Department of Medical Ethics, Philosophy and History of Medicine, Erasmus MC Academic University Hospital, Rotterdam, The Netherlands.
Med Health Care Philos. 2022 Mar;25(1):131-140. doi: 10.1007/s11019-021-10058-9. Epub 2021 Nov 16.
Despite the longstanding debate on definitions of health and disease concepts, and the multitude of accounts that have been developed, no consensus has been reached. This is problematic, as the way we define health and disease has far-reaching practical consequences. In recent contributions it is proposed to view health and disease as practical- and plural concepts. Instead of searching for a general definition, it is proposed to stipulate context-specific definitions. However, it is not clear how this should be realized. In this paper, we review recent contributions to the debate, and examine the importance of context-specific definitions. In particular, we explore the usefulness of analyzing the relation between the practical function of a definition and the context it is deployed in. We demonstrate that the variety of functions that health and disease concepts need to serve makes the formulation of monistic definitions not only problematic but also undesirable. We conclude that the analysis of the practical function in relation to the context is key when formulating context-specific definitions for health and disease. At last, we discuss challenges for the pluralist stance and make recommendations for future research.
尽管人们长期以来一直在争论健康和疾病概念的定义,也已经提出了许多解释,但仍未达成共识。这是有问题的,因为我们对健康和疾病的定义方式会产生深远的实际后果。最近的一些研究建议将健康和疾病视为实用的和多元的概念。与其寻找一个普遍的定义,不如提出具体情境下的定义。然而,如何实现这一点还不清楚。在本文中,我们回顾了最近关于该主题的研究,并探讨了具体情境下定义的重要性。特别是,我们探讨了分析定义的实际功能与所应用的情境之间关系的有用性。我们证明,健康和疾病概念需要满足的各种功能使得制定一元论定义不仅有问题,而且也不可取。我们得出结论,在制定健康和疾病的具体情境定义时,分析实际功能与情境之间的关系是关键。最后,我们讨论了多元论立场所面临的挑战,并为未来的研究提出了建议。