Philosophy 3300:
Philosophy of Medicine
Fall, 2025

Professor Joel Velasco
Office: 251C (Humanities building)
Office Hours: Tu, Th, F 11-12:00 or by appointment

Class meets T, Th, 9:30-10:50 (in HUMA 350)

All of the boilerplate information such as course policies and the grading scheme can be found on the syllabus. The readings for the course are below.

Syllabus (updated Sept 19)

Required Books:

Care and Cure: An Introduction to Philosophy of Medicine by Jacob Stegenga. The University of Chicago Press, 2018.

All class assignments and any other readings will be found on this website. You should check this website reguarly for updates and bring copies of the assigned readings to class. All readings should be done before the date they are listed here. Come to class on that day prepared to discuss them.

This is a tentative schedule/reading list:

Week 1 - Introduction, Health and Disease

Tue, 8/26
- Introduction
Thur, 8/28
- Boorse, Health as a theoretical concept
Extras
- Concepcion, How to read philosophy (the appendix especially)

Week 2 - Conceptual Issues in Medicine - Health and Disease

Tue, 9/2
- Care and Cure, Ch1 and Ch2
Thur, 9/4
Extras:
- Watch: Diagnosis, Season 1, Episode 1 [Netflix]
- Kingma, What is it to be healthy? (critical of Boorse)
- Hausman, Health and functional efficiency (defends Boorse)
- Wakefield, The biostatistical theory versus the harmful dsyfunction analysis
- Boorse, Wakefield's harm-based critique of the biostatistical theory
- Alexandrova, Can the science of well-being be objective?
- Cooper, Disease
- Ereshefsky, Defining 'health' and 'disease'
- Kukla, What counts as a disease and why does it matter?
- Engelhardt, The disease of masturbation: values and the concept of disease
- Amundson, Against normal function

Week 3 - Death

Tue, 9/9
- Visit from Dr. Brad Snodgrass
Thur, 9/11
- Care and Cure, Ch 2.4, 2.5
- Care and Cure, Ch 3
Extras:
- Barclay, (editorial introduction) - guidelines for the determination of death
- President's commission (appendix) - guidelines for the determination of death
- Nagel, Death
- McMahan, The metaphysics of brain death
- Meier, The demise of brain death
- President's Commission (full report) - Defining Death
- Thomson, A defense of abortion
- Marquis, Why abortion is immoral

Week 4 -

Tue, 9/16
- de Georgia, History of Brain Death as Death: 1968 to the present
- Kozlov, The Battle Over How to Redefine Death
- Terry Schiavo documentary (13 min on Youtube)
Thur, 9/18
- Silvers, Disability and Normality
Extras:
- Amundson, Against normal function
- Barnes, Disability, Minority, and Difference
- Dennis, Deaf by design
- Mundy, A world of their own (about parents who want their child to be deaf)
- Crimp Camp - documentary about disability on Netflix

Week 5 -

Tue, 9/23
- Debate 1 - naturalism vs. normativism about health and disease
- Reflection assignment (due Thur)
Thur, 9/25
- Care and Cure, Ch 6
Extras:

Week 6 -

Tue, 9/30
- Why we crave (from Aeon)
- Foddy, Addiction and its sciences-philosophy
Thur, 9/2
- Exam 1 - in class
- Topics/terms to study for review
Extras:
- Flanagan, What is it like to be an addict (this is a paper - also see his book of the same title)

Week 7 - Evidence in Medicine

Tue, 10/7
- Hill, The environment and disease: Association or causation?
Thur, 10/9
- Care and Cure, Ch 9
- Mathematical examples and notes from class
Extras:
- Doll and Hill, Smoking and Carcinoma of the Lung
- Hempel, Sammelweis story (beginning of chapter 2 of The Philosophy of Natural Science)

