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The name of the game: a Wittgensteinian view of ‘invasiveness’
  1. Stacy S Chen1,2,
  2. Connor T A Brenna3,4,5,
  3. Matthew Cho5,
  4. Liam G McCoy6,
  5. Sunit Das5,7,8
  1. 1 Department of Philosophy, University of Toronto, Toronto, Ontario, Canada
  2. 2 Joint Centre for Bioethics, University of Toronto, Toronto, Ontario, Canada
  3. 3 Department of Anesthesiology & Pain Medicine, University of Toronto, Toronto, Ontario, Canada
  4. 4 Department of Physiology, University of Toronto, Toronto, Ontario, Canada
  5. 5 Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
  6. 6 Department of Neurology, University of Alberta, Edmonton, Alberta, Canada
  7. 7 Centre for Ethics, University of Toronto, Toronto, Ontario, Canada
  8. 8 Keenan Chair in Surgery, Division of Neurosurgery, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Stacy S Chen, University of Toronto Department of Philosophy, Toronto, Canada; stacysi.chen{at}

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In their forthcoming article, ‘What makes a medical intervention invasive?’ De Marco, Simons, and colleagues explore the meaning and usage of the term ‘invasive’ in medical contexts. They describe a ‘Standard Account’, drawn from dictionary definitions, which defines invasiveness as ‘incision of the skin or insertion of an object into the body’. They then highlight cases wherein invasiveness is employed in a manner that is inconsistent with this account (eg, in describing psychotherapy) to argue that the term invasiveness is often used to explicitly or implicitly reference interventions that do not fall under the standard account. The authors offer an alternative ‘schematic’ definition of invasiveness, whereby medical interventions entail an underlying context-independent property of ‘basic invasiveness’ and may be understood both relative to each other and to a context-specific threshold of what is ‘invasive’.1

We propose that the meaning of terms such as ‘invasiveness’ is necessarily heterogeneous, and that what is implied by its usage will certainly depend on context, particularly in medical settings. Hence, the creation of a unifying definition is less critical than clarification of the implied and intended meanings of each instance of the term’s use. We further argue that interpreting the use of terms like ‘invasiveness’ in medical practice is complicated by the embedding of each use of this term in a different ‘language game’, whereby words and their meanings are understood by an in-group familiar with …

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  • Twitter @CTA_Brenna, @liamgmccoy

  • Contributors SSC devised the project with help from CTAB and SD and feedback from MC and LGM. SSC led discussions on the content of the manuscript with help from CTAB and contributions from CTAB, MC, LGM and SD. SSC, CTAB, MC and LGM wrote the manuscript together, which was subsequently edited by SSC with help from CTAB, MC, LGM and SD.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests SSC, CTAB, MC, and LGM have nothing to declare. SD declares the following: SD is a speaker for the American Association of Neurological Surgeons and Congress of Neurological Surgeons. He serves as the Provincial Lead for CNS Oncology at Ontario Health (Cancer Care Ontario). His laboratory receives funding from Alkermes. He is on the advisory board of the Subcortical Surgery group and XPan Medical. He receives royalties from Oxford University Press.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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