Thanks for alerting me to this. Its taken me ages to post about it, because every time I tried to wade through this word stew, I lost heart, and decided to do something else.
Just a quick scan through the paper and I see a lot of what I call "red flags":
Citations to authority: Claims or statements of opinion followed by some sort of citation designed make it look "valid" or at the very least "scholarly". Often the cited text turns out to have nothing to do with the current claim. But even when it does, this is still academic sleight of hand, imo.
In my view, when you cite work, you should specify the
function of the citation - whether it is to empirical work that reports the outcome being discussed, or to a previously proposed idea or argument or theory.
Name dropping. When you mention someone by name in the text, when it does not advance your argument in any way. The purpose is to make your work look erudite. e.g. "‘the principle of empiricism’—formulated by John S Mill and taken up, among others, by William James and Karl R Popper..."
Red flag words: Words that sound good but are not easily defined, and serve largely to beautify the text and make the writer appear erudite. They can also be used to obfuscate. e.g., intersubjectively, hermeneutic-normative.
Pretty sentences that are so vague their claims cannot be put to any sort of test, not even a logical one. Some examples below.
I was going to try to translate each claim into plain English, and then speak to it, but some statements are not easy to pin down. Whether by design or accident, I don't know. Here's what I mean (my bolding):
... if we want to have an
intersubjectively testable notion of health and sickness (where ‘sickness’ and ‘health’ are understood as antonyms), there must be some
intersubjectively testable path leading from illness to the remaining causal network of all our experiences (including the aspects of reality perhaps ‘abstracted’ as a disease). In fact, ‘unwarranted causal assumptions’ would give up ‘the principle of empiricism’—formulated by John S Mill and taken up, among others, by William James and Karl R Popper—according to which observation and experimentation are the only sources of evidence relevant for the acceptance or rejection of empirical statements. Moreover, in spite of Sharpe and Greco’s fierce rejection of ‘the dualist logic on which the illness/disease distinction is premised’,
7 their concept of an ‘illness without disease’ mistakenly suggests
entities that could exist independently from each other.
What do they mean by an
"intersubjectively testable notion"? What do they mean by a notion even? Is it an explanatory theory?
What does it mean to say this "notion" needs to be "testable"? If you mean an explanatory theory from which we can derive testable predictions, then say that.
In what way is "intersubjectively testable" different from just "testable"? You mean not made up in your head? That's almost a given, is it not?
And finally, what is an "
intersubjectively testable path leading from illness to the remaining causal network of all our experiences"? Is that a causal model of the illness experience that includes every damn thing the person has experienced, every way in which their body has failed them, and everything in between? A model for each person? Good luck with that.
And finally what are these "
entities" that S&G mistakenly suggest can exist independently of each other? Is this about S&G's claim that some "sicknesses" can be mainly or even entirely caused by psychosocial factors? Then why not just say that?
In our opinion, Sharpe and Greco’s concept of ‘illness without disease’ helps to clarify and promote the relative or, better, methodological autonomy and dignity of the clinical or psychosocial dimension of health and sickness, which recommends forms of treatment that may unjustly ‘appear disappointingly insufficient at best and positively threatening at worst’.
"methodological autonomy and dignity?" Wtf is "methodological dignity"? Do you mean that you should treat
individuals with dignity? Then say that. How can some
methodologies be more dignified than others? Honestly.
What the *** does "
the clinical or psychosocial dimension of health and sickness" mean? It sounds so lovely and sensitive. But what exactly is the claim? Is it a causal one? That thoughts, feelings, or social contexts can somehow play a causal role in "sickness", and addressing them can ameliorate or even cure "sickness"? If so, then you would have to make the argument based on the case or condition, based on evidence (don't think psychosocial interventions are much use if you have ebola, or if your head has been severed from your body).
Or is the claim merely that sickness impacts on people's thoughts, feelings and social circumstances, and those effects can be unpleasant in their own right? The difference in these two claims is huge, and have entirely different implications for the sorts of interventions they support.
However, while we accept that both the experience of illness and what is usually called disease are ‘abstractions’, this is not enough. It is still necessary to raise the question of the relationship both between such abstractions and between them and the rest of reality, clarifying how abstractions thus conceived are connected, at least in principle, in an intersubjectively reproducible and testable way.
Hmmm
... (Sharpe and Greco)... ought to provide a clear view about the causal relationship that exists between the different results of our abstractions, and especially between, on the one hand, the experience of illness, and on the other, that aspect of reality which is usually referred to as ‘disease’, which always includes in some sense an organic correlate....
What a merry verbal dance. They are trying not to say "organic disease", because it is so "dualistic", so they thought they'd better cover it up a bit.
That said, however, we must add that Wilshire and Ward cannot accommodate one of the most important claims made by Sharpe and Greco, namely, that
what is usually designated as the subjective, or better hermeneutic-normative, dimension of health is relatively autonomous... the general model defended by Wilshire and Ward seems to implicitly assume a one-sided conception of causality,
10 that is, a unique direction of the causal vector, from organic reality to subjective lived experiences, excluding the possibility of the opposite flow.
Putting aside the red flags here, they seem not to understand that a model of causation need not be "organic". What does that even mean? The very word is founded on dualistic assumptions. Instead, our model proposes that causal explanations can be phrased at any level of description - including the social and the psychological - and the choice of level is determined by its usefulness at capturing the key causal mechanisms. We simply don't think psychologically phrased causal claims should be made as a default position, but rather that they should be supported by positive evidence - just as is the case with any other causal claim.
The bit below is a reference to our 3-catoegory framework for understanding causation in health and medicine
The third type of model is the most perplexing. It does not contain causal ascriptions, making it different from the other two kinds of model. This suggests that any purely subjective illness must be forever located in the third class as a collection of symptoms, as a merely provisional classification indexed to the current state of biomedical research, which, no doubt, will find, sooner or later, an underlying cause.
Yes, any "purely subjective illness" for which we have no evidence to support a causal explanation is - by definition - an illness for which we have no causal explanation. It is incorrect to insert the word "biomedical" into our argument, we make no claim that the causal evidence
needs to be biological. Our examples are designed to illustrate the problems with positing a psychological cause based merely on the absence of evidence for other causal mechanisms. They are rather persuasive there.
(continued from quote above) ...symptoms should be so placed and understood within a causal network of connections to allow them to be considered just as real as their possible empirical-organic correlates
Do we really need to spell this out? Psychosis is in this third category. Bipolar is in there. Are we claiming that just because they are not explained yet, that they are not real? What a massive straw man! As for "forever located", I think those doing excellent work on these conditions might be a little insulted by that!
Okay, I've lost patience, so will stop there - and maybe have a go at the remaining bits of the paper another day.
