What We Argue about when We Argue about Disease

Authors

DOI:

https://doi.org/10.5195/pom.2023.172

Keywords:

Concepts of health and disease, Natural kinds, Conceptual analysis

Abstract

The disease debate in philosophy of medicine has traditionally been billed as a debate over the correct conceptual analysis of the term “disease.” This paper argues that although the debate’s participants overwhelmingly claim to be in the business of conceptual analysis, they do not tend to argue as if this is the case. In particular, they often show a puzzling disregard for key parameters such as precise terminology, linguistic community, and actual usage. This prima facie strange feature of the debate points to an interesting and potentially instructive hypothesis: the disease debate makes little sense within the paradigm of conceptual analysis but makes good sense on the assumption that pathology is a real kind.

References

Boorse, Christopher. 1975. “On the Distinction between Disease and Illness.” Philosophy & Public Affairs 5, no. 1: 49–68. http://www.jstor.org/stable/2265020.

———. 1977. “Health as a Theoretical Concept.” Philosophy of Science 44, no. 4: 542–573. https://doi.org/10.1086/288768.

———. 1997. “A Rebuttal on Health.” In What Is Disease?, edited by James M. Humber and Robert F. Almeder, 1–134. Totowa, NJ: Humana Press. https://link.springer.com/chapter/10.1007/978-1-59259-451-1_1.

———. 2002. “A Rebuttal on Functions.” In Functions: New Essays in the Philosophy of Psychology and Biology, edited by Andre Ariew, Robert C. Cummins, and Mark Perlman, 63–112. Oxford: Oxford University Press.

———. 2011. “Concepts of Health and Disease.” In Philosophy of Medicine, edited by Fred Gifford, 13–64. Oxford: North-Holland.

———. 2014. “A Second Rebuttal on Health.” Journal of Medicine and Philosophy 39, no. 6: 683–724. https://doi.org/10.1093/jmp/jhu035.

Boyd, Richard. 1999. “Homeostasis, Species, and Higher Taxa.” In Species: New Interdisciplinary Essays, edited by Robert A. Wilson, 141–185. Cambridge, MA: MIT Press.

Cooper, Rachel. 2002. “Disease.” Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences 33, no. 2: 263–282. https://doi.org/10.1016/S0039-3681(02)00018-3.

———. 2004. “Why Hacking Is Wrong about Human Kinds.” British Journal for the Philosophy of Science 55, no. 1: 73–85. https://doi.org/10.1093/bjps/55.1.73.

———. 2018. “Understanding the DSM-5: Stasis and Change.” History of Psychiatry 29, no. 1: 49–65. https://doi.org/10.1177/0957154X17741783.

———. 2020. “The Concept of Disorder Revisited: Robustly Value-Laden despite Change.” Aristotelian Society Supplementary Volume 94, no. 1: 141–161. https://doi.org/10.1093/arisup/akaa010.

Cooper, Rachel and Roger K. Blashfield. 2016. “Re-evaluating DSM-I.” Psychological Medicine 46, no. 3: 449–456. https://doi.org/10.1017/s0033291715002093.

Culver, Charles M. and Bernard Gert. 1982. Philosophy in Medicine: Conceptual and Ethical Issues in Medicine and Psychiatry. Oxford: Oxford University Press.

Deutsch, Max. 2021. “Conceptual Analysis without Concepts.” Synthese 198, no. 11: 11125–11157. https://doi.org/10.1007/s11229-020-02775-0.

Fagerberg, Harriet. 2022. “Reactive Natural Kinds and Varieties of Dependence.” European Journal for Philosophy of Science 12, no. 4, article 72. https://doi.org/10.1007/s13194-022-00500-x.

———. 2023. “Medical Disorder Is Not a Black Box Essentialist Concept: Review of Defining Mental Disorder: Jerome Wakefield and His Critics, edited by Luc Faucher and Denis Forest.” Philosophy of Medicine 4, no. 1: 1–9. https://doi.org/10.5195/pom.2023.165.

Godman, Marion, Antonella Mallozzi, and David Papineau. 2020. “Essential Properties are Super-Explanatory: Taming Metaphysical Modality.” Journal of the American Philosophical Association 6, no. 3: 316–334. http://dx.doi.org/10.1017/apa.2019.48.

Horwitz, Allan V. and Jerome C. Wakefield. 2007. The Loss of Sadness: How Psychiatry Transformed Normal Sorrow into Depressive Disorder. Oxford: Oxford University Press.

