An agenda for future debate on concepts of health and disease


Authors
George Khushf
University of South Carolina
Abstract
The traditional contrast between naturalist and normativist disease concepts fails to capture the most salient features of the health concepts debate. By using health concepts as a window on background notions of medical science and ethics, I show how Christopher Boorse (an influential naturalist) and Lennart Nordenfelt (an influential normativist) actually share deep assumptions about the character of medicine. Their disease concepts attempt, in different ways, to shore up the same medical model. For both, health concepts function like demarcation criteria in the philosophy of science: they mark off the jurisdiction of medical science, and protect it from an inappropriate intrusion of socioeconomic factors, which threaten the integrity of modern medicine. These views are challenged by new developments in healthcare such as managed care and total quality review. To frame the health concepts debate in a way that better captures the issues integral to these new developments, I advance a new way of reading the distinction between weak and strong normativists. Strong normativists are skeptical of the demarcation project, think facts and values cannot be disentangled, and hold that socioeconomic conditions unavoidably influence how pathology is understood. The new health concepts debate should be framed as one between weak and strong normativists, and it concerns how we should respond to the current developments in health care
Keywords concepts of health and disease  demarcation criteria  medical values  normativism  social constructivism
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DOI 10.1007/s11019-006-9021-7
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References found in this work BETA

Health as a Theoretical Concept.Christopher Boorse - 1977 - Philosophy of Science 44 (4):542-573.
On the Distinction Between Disease and Illness.Christopher Boorse - 1975 - Philosophy and Public Affairs 5 (1):49-68.
The Concepts of Health and Illness Revisited.Lennart Nordenfelt - 2007 - Medicine, Health Care and Philosophy 10 (1):5-10.
A Rebuttal on Health.Christopher Boorse - 1997 - In James M. Humber & Robert F. Almeder (eds.), What is Disease? Humana Press. pp. 1--134.

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Citations of this work BETA

How to Proceed in the Disease Concept Debate? A Pragmatic Approach.Leen De Vreese - 2017 - Journal of Medicine and Philosophy 42 (4):424-446.
A New Path for Humanistic Medicine.Juliette Ferry-Danini - 2018 - Theoretical Medicine and Bioethics 39 (1):57-77.

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