Klaus Michael Meyer-Abich: Was es bedeutet, gesund zu sein. Philosophie der Medizin

There is no doubt that occidental conceptions of health and disease harbour Cartesian assumptions thus unfolding far-reaching social and political implications. In accordance with the opinion of medical historians, ethicists and epistemologists, the dualistic image of humanity (Menschenbild) exerted a determining impact on medical science and practice most notably since the dissemination of Descartes’ philosophy. Hallmark of this insight is the partition of body and mind that is grounded on the distinction between two fundamental substances: res extensa and res cogitans. The former stands for moved material of the outside-world, the latter for the immaterial inner-world, thus reducing the body-world to a pure extensional dimension as deduced from a conception aligned on physical principles. In his mechanistic physiology, Descartes compares man with a machine animated with spirit. Accordingly, the immaterial res cogitans corresponds to human consciousness, encompassing man’s capability of reasoning. This radical differentiation between two substances, identified to be constitutional for human beings, leads towards the unsolved question about the nexus between such exceptionally divergent materials—namely the claim of a conclusively substantiated explanation of the body and soul interaction. Descartes in turn assumes that the physical connection between these different structures is represented through the glandula pinealis—which he asserts to be the principal site of the soul—allowing the interaction of the brain (mind) with the body. Subsequently, the inherent systematic argumentative inconsistency of this theory stipulates the advancement of alternative explanatory models, that successively have been evolved by representatives of different Cartesian currents (e. g. occasionalists, interactionists). The implementation of the dualistic principle in contemporary medical science becomes particularly evident in the fields of molecular genetics or neuroscience. A characteristic feature of modern scientific approach is the reconstruction of cause