———. 2012. All We Have to Fear: Psychiatry’s Transformation of Natural Anxieties into Mental Disorders. Oxford: Oxford University Press.

Khalidi, Muhammad Ali. 2013. Natural Categories and Human Kinds: Classification in the Natural and Social Sciences. Cambridge: Cambridge University Press.

———. 2018. “Natural Kinds as Nodes in Causal Networks.” Synthese 195: 1379–1396. https://doi.org/10.1007/s11229-015-0841-y.

Lemoine, Maël. 2013. “Defining Disease beyond Conceptual Analysis: An Analysis of Conceptual Analysis in Philosophy of Medicine.” Theoretical Medicine and Bioethics 34, no. 4: 309–325. https://doi.org/10.1007/s11017-013-9261-5.

Machery, Edouard. 2009. Doing without Concepts. Oxford: Oxford University Press.

Millikan, Ruth G. 1989. “In Defense of Proper Functions.” Philosophy of Science 56, no. 2: 288–302. https://doi.org/10.1086/289488.

———. 2000. On Clear and Confused Ideas: An Essay about Substance Concepts. Cambridge: Cambridge University Press.

———. 2017. Beyond Concepts: Unicepts, Language, and Natural Information. Oxford: Oxford University Press.

Murphy, Dominic and Robert L. Woolfolk. 2000. “Conceptual Analysis versus Scientific Understanding: An Assessment of Wakefield’s Folk Psychiatry.” Philosophy, Psychiatry & Psychology 7, no. 4: 271–293. https://muse.jhu.edu/article/28365.

Neander, Karen. 1991. “Functions as Selected Effects: The Conceptual Analyst’s Defense.” Philosophy of Science 58, no. 2: 168–184. https://www.jstor.org/stable/187457.

Nordenfelt, Lennard. 1987. On the Nature of Health: An Action-Theoretic Approach. Dordrecht: D. Reidel.

———. 1995. On the Nature of Health: An Action-Theoretic Approach. Dordrecht: Springer Science & Business Media.

———. 2001. Health, Science, and Ordinary Language. Amsterdam: Rodopi.

———. 2007. “The Concepts of Health and Illness Revisited.” Medicine, Health Care and Philosophy 10, no. 1: 5–10. https://doi.org/10.1007/s11019-006-9017-3.

———. 2018. “Functions and Health: Towards a Praxis-Oriented Concept of Health.” Biological Theory 13, no. 1: 10–16. https://doi.org/10.1007/s13752-017-0270-x.

Papineau, David. 2009. “The Poverty of Analysis.” Aristotelian Society Supplementary Volume 83, no. 1: 1–30. http://dx.doi.org/10.1111/j.1467-8349.2009.00170.x.

Reznek, Lawrie. 1987. The Nature of Disease. New York: Routledge.

———. 1995. “Dis-ease about Kinds: Reply to D’amico.” Journal of Medicine and Philosophy 20, no. 5: 571–584. https://doi.org/10.1093/jmp/20.5.571.

Sawyer, Sarah. 2020. “Truth and Objectivity in Conceptual Engineering.” Inquiry 63, no. 9–10: 1001–1022. https://doi.org/10.1080/0020174X.2020.1805708.

Spitzer, Robert L and Jean Endicott. 2018. “Medical and Mental Disorder: Proposed Definition and Criteria.” Annales Médico-psychologiques, revue psychiatrique 176, no. 7: 656–665. https://doi.org/10.1016/j.amp.2018.07.004.

Szasz, Thomas S. 1960. “The Myth of Mental Illness.” American Psychologist 15, no. 2: 113–118. https://doi.org/10.1037/h0046535.

Wakefield, Jerome C. 1992. “The Concept of Mental Disorder: On the Boundary between Biological Facts and Social Values.” American Psychologist 47, no. 3: 373–388. https://doi.org/10.1037//0003-066x.47.3.373.

———. 1997. “Diagnosing DSM-IV—Part I: DSM-IV and the Concept of Disorder.” Behaviour Research and Therapy 35, no. 7: 633–649. https://doi.org/10.1016/S0005-7967(97)00018-1.

———. 1999. “Evolutionary versus Prototype Analyses of the Concept of Disorder.” Journal of Abnormal Psychology 108, no. 3: 374–399. https://doi.org/10.1037//0021-843x.108.3.374.

