Breast Cancer Prevention: Angelina Jolie and US Health Care

Around 1981, one of my aunts, a pediatrician and physiatrist who is now retired, had a prophylactic bilateral mastectomy, after a second of her four sisters was found to have breast cancer.

Now Angelina Jolie has announced that she decided to do the same, due to having the BRCA1 gene. The autosomal dominant BRCA1 and BRCA2 genes cause a 60 percent risk of breast cancer and also increase the risk of other cancers. See this link from the National Cancer Institute.

What do Angelina Jolie and my aunt (whose name rhymes with Angelina's) have in common as well? They were able to afford surgery that their insurance did not pay for. Currently, Medicare will not cover even the DNA test for BRCA1, much less the prophylactic double mastectomy and the cosmetic bilateral breast implants.

Vireya rhodedendrons

I took these photos earlier this week.  Our vireya rhodedendrons have started flowering again, after a winter's rest.



Natural Kinds, Complexity, and the Particular: Part I


I've recently read Manuel DeLanda's book Intensive Science and Virtual Philosophy (2005).  Recommended. I've been intrigued by how differently Aristotle and DeLanda consider formal causation as a shaping principle in biology.

For the traditional Aristotelian or Thomistic essentialist (AT-E), living things are a combination of matter and form, with the form determining the essence of the living individual, its natural kind.  The form of that individual living substance is the same between individuals of that species, which otherwise may differ in their accidental, non-essential properties. For the AT-E, the mind understands the nature of that species by abstraction within the mind's thoughts, which comes to hold (as a mental property) the same form that makes individuals of that species the species which they are. Thus, for the AT-E, mental representation captures the true or natural essence of the species, its eternal form.

Though useful for taxonomy of species, there was an unfortunate sterility of the AT-E idea of substance when it came to scientific progress which led to its total abandonment in modern biology. The problem was the tendency for the AT-E philosopher's investigation to end once a satisfactory species definition was decided. The essence of a species, to the AT-E theorist, could be completely captured in a concept that is adequate to separate that species from other species.  Thus, the essence of humanity is captured in "rational animal" and the essence of animal itself is that of a mobile life form. Once defined, these concepts tended to be used to represent the species itself, and the other, often unique characteristics of the species were regarded as mere unimportant "accidents." Yet much of modern biology's success lies in its systematic investigation of what are unessential properties to the AT-E theorist. For example, human DNA and its difference from the DNA of, say, a plant, might be a mere distraction from the more important study of essences to the AT-E theorist, yet many useful technologies in modern life depend upon our understanding of the (unimportant to the A-T metaphysician) accident of differences in DNA.

Lest the reader think I am criticizing a mere straw-man position for the AT-E theorist, let me quote Oderberg, a current AT-E philosopher, on the classification of things such as motile bacteria and intelligent non-humans. First, "Secondly, all motile bacteria and archaea, whatever their relation to the kingdom Animalia and whatever their differences from each other, are animals: they can sense their environment and they can move themselves" (David S. Oderberg, Real Essentialism, p. 190). Second, according to Oderberg, "any truly rational animal, if such were metaphysically possible, would still be human" (Oderberg, p. 104).

Why is this disturbing? Oderberg is letting his definitions govern his science instead of using science to better guide his definitions. If things are only truly known via their essences, the definition of the essence, once settled upon, becomes more important than the other properties of an individual, which are considered mere accidents.  Eventually, the biology becomes ignored by the definition maker and his followers, who are then falsely secure that the essence of their derived mental representation tells them all that is essential about a living creature. In this way, metaphysics can be seen, even today, to lead to a kind of scientific doldrums, where classification is all that is required for understanding.

Although Deluze and DeLanda admit formal causes, and see them as fundamental to living things, they do so in an entirely different way, one that does not confuse our mental categories of representation with the actual causes of the natural categories of various living things. In DeLanda, the formal cause of a living being (such as a bacterium, for example) is instead a complex, historical entity of many specific factors, which does not resemble our mental representation or definition of the individual bacterium, and which might in some other context (such as in a computer simulation) produce an entirely different kind of thing, which would be similar to the bacterium only in that mathematical models of its systems would be similar. That way is the way of multiplicities, or "concrete universals," which are mathematical manifolds containing attractors which describe tendencies of systems to take a particular state (Manuel DeLanda, Intensive Science and Virtual Philosophy, p. 22).

Because DeLanda's universals incorporate the mathematically based models of much of modern science, they do not seem to invite a stultifying and distorting reliance on classical definitions that bedevils Oderberg's work.

As such, DeLanda's universals are promising as a basis for the causes of emergence in my emergent neutral monist schema.  More on this in a future post.



An alternative to Kim's physicalism

In his book Physicalism, or Something Near Enough , Jaegwon Kim says: The final picture that has emerged is this: P is a cause of P*, wi...