Skip to main content
SpringerLink
Log in

Defining disease beyond conceptual analysis: an analysis of conceptual analysis in philosophy of medicine

  • Published:
Theoretical Medicine and Bioethics Aims and scope Submit manuscript

Abstract

Conceptual analysis of health and disease is portrayed as consisting in the confrontation of a set of criteria—a “definition”—with a set of cases, called instances of either “health” or “disease.” Apart from logical counter-arguments, there is no other way to refute an opponent’s definition than by providing counter-cases. As resorting to intensional stipulation (stipulation of meaning) is not forbidden, several contenders can therefore be deemed to have succeeded. This implies that conceptual analysis alone is not likely to decide between naturalism and normativism. An alternative to this approach would be to examine whether the concept of disease can be naturalized.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Notes

  1. Many others have taken part; see, e.g., [7–22]. For mental disorders, see [23–26]. See also [27, 28] for a broader framework of the question and more bibliographical references.

  2. See [14] and reply in [4, p. 41].

  3. See [6; 30, p. 166] for a more elaborate example of this kind.

  4. Others have already treated the issue at length; see, e.g., [35–38].

  5. It is not supposed here that nobody can win, as Nordby argues in [41].

  6. See [42] for further details.

References

  1. Boorse, Christopher. 2011. Concepts of health and disease. In Handbook of the philosophy of science, ed. F. Gifford. Vol. 16. Philosophy of medicine. Amsterdam: Elsevier.

  2. Nordenfelt, Lennart. 1995. On the nature of health: An action-theoretic approach. Dordrecht: Kluwer.

    Book  Google Scholar 

  3. Wakefield, Jerome C. 2001. Evolutionary history versus current causal role in the definition of disorder: Reply to McNally. Behaviour Research and Therapy 39: 347–366.

    Article  Google Scholar 

  4. Boorse, Christopher. 1997. A rebuttal on health. In What is disease?, ed. J.M. Humber, and R.F. Almeder, 1–134. Totowa: Humana Press.

    Chapter  Google Scholar 

  5. Boorse, Christopher. 1977. Health as a theoretical concept. Philosophy of Science 44: 542–573.

    Article  Google Scholar 

  6. Wakefield, Jerome C. 1992. The concept of mental disorder: On the boundaries between biological facts and social values. American Psychologist 47(3): 373–388.

    Article  Google Scholar 

  7. King, Lester S. 1954. What is disease? Philosophy of Science 21(3): 193–203.

    Article  Google Scholar 

  8. Canguilhem, Georges. 1978. The normal and the pathological. Dordrecht: Kluwer.

    Book  Google Scholar 

  9. Engelhardt Jr., H.Tristram. 1975. Concepts of health and disease. In Concepts of health and disease: Interdisciplinary perspectives, ed. A. Caplan and H.T. Engelhardt, 31–45. Reading, MA: Addison-Wesley.

    Google Scholar 

  10. Engelhardt Jr., H.Tristram. 1984. Clinical problems and the concept of disease. In Health, disease and causal explanations in medicine, ed. L. Nordenfelt and B.I.B. Lindahl, 27–41. Dordrecht: Reidel.

    Chapter  Google Scholar 

  11. Margolis, Joseph. 1976. The concept of disease. Journal of Medicine and Philosophy 1: 239–255.

    Article  Google Scholar 

  12. Whitbeck, Caroline. 1978. Four basic concepts of medical science. PSA: Proceedings of the Biennial Meeting of the Philosophy of Science Association 1: 210–222.

    Google Scholar 

  13. Whitbeck, Caroline. 1981. A theory of health. In Concepts of health and disease: Interdisciplinary perspectives, ed. A.L. Caplan, H.T. Engelhardt, and J.J. McCartney, 611–626. Reading, MA: Addison-Wesley.

    Google Scholar 

  14. Clouser, K.Danner, Charles M. Culver, and Bernard Gert. 1981. Malady: A new treatment of disease. Hastings Center Report 11(3): 29–37.

    Article  Google Scholar 

  15. Reznek, Lawrie. 1987. The nature of disease. London: Routledge & Kegan Paul.

    Google Scholar 

  16. Wachbroit, Robert. 1994. Normality as a biological concept. Philosophy of Science 61: 579–591.

    Article  Google Scholar 

  17. Stempsey, William E. 2000. Disease and diagnosis: Value-dependent realism. Dordrecht: Kluwer.

    Book  Google Scholar 

  18. Cooper, Rachel. 2002. Disease. Studies in History and Philosophy of Biology and Biomedical Sciences 33: 263–282.

    Article  Google Scholar 

  19. Nesse, Randolph M. 2001. On the difficulty of defining disease: A Darwinian perspective. Medicine, Health Care and Philosophy 4: 37–46.

    Article  Google Scholar 

  20. Schramme, Thomas. 2007. A qualified defence of a naturalist theory of health. Medicine, Health Care and Philosophy 10: 11–17.

    Article  Google Scholar 

  21. Ananth, Mahesh. 2008. In defense of an evolutionary concept of health: Nature, norms, and human biology. Aldershot: Ashgate.

