Autopoiesis and organ intelligence: toward a cognitive paradigm in medicine
Department of Cardiothoracic and Vascular Surgery, Westpfalz Klinikum, Kaiserslautern, Germany
Second Department of Surgery, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
Department of Cardiothoracic Surgery, Faculty of Medicine, University of Thessaly, Biopolis, Larissa, Greece
Department of Cardiac Surgery, Ippokrateio General Hospital of Athens, Athens, Greece
Department of Oncology, General University Hospital of Patras, Greece
Department of Urology, General Hospital of Eastern Achaia-Unit of Aigio, Aigio, Greece
Department of Urology, General University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
Department of Urology, University of Patras, Greece.
Department of Vascular Surgery, General University Hospital of Patras, Greece
Department of Radiology, General University Hospital of Patras, Patras, Greece
Medical School, National and Kapodistrian University of Athens (NKUA), Aretaeion Hospital, Athens, Greece
First Department of Otolaryngology, Hippokration General Hospital, National and Kapodistrian University of Athens, Athens, Greece
First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
Laboratory of Bioethics, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
Modern medicine has been dominated by a neurocentric paradigm that locates cognition exclusively in the brain and treats organs as passive executors of function. Emerging evidence from biology and medicine challenges this view, suggesting that living systems are autopoietic and that organs such as the heart and gut, and the immune system exhibit forms of intrinsic intelligence. This article explores the conceptual foundations and clinical implications of cognitive biology, with particular emphasis on autopoiesis and distributed organ cognition, as a framework for rethinking health, disease, and medical practice. A narrative review was conducted, integrating key contributions from systems theory, cognitive biology, and philosophy of biology with empirical findings from cardiology, gastroenterology, immunology, oncology, and psychoneuroimmunology. Representative case studies and biomedical evidence were selected to illustrate how autopoietic and cognitive principles manifest in clinical contexts.
Keywords
cognitive biology, autopoiesis, organ intelligence, distributed cognition, systems medicine, clinical epistemology
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