Health Care Analysis

, Volume 2, Issue 4, pp 339–342 | Cite as

Debating point

The artificial and elusive demarcation between health and disease
  • J. Ridderikhoff


A number of problems and uncertainties have been raised by this brief review. Although they are well-known in philosophical and social scientific circles they are otherwise consistently ignored. But I call for a wider debate about them. If medicine cannot come to terms with its own confusing terminology and methodology; if medicine cannot stop raising expectations it cannot fulfil; if medicine does not deliberately restrict its boundaries; and if medicine does not take serious steps to explain why it chooses to call some conditions states of health and others states of disease; then the result must be that health policy (which medicine largely continues to direct) will either be simply an arbitrary matter, or will be implemented on the basis of economic arguments. Where everything else is imprecise the discipline that offers precision will triumph. And the evidence of the moment is that this is exactly what is happening.


Public Health Health Policy Condition State Economic Argument Wide Debate 
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  1. 1.
    Kellert, S. R. (1976). A sociocultural concept of health and illness.Journal of Medical Philosophy 1, 222–228.Google Scholar
  2. 2.
    Mechanic, D. (1978).Medical Sociology, 2nd edn, Free Press, New York.Google Scholar
  3. 3.
    Hippocrates. (1950).The Medical Works of Hippocrates, Blackwell, Oxford.Google Scholar
  4. 4.
    Sadegh-Zadeh, K. (1977). Krankheitsbegriffe und nosologische systeme.Metamed 1, 4–41.Google Scholar
  5. 5.
    Ridderikhoff, J. (1989).Methods in Medicine, Kluwer Academic Publishers, Dordrecht.Google Scholar
  6. 6.
    Sadegh-Zadeh, K. (1980). Toward metamedicine. Editorial.Metamedicine 1, 3–10.CrossRefGoogle Scholar
  7. 7.
    Sauvages de Lacroix, F. B. (1731).Nouvelles Classes de Maladies, qui dans un ordre semblable à celui des Botanistes, comprennent les genres et les espèces de toutes les Maladies, avec leurs signes et leurs indications, Avignon.Google Scholar
  8. 8.
    Sneath, P. H. A. and Sokal, R. R. (1973).Numerical Taxonomy. The Principles and Practice of Numerical Classifications, W. H. Freeman & Co., San Francisco.Google Scholar
  9. 9.
    Boorse, C. (1977). Health as a theoretical concept.Philosophy of Science 44, 542–573.CrossRefGoogle Scholar
  10. 10.
    Brody, D. S. (1980). The patient's role in clinical decision making.Annals of Internal Medicine 93, 718–722.PubMedGoogle Scholar
  11. 11.
    Horrobin, D.F. (1987). Scientific medicine—success or failure? In,Oxford Textbook of Medicine, ed. by D. J. Weatherall, J. G. G. Ledingham and D. A. Warrell, Oxford University Press, Oxford.Google Scholar

Copyright information

© John Wiley & Sons, Ltd. 1994

Authors and Affiliations

  • J. Ridderikhoff
    • 1
  1. 1.Department of Family MedicineErasmus University RotterdamThe Netherlands

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