Nesse R M
University of Michigan, Institute for Social Research, Room 5057, 426 Thompson Street, Ann Arbor, MI 48104, USA.
Med Health Care Philos. 2001;4(1):37-46. doi: 10.1023/a:1009938513897.
Most attempts to craft a definition of disease seem to have tackled two tasks simultaneously: 1) trying to create a series of inclusion and exclusion criteria that correspond to medical usage of the word disease and 2) using this definition to understand the essence of what disease is. The first task has been somewhat accomplished, but cannot reach closure because the concept of "disease" is based on a prototype, not a logical category. The second task cannot be accomplished by deduction, but only by understanding how the body works and what each component is for, in evolutionary detail. An evolutionary view of the origins of the body and its vulnerabilities that result in disease provides an objective foundation for recognizing pathology. Our social definition of disease will remain contentious, however, because values vary, and because the label "disease" changes judgments about the moral status of people with various conditions, and their rights to medical and social resources.
1）试图创建一系列与疾病一词的医学用法相对应的纳入和排除标准；2）使用这个定义来理解疾病的本质。第一项任务已在一定程度上完成，但无法达成定论，因为“疾病”的概念基于一个原型，而非逻辑范畴。第二项任务无法通过演绎来完成，而只能通过详细了解身体如何运作以及每个组成部分的功能，从进化的角度来实现。从进化的角度看待身体的起源及其导致疾病的脆弱性，为识别病理学提供了客观基础。然而，我们对疾病的社会定义仍将存在争议，因为价值观各不相同，而且“疾病”这个标签会改变对患有各种病症的人的道德地位及其获得医疗和社会资源权利的判断。
