De Vreese Leen
Ghent University, Ghent, Belgium.
J Med Philos. 2017 Aug 1;42(4):424-446. doi: 10.1093/jmp/jhx011.
In the traditional philosophical debate over different conceptual analyses of "disease," it is often presupposed that "disease" is univocally definable and that there are clear boundaries which distinguish this univocal category "disease" from the category of "nondisease." In this paper, I will argue for a shift in the discussion on the concept of "disease" and propose an alternative, pragmatic approach that is based on the conviction that "disease" is not a theoretical concept but a practical term. I develop a view on which our use of the term "disease" is determined by two interacting factors, namely, value-laden considerations about the (un)desirabilty of certain states and discoveries of cause(s) which is/are explanatorily relevant. I show how these factors interact with regard to a taxonomy of kinds of diseases. This pragmatic approach will not lead me to a final definition of "disease," but will result in a more realistic description of the way we build, use, apply, and change our concept of "disease." Meanwhile, it is useful as a basis for critical reflection on disease-labeling in medicine.
在关于“疾病”不同概念分析的传统哲学辩论中，人们常常预先假定“疾病”能够被明确地定义，并且存在清晰的界限将“疾病”这一明确的类别与“非疾病”类别区分开来。在本文中，我将主张转变关于“疾病”概念的讨论，并提出一种替代性的实用方法，该方法基于这样一种信念，即“疾病”不是一个理论概念，而是一个实用术语。我提出一种观点，即我们对“疾病”一词的使用由两个相互作用的因素决定，即关于某些状态的（不）可取性的价值负载考量以及具有解释相关性的病因发现。我将展示这些因素在疾病种类的分类方面是如何相互作用的。这种实用方法不会让我得出“疾病”的最终定义，但会对我们构建、使用、应用和改变“疾病”概念的方式进行更现实的描述。同时，它作为对医学中疾病标签进行批判性反思的基础是有用的。
