Abstract
David Thomasma called for the development of a medical ethics based squarely on the philosophy of medicine. He recognized, however, that widespread anti-essentialism presented a significant barrier to such an approach. The aim of this article is to introduce a theory that challenges these anti-essentialist objections. The notion of natural kinds presents a modest form of essentialism that can serve as the basis for a foundationalist philosophy of medicine. The notion of a natural kind is neither static nor reductionistic. Disease can be understood as making necessary reference to living natural kinds without invoking the claim that diseases themselves are natural kinds. The idea that natural kinds have a natural disposition to flourish as the kinds of things that they are provides a telos to which to tether the notion of disease – an objective telos that is broader than mere survival and narrower than subjective choice. It is argued that while nosology is descriptive and may have therapeutic implications, disease classification is fundamentally explanatory. Sickness and illness, while referring to the same state of affairs, can be distinguished from disease phenomenologically. Scientific and diagnostic fallibility in making judgments about diseases do not diminish the objectivity of this notion of disease. Diseases are things, not kinds. Injury is a concept parallel to disease that also makes necessary reference to living natural kinds. These ideas provide a new possibility for the development of a philosophy of medicine with implications for medical ethics.
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References
George. Agich (1997) “Toward a Pragmatic Theory of Disease” James M. Humber Robert F. Almeder. 221--246 (Eds) What is Disease? Humana Press Totowa,New Jersey
G.E.M. Anscombe (1970) “War and Murder” E.A. Wasserman. 42--53 (Eds) War and Morality Wadsworth Belmont, CA 42–53
Aristotle (1979) Metaphysics The Peripatetic Press Grinnell Iowa
Christopher. Boorse (1987) “Concepts of Health” Donald VanDeVeer Tom Regan. 359--393. (Eds) Health Care Ethics: An Introduction University Press Philadelphia 359–393
Christopher Boorse (1975) ArticleTitle“On the Distinction Between Disease and Illness” Philosophy and Public Affairs 5 49–68
Christopher Boorse (1997) “A Rebuttal on Health” Humber James M. Robert F. Almeder. 3--134. (Eds) What is Disease? Humana Press Totowa, New Jersey 3–134
Baruch Brody (1980) Identity and Essence Princeton University Press Princeton, NJ
L. Caplan Arthur (2004) “The Unnaturalness of Aging – Give Me a Reason to Live” Arthur L. Caplan James J. McCartney Dominic A. Sisti. 117--127. (Eds) Health, Disease, and Illness Georgetown University Press Washington, DC 117–127
Samuel A. Cartwright (2004) “Report on the Diseases and Physical Peculiarities of the Negro Race” Arthur L. Caplan James J. McCartney Dominic A. Sisti. 28--39. (Eds) Health, Disease, and Illness: Concepts in Medicine Georgetown University Press Washington, DC 28–39
Robert D’Amico (1995) ArticleTitle“Is Disease a Natural Kind?” Journal of Medicine and Philosophy 20 551–569
H. Tristram Engelhardt (1986) The Foundations of Bioethics Oxford University Press New York
Philippa Foot (2001) Natural Goodness Clarendon Press of Oxford University Press Oxford
Bjørn Hofman (2002) ArticleTitle“On the Triad Disease, Illness and Sickness” Journal of Medicine and Philosophy 27 651–673 Occurrence Handle10.1076/jmep.27.6.651.13793
Thomas Hurka (1993) Perfectionism Oxford University Press New York
Uffe J. Jensen (1984) “A Critique of Essentialism in Medicine” Lennart Nordenfelt B. Ingemar Lindhal. 63--73. (Eds) Health, Disease, and Causal Explanations in Medicine D. Reidel Boston 63–73
Saul A. Kripke (1971) “Identity and Necessity” Milton K. Munitz. 135--164 (Eds) Identity and Individuation New York University Press New York 135–164
Saul A. Kripke (1972) “Naming and Necessity” Gilbert Harman Donald Davidson. 253--355. (Eds) Semantics of Natural Language D. Reidel Dordrecht, Netherlands 253–355
Anthony J Lisska (1996) Aquinas’ Theory of Natural Law: An Analytic Reconstruction The Clarendon Press of Oxford University Press Oxford
Bernard J.F Lonergan (1978) Insight: A Study of Human Understanding Harper and Row San Francisco, California
MacIntyre, Alasdair. Dependent Rational Animals: Why Human Beings Need the Virtues. Chicago: Open Court Press, 1999
Janice McCormick Sheryl Reimer Kirkham Virginia Haynes (1998) ArticleTitle“Abstracting Women: Essentialism in Women’s Health Research” Health Care for Women International 19 495–504
Nikhil C. Munshi Guido Tricott and Bart Barlogie. (2001) “Plasma Cell Neoplasms” Vincent T. DeVita Samuel Hellman Steven A. Rosenberg. (Eds) Principles and Practice of Oncology EditionNumber6 Lippincott Williams and Wilkins Philadelphia
Nancey, and Murphy George F.R. Ellis (1996) On the Moral Nature of the Universe Minneapolis Fortress Press Minnesota
Talcott. Parsons (1979) “Definitions of Health and Illness in the Light of American Values and Social Structure” E.G. Jaco. 120–144 (Eds) Patients, Physicians, and Illness Free Press New York 120–144
Lawrie Reznek (1995) ArticleTitle“Dis-ease about Kinds: Reply to D’Amico” Journal of Medicine and Philosophy 20 571–584
John Searle (1983) Intentionality: An Essay in the Philosophy of Mind Cambridge University Press New York
P Sulmasy Daniel (2002) ArticleTitle“Four Basic Notions of the Common Good” St. John’s Law Review 75 303–310
Fredrik Svenaeus (2000) ArticleTitle“Das Unheimliche: Towards a Phenomenology of Illness” Medicine Health Care and Philosophy 3 3–16
David C., and Thomasma Edmund D. Pellegrino (1981) ArticleTitle“Philosophy of Medicine as the Source for Medical Ethics” Metamedicine 2 5–11 Occurrence Handle10.1007/BF00886339
David C Thomasma (1997) ArticleTitle“Antifoundationalism and the Possibility of a Moral Philosophy of Medicine” Theoretical Medicine 18 127–143
Jukka Varelius (2003) ArticleTitle“Autonomy, Subject-relativity, and Subjective and Objective Theories of Well-being in Bioethics” Theoretical Medicine and Bioethics 24 363–379 Occurrence Handle10.1023/B:META.0000006908.26112.fe
David Wiggins (1980) Sameness and Substance Harvard University Press Cambridge, Massachusetts
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Sulmasy, D. “Diseases and Natural Kinds”. Theor Med Bioeth 26, 487–513 (2005). https://doi.org/10.1007/s11017-005-2206-x
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DOI: https://doi.org/10.1007/s11017-005-2206-x