Perspectives in Biology and Medicine 51 (3):320-334 (2008)

Authors
Peter H. Schwartz
Indiana University Purdue University, Indianapolis
Abstract
The way that diseases such as high blood pressure (hypertension), high cholesterol, and diabetes are defined is closely tied to ideas about modifiable risk. In particular, the threshold for diagnosing each of these conditions is set at the level where future risk of disease can be reduced by lowering the relevant parameter (of blood pressure, low-density lipoprotein, or blood glucose, respectively). In this article, I make the case that these criteria, and those for diagnosing and treating other “risk-based diseases,” reflect an unfortunate trend towards reclassifying risk as disease. I closely examine stage 1 hypertension and high cholesterol and argue that many patients diagnosed with these “diseases” do not actually have a pathological condition. In addition, though, I argue that the fact that they are risk factors, rather than diseases, does not diminish the importance of treating them, since there is good evidence that such treatment can reduce morbidity and mortality. For both philosophical and ethical reasons, however, the conditions should not be labeled as pathological.The tendency to reclassify risk factors as diseases is an important trend to examine and critique.
Keywords risk  disease
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DOI 10.1353/pbm.0.0027
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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.
Just Health Care.Norman Daniels - 1985 - Cambridge University Press.
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

A Second Rebuttal On Health.Christopher Boorse - 2014 - Journal of Medicine and Philosophy 39 (6):683-724.
The Line-Drawing Problem in Disease Definition.Wendy A. Rogers & Mary Jean Walker - 2017 - Journal of Medicine and Philosophy 42 (4):405-423.
Medicalization and Overdiagnosis: Different but Alike.Bjørn Hofmann - 2016 - Medicine, Health Care and Philosophy 19 (2):253-264.
What Are Chronic Diseases?Jonathan Fuller - 2018 - Synthese 195 (7):3197-3220.
Progress in Defining Disease: Improved Approaches and Increased Impact.Peter H. Schwartz - 2017 - Journal of Medicine and Philosophy 42 (4):485-502.

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