Week 8 -

Tue, 10/14
- Gigerenzer et al. Helping doctors and patients make sense of health statistics (I'll print out parts to work through in class)
- The covid vaccine study we looked at
Thur, 10/16
- Care and Cure, Ch 7
- Bayes' Theorem examples
Extras:
- Gigerenzer et al. Helping doctors and patients make sense of health statistics
- The new math of clinical trials (the Bayesian doctor)
- Hacking, Odd questions + Bayes Rule

Week 9 -

Tue, 10/21
- Care and Cure, Ch 7
- Care and Cure, Ch 10 (just start?)
Thur, 10/23
- Care and Cure, Ch 10
- BBC documentary: Placebo effect and knee surgery (youtube)
Extras:
- One big myth about medicine: We know how drugs work (Washington Post)
- Cartwright, Are RCTs the gold standard?
- Cartwright, A philosopher's view of the long road from RCTs to effectiveness
- Worrall, Evidence in Medicine and Evidence-Based Medicine
- La Caze, The randomized controlled trial: Internal and external validity
- Worrall, Homeopathy and evidence-based policy (blog post)
- Worrall, The placebo effect and evidence-based policy (blog post)
- Worrall, The ethical homeopathic placebo (blog post)
- Science Daily: Study finds common knee surgery no better than placebo
- Moseley et al. A Controlled Trial of Arthroscopic Surgery for Osteoarthritis of the Knee
- Stegenga, Medical Nihilism and Gentle Medicine (youtube video)
- Stegenga's book - Medical Nihilism (on Canvas)
- Review of Stegenga's book Medical Nihilism

Week 10 - Diagnosis and Screening

Tue, 10/28
- Care and Cure, Ch 11
Thur, 10/30
- Care and Cure, Ch 12
Extras:
- Quanstrum and Hayward, Lessons from the mammography wars
- Plutynski, Ethical issues in cancer screening and prevention
- Plutynski, Safe or Sorry? Cancer Screening and Inductive Risk
- Welch and Black, Overdiagnosis in Cancer

Week 11 -

Tue, 11/4
- In class debate on Medical Nihilism
- Reflection assignment (due Friday)
Thur, 11/6
- In class quiz on correlation, risk, and bayes's theorem
- Quiz answers
- Tsou, Natural Kinds, psychiatric classification, and the history of the DSM
Extras:
- Hacking, Madness: Biological or Constructed? (from The Social Construction of What?) - on Canvas
- Wakefield, The concept of mental disorder
- Shapin, Seeing the Spectrum (The New Yorker)

Week 12 - Philosophy of Psychiatry

Tue, 11/11
- Szasz, The myth of mental illness
- Garson, Madness-as-strategy
Thur, 11/13
- In class exam
- Study guide for exam
Extras:
- Targeted (Aeon article by Justin Garson)

Week 13 - Race in Medicine

Tue, 11/18
- AABA statement on race and racism
- Metaphysics textbook introductory chapter on the philosophy of race (by Alyssa Ney and Allan Hazlett)
Thur, 11/20
- AMA: Racism is a threat to public health
- Burchard et al., The Importance of Race and Ethnic Background in Biomedical Research and Clinical Practice
- Roberts, Is race based medicine good for us?
- Vyas et al., Hidden in Plain Sight — Reconsidering the Use of Race Correction in Clinical Algorithms
Extras:
- What is race?
  - Extra readings, slides, and video discussions and interviews on 'What is race' and 'Race and Biology'
- Race in Medicine?
  - Dorothy Roberts, The problem with race-based medicine (video)
  - Roberts, Abolish race correction
  - Velasco and Snodgrass, The Use of Race in eGFR: Why Racial Justice Requires Accuracy
  - Satel, I am a racially profiling doctor (New York Times Magazine)

Week 14 - Debate - Race in Medicine

Tue, 11/25
- In class debate - race in medicine
- Debate reflection assignment (due next Tuesday)
Thur, 11/27
- No class - Thanksgiving
Extras:

Week 15 -

Tue, 12/2 - last day of class

Race in Medicine discussion

Extras:

Individual presentations - Saturday, Dec 6th 10:30am-1:00pm