Medicine, Health Care and Philosophy 20 (2):269-280 (2017)

Authors
Wendy A. Rogers
Macquarie University
Mary Jean Walker
La Trobe University
Abstract
Recently, concerns have been raised about the phenomenon of ‘overdiagnosis’, the diagnosis of a condition that is not causing harm, and will not come to cause harm. Along with practical, ethical, and scientific questions, overdiagnosis raises questions about our concept of disease. In this paper, we analyse overdiagnosis as an epistemic problem and show how it challenges many existing accounts of disease. In particular, it raises ques- tions about conceptual links drawn between disease and dysfunction, harm, and risk. We argue that ‘disease’ should be considered a vague concept with a non-classical structure. On this view, overdiagnosed cases are ‘borderline’ cases of disease, falling in the zone between cases that are clearly disease, and cases that are clearly not disease. We then develop a pre ́cising definition of disease designed to provide practical help in preventing and limiting overdiagnosis. We argue that for this purpose, we can define disease as dysfunction that has a significant risk of causing severe harm to the patient.
Keywords Overdiagnosis  Disease definition  Dysfunction
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DOI 10.1007/s11019-016-9748-8
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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.
Wright on Functions.Christopher Boorse - 1976 - Philosophical Review 85 (1):70-86.

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Citations of this work BETA

Progress in Defining Disease: Improved Approaches and Increased Impact.Peter H. Schwartz - 2017 - Journal of Medicine and Philosophy 42 (4):485-502.
Précising Definitions as a Way to Combat Overdiagnosis.Wendy A. Rogers & Mary J. Walker - 2018 - Journal of Evaluation in Clinical Practice 24 (5):1019-1025.

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