Theoretical Medicine and Bioethics 26 (6):487-513 (2005)

Authors
Daniel Sulmasy
Georgetown University
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.
Keywords Philosophy   Philosophy   Ethics   Philosophy of Medicine   General Surgery   History of Medicine
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DOI 10.1007/s11017-005-2206-x
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References found in this work BETA

Natural Goodness.Philippa Foot - 2001 - Oxford University Press.
Perfectionism.Thomas Hurka - 1993 - Oxford University Press.
Sameness and Substance.David Wiggins - 1980 - Harvard University Press.

View all 24 references / Add more references

Citations of this work BETA

“Disease Entity” as the Key Theoretical Concept of Medicine.Peter Hucklenbroich - 2014 - Journal of Medicine and Philosophy 39 (6):609-633.
Patients' Substantialization of Disease, the Hybrid Symptom Andmetaphysical Care.Alexandra Pârvan - 2015 - Journal of Evaluation in Clinical Practice 21 (3):380-388.
Diseases as Natural Kinds.Stefan Dragulinescu - 2010 - Theoretical Medicine and Bioethics 31 (5):347-369.

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