On values, professionalism and nosology: an essay with late commentary on essays by DeVito and Rudnick

The essays by Scott DeVito and Abraham Rudnick are on largely the same topics--the meanings of healthy(y), normal, disease, pathological, diagnosis, etc., and they contain compatible conclusions--that medical precepts are value-laden and less objective than some naive model of scientific objectivity would suggest. This commentary opens with a brief critique of each and ends with a more in-depth account, one complaint being how lacking in weight the analyses are. In the middle portion of this commentary, I consider the sorts of values that are present in some case studies--values that give the project much more weight. These include the values, scientific and self-serving, that professionalism provides. I show how medicine and its disease-related concepts can be thought to evolve in many ways.