DeVito S
Department of Phiosophy, Yale University, New Haven, Connecticut 06520, USA.
J Med Philos. 2000 Oct;25(5):539-67. doi: 10.1076/0360-5310(200010)25:5;1-W;FT539.
A number of philosophers of medicine have attempted to provide analyses of health and disease in which the role that values play in those concepts is restricted. There are three ways in which values can be restricted in the concepts of health and disease. They can be: (i) eliminated, (ii) tamed or (iii) corralled. These three approaches correspond, respectively, to the work of Boorse, Lennox, and Wakefield. The concern of each of these authors is that if unrestricted values are allowed to infect our concepts of health and disease, then anything could be construed as healthy or diseased. They believe that, if at all possible, such a result should be avoided. Unfortunately, as I argue, this result is unavoidable and such attempts to limit values in these concepts are destined to fail. I argue for this position by showing how each of these three attempts to provide value-restricted analyses of health and disease fail as analyses of the concepts of health and disease and that they fail because of their attempts to restrict the role of values in their accounts. I also show how, despite their best efforts, each of these analyses are, themselves, value-driven and value-laden. This leads to the conclusion that values infect our concepts of health and disease at all levels.
许多医学哲学家试图对健康和疾病进行分析，在这些分析中，价值观在这些概念中所起的作用受到限制。在健康和疾病的概念中，价值观可以通过三种方式受到限制。它们可以是：（i）被消除，（ii）被驯化或（iii）被圈定。这三种方法分别对应于博尔泽、伦诺克斯和韦克菲尔德的工作。这些作者各自关注的是，如果允许不受限制的价值观影响我们对健康和疾病的概念，那么任何事物都可能被解释为健康的或患病的。他们认为，如果有可能，应该避免这样的结果。不幸的是，正如我所论证的，这个结果是不可避免的，而且在这些概念中限制价值观的此类尝试注定会失败。我通过展示这三种对健康和疾病进行价值受限分析的尝试，作为对健康和疾病概念的分析是如何失败的，以及它们之所以失败是因为它们试图在其解释中限制价值观的作用，来论证这一立场。我还展示了，尽管他们尽了最大努力，但这些分析本身都是由价值观驱动且充满价值观的。这就得出了一个结论，即价值观在各个层面都影响着我们对健康和疾病的概念。
