Bueter Anke
Institute of Philosophy, Leibniz Universität Hannover, Im Moore 21, 30167, Hanover, Germany.
Med Health Care Philos. 2019 Sep;22(3):463-474. doi: 10.1007/s11019-019-09886-7.
The distinction between 'disease' and 'illness' has played an important role in the debate between naturalism and normativism. Both employ these notions, yet disagree on whether to assign priority to 'disease' or 'illness'. I argue that this discussion suffers from implicit differences in the underlying interpretations: While for naturalists the distinction between 'disease' and 'illness' is one between a descriptive and a prescriptive notion, for normativists it is one between cause and effect. This discrepancy is connected to different interpretations of priority, which also tend to be conflated in the debate. I disambiguate these different usages and develop a distinction between 'disease' and 'illness' that is theoretically neutral with regard to naturalism or normativism. Moreover, I propose a concept of heuristic priority that could serve as a common focus. This framework can avoid common confusions by providing a shared terminology and thereby help to make debates on disease-concepts more fruitful.
“疾病”与“病患”之间的区别在自然主义与规范主义的争论中发挥了重要作用。双方都使用这些概念，但在是将“疾病”还是“病患”置于优先地位的问题上存在分歧。我认为，这场讨论因潜在解释中隐含的差异而受到影响：对于自然主义者而言，“疾病”与“病患”之间的区别是描述性概念与规范性概念之间的区别；而对于规范主义者来说，这是因果之间的区别。这种差异与对优先性的不同解释相关联，而在这场争论中这些解释也往往相互混淆。我对这些不同用法进行了区分，并提出了一种在自然主义或规范主义方面理论中立的“疾病”与“病患”之间的区别。此外，我提出了一种启发式优先性的概念，它可以作为一个共同焦点。这个框架通过提供一个共享术语来避免常见的混淆，从而有助于使关于疾病概念的争论更富有成效。
