Hostname: page-component-8448b6f56d-qsmjn Total loading time: 0 Render date: 2024-04-23T16:51:34.376Z Has data issue: false hasContentIssue false

Rehabilitating “Disease”: Function, Value, and Objectivity in Medicine

Published online by Cambridge University Press:  01 January 2022

Abstract

The concept of disease remains hotly contested. In light of problems with existing accounts, some theorists argue that the disease concept ought to be eliminated. We answer this skeptical challenge by reframing the discussion in terms of the role that the disease concept plays in the complex network of health care institutions in which it is deployed. We argue that while prevailing accounts do not suffer from the particular defects that critics have identified, they do suffer from other deficits, and this leads us to propose a new account that satisfies the desiderata for a concept of disease in human medicine.

Type
Biological Sciences
Copyright
Copyright © The Philosophy of Science Association

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

The authors would like to thank Marc Ereshefsky, Allen Buchanan, Şerife Tekin, Sune Holm, Steve Clarke, as well as audiences at the PSA 2018, University of Miami, University of Oxford, University at Albany, ester Institute of Technology, and Boston University, for comments on an earlier draft of this manuscript. Scarffe is grateful to the Social Sciences and Humanities Research Council of Canada for support of this research.

References

Amundson, R. 2000. “Against Normal Function.” Studies in History and Philosophy of Biological and Biomedical Sciences 31 (1): 3353..CrossRefGoogle Scholar
Bengt, A. 2019. “Survival, Reproduction, and Functional Efficiency.” Philosophy of Science, in this issue.Google Scholar
Bingham, R., and Banner, N.. 1999. “The Definition of Mental Disorder: Evolving but Dysfunctional?Journal of Medical Ethics 40 (8): 537–42..Google Scholar
Boorse, C. 1977. “Health as a Theoretical Concept.” Philosophy of Science 44:542–73.CrossRefGoogle Scholar
Boorse, C.. 1997. “A Rebuttal on Health.” In What Is Disease?, ed. Humber, J. M. and Almeder, R. F., 3143. Totowa, NJ: Humana.Google Scholar
Buchanan, A., ed. 2001. From Chance to Choice: Genetics and Justice. Cambridge: Cambridge University Press.Google Scholar
Engelhardt, T. 1974. “The Disease of Masturbation: Values and the Concept of Disease.” Bulletin of the History of Medicine 48 (2): 234–48..Google ScholarPubMed
Engelhardt, T.. 1976. “Ideology and Etiology.” Journal of Medicine and Philosophy 1 (3): 256–68..CrossRefGoogle Scholar
Ereshefsky, M. 2009. “Defining ‘Health’ and ‘Disease.’Studies in History and Philosophy of Biological and Biomedical Sciences 40 (3): 221–27..CrossRefGoogle Scholar
Goosens, W. 1980. “Values, Health, and Medicine.” Philosophy of Science 47 (1): 238–55..CrossRefGoogle ScholarPubMed
Hausman, D. M. 2011. “Is an Overdose of Paracetamol Bad for One’s Health?British Journal for the Philosophy of Science 62 (3): 657–68..CrossRefGoogle Scholar
Hausman, D. M.. 2014. “Health and Functional Efficiency.” Journal of Medicine and Philosophy 39 (6): 634–47..CrossRefGoogle ScholarPubMed
Hausman, D. M.. 2015. Valuing Health: Well-Being, Freedom, and Suffering. Oxford: Oxford University Press.Google Scholar
Hull, D. 1986. “On Human Nature.” Philosophy of Science 2:313.Google Scholar
Kingma, E. 2014. “Naturalism about Health and Disease: Adding Nuance for Progress.” Journal of Medicine and Philosophy 39 (6): 590.CrossRefGoogle ScholarPubMed
Neander, K. 1991. “Functions as Selected Effects: The Conceptual Analyst’s Defense.” Philosophy of Science 58 (2): 168–84..CrossRefGoogle Scholar
Powell, R., and Scarffe, E.. 2019. “Rethinking ‘Disease’: A Fresh Diagnosis and a New Philosophical Treatment.” Journal of Medical Ethics 45 (9): 579–88..CrossRefGoogle Scholar
Roache, R., and Savulescu, J.. 2018. “Psychological Disadvantage and a Welfarist Approach to Psychiatry.” Philosophy, Psychiatry and Psychology 25 (4): 245–59..CrossRefGoogle Scholar
Tekin, S., and Mosko, M.. 2015. “Hyponarrativity and Context-Specific Limitations of the DSM-5.” Public Affairs Quarterly 29 (1): 109–34..Google Scholar
Wakefield, J. 2007. “The Concept of Mental Disorder: Diagnostic Implications of Harmful Dysfunction Analysis.” World Psychiatry 6 (3): 149–56..Google ScholarPubMed
Wakefield, J.. 2014. “The Biostatistical Theory versus the Harmful Dysfunction Analysis.” Journal of Medicine and Philosophy 39 (6): 648–82..CrossRefGoogle ScholarPubMed