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THE FACTORY MODEL OF DISEASE * * * * * * Neil E. Williams (University at Buffalo) Philosophy of Biology Symposium Septe PowerPoint Presentation
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THE FACTORY MODEL OF DISEASE * * * * * * Neil E. Williams (University at Buffalo) Philosophy of Biology Symposium September 29 th 2007. Three Aims of this Presentation:. Primary Aim: Suggest a new metaphor for thinking about disease. Germ Theory of Disease. Attack by Foreigners.

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THE FACTORY MODEL OF DISEASE* * * * * *Neil E. Williams (University at Buffalo) Philosophy of Biology SymposiumSeptember 29th 2007

three aims of this presentation
Three Aims of this Presentation:

Primary Aim:

Suggest a new metaphor for thinking about disease

germ theory of disease
Germ Theory of Disease

Attack by Foreigners

germ theory of disease4
Germ Theory of Disease

Useful in 19th Century; now antiquated

Misses out on a great number of diseases:

genetic diseases, immune system diseases, nutritional deficiencies, mental illnesses

three aims of this presentation5
Three Aims of this Presentation:

Primary Aim:

Suggest a new metaphor for thinking about disease

Secondary Aims:

Reconsider the place of causation in disease

Offer a refurbished analysis of ‘disease’

plan of attack
Plan of Attack

1 - Distinguish diseases from disorders

2 - Standards for structure

3 - Causes and Cellular Processes

4 - The Factory Model

5 - Disease Re-Defined

slide8
Part of establishing a clear understanding of disease requires distinguishing cases of disease from non-disease
  • This helps restrict the class of diseases, but will also provide a parallel framework against which disease can be understood
slide9
Because ‘disease’ has long been treated as the ‘absence of health’, there has been a tendency to lump in all sorts of medical conditions under a the general name ‘disease’

Broken Arms

Hernias

Ingrown Toenails

Gall Stones

Color-blindness

disorders
Disorders
  • By ‘disorder’ I will understand a purely structuraldeviation from the norm
  • ‘Structure’ is an anatomical catch-all including: topography, shape, proportion and number
  • Determination of disorder is independent of cause and of need for medical attention
slide12
Disorders are bodily states of anatomical abnormality
  • They are deviations—as such they arise against a backdrop of structural normality
  • But what is normal?
slide13
Within comparison classes we find a high degree of structural similarity
  • This allows us to determine statistical averages that determine a standard (Foundational Model of Anatomy – Rosse and Mejino 2003)
  • Comparison is made against that standard
the canonical skeleton
The Canonical Skeleton
  • An excellent case concerns the human skeleton
  • The canonical skeleton is part statistical average, part prototype, so is insensitive to minor contingent peculiarities
  • Canonical is not ideal (ideal for what?)
  • Consider the IRS’s concept of average tax payer: it is not merely a numerical average
slide15
Other disorders are modeled on the skeletal case: musculature, cells, organs, vascular system
  • We have excellent information about human biological architecture
  • Borderline cases come out in the wash (medical practitioners are highly successful at recognizing and naming what I have called ‘disorders’)
slide16
The general model of deviation as it pertains to disorder will be used in the consideration of disease
  • Disorder concerns bodily structure; disease concerns cells and cellular processes
  • Disease will be defined against a backdrop of standard processes of cellular interation
cells as power centres
Cells as ‘Power-Centres’
  • Every cell has, as part of its biological programming, a vast range of capacities
  • The causal ‘preparedness’ of the cell includes instructions for what to do in the presence or absence of various molecules and other cells
  • Most responses are homeostatic and fall within a limited range
slide19
Due to contingent features, only a small number of these capacities are ever exercised
  • Cells are not agents: responses are programmed
  • Typically stable environments makes for routine cellular responses
slide20
Cellular environments include various chemicals, but also other cells
  • Cells operate reciprocally with other cells
  • Cells individually contribute to what are mutual effects
  • These co-operative interactions make for cellular networks
slide22
We can think of the actions of the cell within a cellular network (or within the body as a whole) as analogous with the place of the assembly-line factory worker within the factory
simple tasks complex results
Simple Tasks; Complex Results
  • Humans owe their biological complexity and adaptive success to the same features that make assembly-lines so good for output:

Division of labour

Specialized tasks

Bringing work to the worker

slide25
But just like the factory worker, that a cell performs a specific role does not mean it is not capable of far more
  • Cells can be re-assigned within the body to perform different tasks, just like a factory worker who labels bottles can be asked to cap them instead
slide26
Reflecting on the cell/factory worker analogy, we can get a rudimentary sense of the account of disease on offer when we imagine some ways how things might go wrong at the factory
  • the method of breakdown or cessation of factory production is akin to distortions of typical cellular processes, and those distorted processes will constitute diseases
trouble at mill
Trouble at Mill?

1 – Problems internal to the worker

Shirley is sick, hungry, confused

2 – Problems within/across Co-workers

Laverne is angry, jealous, confused

3 – Lack of Resources

4 – Lack of Power

5 – Assembly line blockages

trouble at cell
Trouble at Cell?

1 – Problems internal to the cell

Cell cannot operate; instructions

2 – Problems within/across cells

Miscoding; chemical issues

3 – Lack of Resources

4 – Lack of Energy

5 – Physical Occlusions

disease or disorder
Disease or Disorder?
  • You may have noted that some of the problems are themselves disorders
  • The disorder is not the disease, but could be a cause
  • As might be expected, disorders can give rise to distorted cellular processes, thereby resulting in diseases (and diseases might give rise to disorders)
disease or symptom
Disease or Symptom?
  • Mistaking disorders for disease is akin to mistaking symptoms for diseases
  • A symptom is something that arises because of a disease, but is not the disease itself
  • It can serve as an indicator of a disease
slide32
x is a disease =dfx is

a prolonged distortion of cellular network processes, wherein the activities of the network:

(i) fall outside an acceptable normal range for the organism’s comparison class,

slide33
x is a disease =dfx is

a prolonged distortion of cellular network processes, wherein the activities of the network:

(ii) are not capable of remedy by the system itself without thereby distorting the activities of some other network, and

slide34
x is a disease =dfx is

a prolonged distortion of cellular network processes, wherein the activities of the network:

(iii) tend to reduce the organism’s ability to cope with environmental pressures