Sarah Yvonnet I am a postdoc at Medical Museion and Novo Nordisk Foundation Centre for Basic Metabolic Research (CBMR). I have a background in biology and philosophy. I am currently working with Associate Professor Karin Tybjerg on a project called “Between Knowing and Doing”, which you will know more about with this blogpost.
Being diagnosed is something that most people will experience at some point in their life. When people fall sick, they will go to the doctor in the hope of getting a diagnosis that will help explain the cause of their symptoms, identify a treatment, and sometimes provide insights into the likely evolution of the disease. But despite its apparent simplicity, the concept of diagnosis raises several important philosophical questions. For example, diagnoses serve different purposes (they can be used to explain a disease, to give a prognosis or a therapeutic indication, or as a classificatory criterion in an institutional/legal setting) across different contexts (for research purposes or clinical practice). Diagnoses also very often evolve through time – both at the level of the individual (with the evolution of the patient’s disease through time) but also as classificatory systems that tend to follow the developmentof our scientific knowledge. Finally, diagnoses are boxes or categories that raise questions about how we set boundaries between different conditions and what we do about patients falling in between our outside of the established categories. Therefore, diagnosis is a highly intriguing topic for philosophers.
The project “Between Knowing and Doing” is a collaboration between researchers at Medical Museion and the Novo Nordisk CBMR that combines the fields of philosophy, basic science, and clinical practice. The project aims to follow the emergence of diagnostic categories in the making across the lab and the clinic and to observe the links between biomolecular research and clinical medicine. It mainly focuses on Type 2 diabetes (T2D) and obesity. Both conditions are considered as one of the major public health challenges of our societies and research increasingly shows that the mechanisms of both conditions are highly complex, involving multiple factors including genetics and the environment. Despite this, the way to diagnose and classify them mainly relies on a simple threshold: in the case of obesity, a Body Mass Index over 35, and in T2D, a fasting blood glucose level over 126 mg/dL. These simple measure mean that both conditions are associated with a highly heterogeneous group of patients, different clinical manifestations of the condition, and different responses to their assigned treatment. Refining obesity and T2D categories has thus become an important goal for biomedicine to connect a better understanding of biological mechanisms behind those diseases, capture heterogeneity in patient groups and hopefully improve clinical management of the disease.
To better understand the interactions between clinical diagnoses and research categories, we will draw on the method of Philosophy of Science in Practice. We will conduct interviews and field observations to actively engage with scientists and clinicians about philosophical questions relating to their work. The project is a unique and exciting opportunity to bring together philosophers and historians from Medical Museion with researchers and clinicians working at or with CBMR. It will generate a dynamic interdisciplinary environment that can both cast light on how scientific knowledge takes form in practice and engage with science in the conceptual, analytical, and interpretative level.
Just like diagnoses and classifications transgress contexts, we aim to transgress disciplinary boundaries by bringing together different researchers and practioners to better understand how new diagnostic categories emerge.
