https://doi.org/10.1086/392636.

Griffiths, Paul E., and Stefan Linquist. 2024. “The Distinction Between Innate and Acquired Characteristics.” In The Stanford Encyclopedia of Philosophy (Fall 2024 Edition), edited by Edward N. Zalta and Uri Nodelman. https://plato.stanford.edu/archives/fall2024/entries/innate-acquired/.

Hoffman, Ginger A. 2016. “Out of Our Skulls: How the Extended Mind Thesis Can Extend Psychiatry.” Philosophical Psychology 29 (8): 1160–1174. https://doi.org/10.1080/09515089.2016.1236369.

Janeway, Charles A, Jr. 2001. “How the Immune System Protects the Host From Infection.” Microbes and Infection 3 (13): 1167–1171. https://doi.org/10.1016/s1286-4579(01)01477-0.

Kitcher, Philip. 2001. “Battling the Undead: How (and How Not) to Resist Genetic Determinism.” In Thinking About Evolution: Historical, Philosophical and Political Perspectives (Festschrift for Richard Lewontin), edited by Rama S. Singh, Costas B. Krimbas, Diane B. Paul, and John Beatty, 396–414. Cambridge University Press.

Kripke, Saul. 1980. Naming and Necessity. Harvard University Press.

Krueger, Joel. 2020. “Schizophrenia and the Scaffolded Self.” Topoi 39: 597–609. https://doi.org/10.1007/s11245-018-9547-3.

Levy, Neil. 2013. “Addiction Is Not a Brain Disease (and It Matters).” Frontiers in Psychiatry 4: article 24. https://doi.org/10.3389/fpsyt.2013.00024.

Marcus, Ruth Barcan. 1961. “Modalities and Intensional Languages.” Synthese 13: 303–322. https://doi.org/10.1007/BF00486629.

Müller, Gerd B. 2007. “Evo–Devo: Extending the Evolutionary Synthesis.” Nature Reviews Genetics 8 (12): 943–949. https://doi.org/10.1038/nrg2219.

Oyama, Susan. 1985. The Ontogeny of Information. Cambridge University Press.

Pigliucci, Massimo. 2007. “Do We Need an Extended Evolutionary Synthesis?” Evolution 61 (12): 2739–3011. https://www.jstor.org/stable/4627087.

Pradeu, Thomas. 2012. The Limits of the Self: Immunology and Biological Identity. Oxford University Press.

Putnam, Hilary. 1975. “The Meaning of ‘Meaning’.” Minnesota Studies in the Philosophy of Science 7: 131–193. https://hdl.handle.net/11299/185225.

Roberts, Tom, Joel Krueger, and Shane N. Glackin. 2019. “Psychiatry Beyond the Brain: Externalism, Mental Health, and Autistic Spectrum Disorder.” Philosophy, Psychiatry, & Psychology 26 (3): E-51–E-68. https://doi.org/10.1353/ppp.2019.0030.

Russell, Bertrand. 1905. “II. On Denoting.” Mind 14 (4): 479–493. https://doi.org/10.1093/mind/XIV.4.479.

Smith, J.P. 2019. “Where Did the ‘Rectangle Analogy’ Come From and How Compelling Is It?” Medium, blog post, August 8. https://jpsmith-31800.medium.com/where-did-the-rectangle-analogy-come-from-and-how-compelling-is-it-4374755d9c23.

Sneddon, Andrew. 2002. “Towards Externalist Psychopathology.” Philosophical Psychology 15 (3): 297–316. https://doi.org/10.1080/0951508021000006102.

Stein, Dan J., Kris Nielsen, Anna Hartford, et al. 2024. “Philosophy of Psychiatry: Theoretical Advances and Clinical Implications.” World Psychiatry 23 (2): 215–232. https://doi.org/10.1002/wps.21194.

Swiatczak, Bartlomiej, and Alfred I. Tauber. 2020. “Philosophy of Immunology.” In The Stanford Encyclopedia of Philosophy (Summer 2020 Edition), edited by Edward N. Zalta. https://plato.stanford.edu/archives/sum2020/entries/immunology/.

