Nordby Halvor
Faculty of Health and Social work, The University College of Lillehammer, 2624 Lillehammer, Norway.
Med Health Care Philos. 2006;9(2):169-80. doi: 10.1007/s11019-006-0002-7.
Within philosophy of medicine it has been a widespread view that there are important theoretical and practical reasons for clarifying the nature of basic health concepts like disease, illness and sickness. Many theorists have attempted to give definitions that can function as general standards, but as more and more definitions have been rejected as inadequate, pessimism about the possibility of formulating plausible definitions has become increasingly widespread. However, the belief that no definitions will succeed since no definitions have succeeded is an inductive objection, open to realist responses. The article argues that an influential argument from philosophy of language constitutes a more fundamental objection. I use disease as an example and show that this argument implies that if a common understanding of disease can be analysed into a definition, then this is a non-trivial definition. But any non-trivial analysis must be viciously circular: the analysis must presuppose that disease can be defined, but this is what the analysis is supposed to yield as a result. This means, the article concludes, that disease and other controversial health concepts do not have analyses grounded in a common language. Stipulative and contextual definitions can have local significance, but the normative roles of such definitions are at the same time limited.
在医学哲学领域，一种普遍的观点认为，阐明诸如疾病、病患和病症等基本健康概念的本质具有重要的理论和实践意义。许多理论家试图给出能作为通用标准的定义，但随着越来越多的定义因不充分而被摒弃，对于能否制定出合理定义的悲观情绪日益蔓延。然而，认为既然没有定义成功过，就不会有定义能成功的观点是一种归纳性异议，容易受到实在论回应的反驳。本文认为，来自语言哲学的一个有影响力的论证构成了一个更根本的异议。我以疾病为例，表明该论证意味着，如果对疾病的共同理解能够被分析成一个定义，那么这将是一个非平凡的定义。但任何非平凡的分析必然会陷入恶性循环：分析必须预先假定疾病是可定义的，但这正是分析本应得出的结果。本文总结道，这意味着疾病及其他有争议的健康概念不存在基于通用语言的分析。规定性定义和语境定义可能具有局部意义，但此类定义的规范作用同时也是有限的。
