Abstract
What exactly is a genetic disease? For a phrase one hears on a daily basis, there has been surprisingly little analysis of the underlying concept. Medical doctors seem perfectly willing to admit that the etiology of disease is typically complex, with a great many factors interacting to bring about a given condition. On such a view, descriptions of diseases like cancer as geneticseem at best highly simplistic, and at worst philosophically indefensible. On the other hand, there is clearly some practical value to be had by classifying diseases according to theirpredominant cause when this can be accomplished in a theoretically satisfactory manner. The question therefore becomes exactly how one should go about selecting a single causal factor among many to explain the presence of disease. When an attempt to defend such causal selection is made at all, the standard accounts offered (Koch's postulates, Hill's epidemiological criteria, manipulability) are all clearly inadequate. I propose, however, an epidemiological account of disease causation which walks the fine line between practical applicability and theoretical considerations of causal complexity and attempts to compromise between patient-centered and population-centered concepts of disease. The epidemiological account is the most basic framework consistent with our strongly held intuitions about the causal classification of disease, yet it avoids the difficulties encountered by its competitors.
Similar content being viewed by others
References
Brandon, R.N. et al.: 1994, 'Sober on Brandon on screeningoff and the levels of selection', Philosophy of Science 61(3), 475–486.
Burian, R.: 1981–1982, 'Human sociobiology and genetic determinism', The Philosophy Forum XIII(2–3), 43–66.
Collingwood, R.G.: 1938, 'On the so–called idea of causation', in Proceedings of the Aristotelian Society, pp. 85–112.
Ducasse, C.J.: 1924, 'Causation and the types of necessity', University of Washington Publications in the Social Sciences 1(2), 69–200.
Gardenfors, P.: 1980, 'A pragmatic theory of explanation', Philosophy of Science 47, 404–423.
Gifford, F.: 1990, 'Genetic traits', Biology and Philosophy 5(3), 327–347.
Hart, H.L.A. and A.M. Honore: 1959, Causation in the Law. Oxford: Oxford University Press.
Hesslow, G.: 1983, 'Explaining differences and weighting causes', Theoria 49, 87–111.
Hesslow, G.: 1984, 'What is a genetic disease? On the relative importance of causes', in: L. Nordenfelt and B.I.B. Lindahl (eds.), Health, Disease, and Causal Explanations in Medicine. Dordrecht: Reidel.
Hesslow, G.: 1988, 'The problem of causal selection', in: D.J. Hilton (ed.), Contemporary Science and Natural Explanation: Commonsense Conceptions of Causality, New York: NYU Press.
Hilton, D.J.: 1988, 'The problem of causal selection', in: D.J. Hilton (ed.), Contemporary Science and Natural Explanation: Commonsense Conceptions of Causality. New York: NYU Press.
Mackie, J.L.: 1965, 'Causes and conditions', American Philosophical Quarterly 2(4), 245–264.
Mackie, J.L.: 1974, Cement of the Universe. Oxford: Clarendon Press.
Martin, R.: 1978, 'Judgments of contributory causes and objectivity', Philosophy of Social Science 8, 173–186.
Mill, J.S.: 1859, A System of Logic. London: Longmanns (reprinted 1961).
Nagel, E.: 1961, The Structure of Science: Problems in the Logic of Scientific Explanation. New York: HBJ.
Rothman, K.J.: 1976, 'Causes', American Journal of Epidemiology 104, 587–592.
Ryle, G.: 1949, The Concept of Mind. London: Hutchison.
Salmon, W.: 1984, Scientific Explanation and the Causal Structure of the World. Princeton: Princeton University Press.
Smith, K.C.: 1999 (in press), 'What is a genetic trait?', in: D. Magnus (ed.), Contemporary Genetic Technology: Scientific, Ethical, and Social Challenges. Melbourne: Krieger Publishing.
Smith, K.C.: 1998, 'Equivocal notions of accuracy and genetic screening of the general population', The Mount Sinai Journal of Medicine 65(3), 178–183.
Smith, K.C.: 1992, 'The new problem of genetics: A response to Gifford', Biology and Philosophy 7, 331–348.
Sterelny, K., K.C. Smith and M. Dickison: 1996, 'The extended replicator', Biology and Philosophy 11, 377–403.
Stern, C.: 1973, Principles of Human Genetics. San Francisco: Freeman.
Van Fraassen, B.C.: 1980, The Scientific Image. Oxford: Oxford University Press.
Wulff, H.R.: 1984, 'The causal basis of the current disease classification', in: L. Nordenfelt and B.I.B. Lindahl (eds.), Health, Disease, and Causal Explanations in Medicine. Dordrecht: Reidel.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Smith, K.C. A disease by any other name: Musings on the concept of a genetic disease. Med Health Care Philos 4, 19–30 (2001). https://doi.org/10.1023/A:1009930312079
Issue Date:
DOI: https://doi.org/10.1023/A:1009930312079