Valles, Sean. 2018. Philosophy of Population Health: Philosophy for a New Public Health Era. Routledge.

Varga, Somogy. 2018. “Embodied Concepts and Mental Health.” Journal of Medicine and Philosophy 43 (2): 241–260. https://doi.org/10.1093/jmp/jhx040.

Ward, Dave, David Silverman, and Mario Villalobos. 2017. “Introduction: The Varieties of Enactivism.” Topoi 36: 365–375. https://doi.org/10.1007/s11245-017-9484-6.

WHO (World Health Organization). 2021. The Life-Course Approach: From Theory to Practice—Case Stories From Two Small Countries in Europe. Copenhagen: WHO Publications. https://www.who.int/europe/publications/i/item/9789289053266.

———. n.d. “Occupational Health.” Health Topics, World Health Organization. https://www.who.int/health-topics/occupational-health.

Wilson, Robert A. 1995. Cartesian Psychology and Physical Minds: Individualism and the Sciences of the Mind. Cambridge University Press.

Zachar, Peter, and Kenneth S. Kendler. 2007. “Psychiatric Disorders: A Conceptual Taxonomy.” American Journal of Psychiatry 164 (4): 557–565. https://doi.org/10.1176/ajp.2007.164.4.557.

Downloads

Published

2025-08-15

How to Cite

Glackin, S. (2025). Externalist Medicine and Externalist Biology. Philosophy of Medicine, 6(1). https://doi.org/10.5195/pom.2025.237

Issue

Vol. 6 No. 1 (2025)

Section

Analysis

License

Copyright (c) 2025 Shane Glackin

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors who publish with this journal agree to the following terms:

  1. The Author retains copyright in the Work, where the term “Work” shall include all digital objects that may result in subsequent electronic publication or distribution.
  2. Upon acceptance of the Work, the author shall grant to the Publisher the right of first publication of the Work.
  3. The Author shall grant to the Publisher and its agents the nonexclusive perpetual right and license to publish, archive, and make accessible the Work in whole or in part in all forms of media now or hereafter known under a Creative Commons Attribution 4.0 International License or its equivalent, which, for the avoidance of doubt, allows others to copy, distribute, and transmit the Work under the following conditions:
    1. Attribution—other users must attribute the Work in the manner specified by the author as indicated on the journal Web site;
    with the understanding that the above condition can be waived with permission from the Author and that where the Work or any of its elements is in the public domain under applicable law, that status is in no way affected by the license.
  4. The Author is able to enter into separate, additional contractual arrangements for the nonexclusive distribution of the journal's published version of the Work (e.g., post it to an institutional repository or publish it in a book), as long as there is provided in the document an acknowledgement of its initial publication in this journal.
  5. Authors are permitted and encouraged to post online a prepublication manuscript (but not the Publisher’s final formatted PDF version of the Work) in institutional repositories or on their Websites prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. Any such posting made before acceptance and publication of the Work shall be updated upon publication to include a reference to the Publisher-assigned DOI (Digital Object Identifier) and a link to the online abstract for the final published Work in the Journal.
  6. Upon Publisher’s request, the Author agrees to furnish promptly to Publisher, at the Author’s own expense, written evidence of the permissions, licenses, and consents for use of third-party material included within the Work, except as determined by Publisher to be covered by the principles of Fair Use.
  7. The Author represents and warrants that:
    1. the Work is the Author’s original work;
    2. the Author has not transferred, and will not transfer, exclusive rights in the Work to any third party;
    3. the Work is not pending review or under consideration by another publisher;
    4. the Work has not previously been published;
    5. the Work contains no misrepresentation or infringement of the Work or property of other authors or third parties; and
    6. the Work contains no libel, invasion of privacy, or other unlawful matter.
  8. The Author agrees to indemnify and hold Publisher harmless from Author’s breach of the representations and warranties contained in Paragraph 6 above, as well as any claim or proceeding relating to Publisher’s use and publication of any content contained in the Work, including third-party content.
  9. The Author agrees to digitally sign the Publisher’s final formatted PDF version of the Work.