Maltzman I
Department of Psychology, University of California, Los Angeles 90024-1563.
J Psychoactive Drugs. 1994 Jan-Mar;26(1):13-31. doi: 10.1080/02791072.1994.10472598.
Arguments of proponents and critics of a disease concept of alcoholism are reviewed. It is concluded that the disease concept of alcoholism is in accord with modern usage of the concept of disease in the philosophy of science and the practice of biomedical science. Ascription of the term "disease" involves a value judgment by experts that observed lawfully recurring signs and symptoms are a significant deviation from a norm or standard of health. Value judgments of this and other kinds are inherent in biobehavioral science and its application. Criticisms of the traditional conception of the disease concept fail to distinguish empirical questions of etiology, treatment, and the characteristic features of alcoholism from the conventional and evaluative nature of the classification "disease." A critical review of the empirical research purporting to question the signs and symptoms of loss of control in alcoholics is also provided.
本文回顾了支持和反对酒精成瘾疾病概念的各方观点。结论是，酒精成瘾的疾病概念符合科学哲学和生物医学实践中疾病概念的现代用法。将“疾病”一词用于某种情况，涉及专家的价值判断，即观察到的规律出现的体征和症状是与健康规范或标准的显著偏差。这种以及其他类型的价值判断在生物行为科学及其应用中是固有的。对疾病概念传统观念的批评未能将酒精成瘾的病因、治疗和特征等实证问题与“疾病”分类的传统性和评价性本质区分开来。本文还对旨在质疑酗酒者失控体征和症状的实证研究进行了批判性综述。