———. 2000. “Spandrels, Vestigial Organs, and Such: Reply to Murphy and Woolfolk’s ‘The Harmful Dysfunction Analysis of Mental Disorder’.” Philosophy, Psychiatry & Psychology 7, no. 4: 253–269. http://dx.doi.org/10.1353/ppp.2000.0040.

———. 2007. “The Concept of Mental Disorder: Diagnostic Implications of the Harmful Dysfunction Analysis.” World Psychiatry 6, no. 3: 149–156. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2174594/pdf/wpa060149.pdf.

———. 2014. “The Biostatistical Theory versus the Harmful Dysfunction Analysis, Part 1: Is Part-Dysfunction a Sufficient Condition for Medical Disorder?” Journal of Medicine and Philosophy 39, no. 6: 648–682. https://doi.org/10.1093/jmp/jhu038.

———. 2015. “DSM-5, Psychiatric Epidemiology and the False Positives Problem.” Epidemiology and Psychiatric Sciences 24, no. 3: 188–196. https://doi.org/10.1017/S2045796015000116.

———. 2016. “Diagnostic Issues and Controversies in DSM-5: Return of the False Positives Problem.” Annual Review of Clinical Psychology 12 :105–132. https://doi.org/10.1146/annurev-clinpsy-032814-112800.

———. 2021. “Quinian Qualms, or Does Psychiatry Really Need the Harmful Dysfunction Analysis? Reply to Harold Kincaid.” In Defining Mental Disorder: Jerome Wakefield and His Critics, edited by Luc Faucher and Denis Forest. Cambridge, MA: MIT Press. https://doi.org/10.7551/mitpress/9949.003.0011.

Downloads

Published

2023-12-21

How to Cite

Fagerberg, H. (2023). What We Argue about when We Argue about Disease. Philosophy of Medicine, 4(1). https://doi.org/10.5195/pom.2023.172

Issue

Vol. 4 No. 1 (2023)

Section

Original Research Articles (health, disease and illness)

License

Copyright (c) 2023 Harriet Fagerberg

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors who publish with this journal agree to the following terms:

  1. The Author retains copyright in the Work, where the term “Work” shall include all digital objects that may result in subsequent electronic publication or distribution.
  2. Upon acceptance of the Work, the author shall grant to the Publisher the right of first publication of the Work.
  3. The Author shall grant to the Publisher and its agents the nonexclusive perpetual right and license to publish, archive, and make accessible the Work in whole or in part in all forms of media now or hereafter known under a Creative Commons Attribution 4.0 International License or its equivalent, which, for the avoidance of doubt, allows others to copy, distribute, and transmit the Work under the following conditions:
    1. Attribution—other users must attribute the Work in the manner specified by the author as indicated on the journal Web site;
    with the understanding that the above condition can be waived with permission from the Author and that where the Work or any of its elements is in the public domain under applicable law, that status is in no way affected by the license.
  4. The Author is able to enter into separate, additional contractual arrangements for the nonexclusive distribution of the journal's published version of the Work (e.g., post it to an institutional repository or publish it in a book), as long as there is provided in the document an acknowledgement of its initial publication in this journal.
  5. Authors are permitted and encouraged to post online a prepublication manuscript (but not the Publisher’s final formatted PDF version of the Work) in institutional repositories or on their Websites prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. Any such posting made before acceptance and publication of the Work shall be updated upon publication to include a reference to the Publisher-assigned DOI (Digital Object Identifier) and a link to the online abstract for the final published Work in the Journal.
  6. Upon Publisher’s request, the Author agrees to furnish promptly to Publisher, at the Author’s own expense, written evidence of the permissions, licenses, and consents for use of third-party material included within the Work, except as determined by Publisher to be covered by the principles of Fair Use.
  7. The Author represents and warrants that:
    1. the Work is the Author’s original work;
    2. the Author has not transferred, and will not transfer, exclusive rights in the Work to any third party;
    3. the Work is not pending review or under consideration by another publisher;
    4. the Work has not previously been published;
    5. the Work contains no misrepresentation or infringement of the Work or property of other authors or third parties; and
    6. the Work contains no libel, invasion of privacy, or other unlawful matter.
  8. The Author agrees to indemnify and hold Publisher harmless from Author’s breach of the representations and warranties contained in Paragraph 6 above, as well as any claim or proceeding relating to Publisher’s use and publication of any content contained in the Work, including third-party content.
  9. The Author agrees to digitally sign the Publisher’s final formatted PDF version of the Work.