    Google Scholar 

  22. Scadding, John G. 1967. Diagnosis, the clinician and the computer. Lancet 290(7521): 877–882.

    Article  Google Scholar 

  23. Kendell, Robert E. 1975. The concept of disease and its implications for psychiatry. British Journal of Psychiatry 127: 305–315.

    Article  Google Scholar 

  24. Kendell, Robert E. 1986. What are mental disorders? In Issues in psychiatric classification: Science, practice and social policy, ed. A.M. Freedman, R. Brotman, I. Silverman, and D. Hutson, 23–45. New York: Human Sciences Press.

    Google Scholar 

  25. Spitzer, Robert L., and John Endicott. 1978. Medical and mental disorder: Proposed definition and criteria. In Critical issues in psychiatric diagnosis, ed. R.L. Spitzer and D.F. Klein, 15–39. New York: Raven Press.

    Google Scholar 

  26. Fulford, K.W.M. 1989. Moral theory and medical practice. Cambridge: Cambridge University Press.

    Google Scholar 

  27. Hofmann, Björn. 2001. Complexity of the concept of disease as shown through rival theoretical frameworks. Theoretical Medicine 22: 211–236.

    Article  Google Scholar 

  28. Simon, Jeremy R. 2011. Medical ontology. In Handbook of philosophy of science, ed. F. Gifford, 65–114. Vol. 16. Philosophy of medicine. Amsterdam: Elsevier.

  29. Nordenfelt, Lennart. 1993. On the relevance and importance of the notion of disease. Theoretical Medicine 14: 15–26.

    Article  Google Scholar 

  30. Wakefield, Jerome C. 1993. Limits of operationalization: A critique of Spitzer and Endicott’s (1978) proposed operational criteria for mental disorders. Journal of Abnormal Psychology 102(1): 160–172.

    Article  Google Scholar 

  31. Wakefield, Jerome C. 1999. Evolutionary versus prototype analyses of the concept of disorder. Journal of Abnormal Psychology 108(3): 374–399.

    Article  Google Scholar 

  32. Kingma, Elselijn. 2010. Paracetamol, poison, and polio: Why Boorse’s account of function fails to distinguish health and disease. British Journal of Philosophy of Science 61: 241–264.

    Article  Google Scholar 

  33. Wakefield, Jerome C. 1992. Disorder as harmful dysfunction: A conceptual critique of DSM-III-R’s definition of mental disorder. Psychological Review 99(2): 232–247.

    Article  Google Scholar 

  34. Horwitz, Allan V., and Jerome C. Wakefield. 2007. The loss of sadness: How psychiatry transformed normal sorrow into depressive disorder. New York: Oxford University Press.

    Google Scholar 

  35. Sadegh-Zadeh, Kazem. 2011. Handbook of the analytic philosophy of medicine. Dordrecht: Springer.

    Google Scholar 

  36. Hempel, Carl G. 1952. Fundamentals of concept formation in empirical science. Chicago: University of Chicago Press.

    Google Scholar 

  37. Lemoine, Maël. 2014. Forthcoming. Is the dysfunction component of the ‘Harmful dysfunction analysis’ stipulative? In Defining mental disorders: Jerome Wakefield and his critics, ed. Luc Faucher and Denis Forest. Cambridge: MIT Press.

  38. Millikan, Ruth G. 1993. White queen psychology and other essays for Alice. Cambridge: MIT Press.

    Google Scholar 

  39. Wakefield, Jerome C. 1999. The concept of disorder as a foundation for the DSM’s theory-neutral nosology: Response to Follette and Houts, part 2. Behavior Research and Therapy 37(10): 1001–1027.

    Article  Google Scholar 

  40. Bolton, Derek, and Jonathan Hill. 2003. Mind, meaning and mental disorders: The nature of causal explanation in psychology and psychiatry. Oxford: Oxford University Press.

    Google Scholar 

  41. Nordby, Halvor. 2006. The analytic–synthetic distinction and conceptual analyses of basic health concepts. Medicine, Health Care and Philosophy 9: 169–180.

    Article  Google Scholar 

  42. Lemoine, Maël. 2013. Forthcoming. The naturalization of the concept of disease. In Classification, disease and evidence: New essays in the philosophy of medicine, ed. G. Lambert, M. Silberstein, and P. Huneman. Amsterdam: Springer.

Download references

Acknowledgments

Some parts of this paper were discussed at the meeting of the Philosophy of Medicine Roundtable Conference in San Sebastian, Basque Country, Spain. I am very grateful for comments by Michael Baty, Marie Darrason, and Kathryn Tabb, and, as always, I owe special thanks to Elodie Giroux. Thanks also to the editors who have worked very hard to improve my paper.

Author information

Authors and Affiliations

  1. University of Tours, 10 Bd Tonnellé, 37000, Tours, France

    Maël Lemoine

Authors
  1. Maël Lemoine
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Maël Lemoine.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lemoine, M. Defining disease beyond conceptual analysis: an analysis of conceptual analysis in philosophy of medicine. Theor Med Bioeth 34, 309–325 (2013). https://doi.org/10.1007/s11017-013-9261-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11017-013-9261-5

Keywords

Search

Navigation