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Diagnoses are not diseases.

R H Mindham1, J G Scadding, R H Cawley

  • 1University of Leeds.

The British Journal of Psychiatry : the Journal of Mental Science
|November 1, 1992
PubMed
Summary

Psychiatry medicalizes behavior, blurring the lines between disease and diagnosis. This approach, by framing actions as involuntary illnesses, can lead to societal injustice and a denial of personal responsibility.

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Area of Science:

  • Philosophy of Medicine
  • Social Psychiatry
  • Medical Ethics

Background:

  • The medical legitimacy of psychiatry is questioned for conflating diagnoses with disease.
  • Psychiatric conditions are debated as either brain diseases or behavioral issues, not inherent illnesses.
  • The medicalization of behavior is critiqued as an institutionalized denial of life's tragic aspects and individual responsibility.

Purpose of the Study:

  • To analyze the conceptual confusion between psychiatric diagnoses and disease.
  • To critique the societal implications of literalizing psychiatric metaphors.
  • To examine how legal frameworks like the Americans With Disabilities Act (AWDA) adopt psychiatric terminology.

Main Methods:

  • Conceptual analysis of psychiatric terminology and its medicalization.
  • Examination of the role of metaphor in psychiatric discourse.
  • Review of legal and diagnostic classifications (e.g., AWDA, DSM-III-R).

Main Results:

  • Psychiatric diagnoses are often presented as diseases independent of motivation or will.
  • The literal interpretation of psychiatric metaphors by law contributes to injustice.
  • Legal acts like AWDA incorporate behaviors as diseases, regardless of their volitional nature.

Conclusions:

  • The psychiatric community's insistence on equating diagnoses with disease lacks medical legitimacy.
  • Medicalizing behavior undermines the concepts of free will and responsibility.
  • The societal impact of psychiatric terminology, particularly in legal contexts, warrants critical re-evaluation.

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