Harm and the concept of medical disorder

Area of Science:

• Philosophy of Medicine
• Medical Ethics
• Conceptual Analysis

Background:

• Jerome Wakefield's harmful dysfunction analysis (HDA) is a prominent theory defining medical disorders.
• HDA posits that a disorder requires both a failure of a natural internal function and resulting harm to the individual.

Purpose of the Study:

• To critically evaluate the 'harm' component of Wakefield's harmful dysfunction analysis (HDA).
• To explore the implications of different conceptions of harm for defining medical disorders.

Main Methods:

• Analysis of the 'harm' criterion within the harmful dysfunction analysis (HDA).
• Examination of both comparative and non-comparative accounts of harm.
• Philosophical argumentation regarding the necessity and sufficiency of harm in disorder definitions.

Main Results:

• Significant conceptual problems arise when applying the harm criterion, regardless of whether harm is understood comparatively or non-comparatively.
• Existing accounts of harm, whether comparative or non-comparative, face substantial challenges within the HDA framework.
• The harm criterion, as currently formulated, appears problematic for a robust definition of medical disorder.

Conclusions:

• The concept of harm presents significant difficulties when used to define medical disorders within the harmful dysfunction analysis (HDA).
• A revised analysis of medical disorder may need to move beyond the concept of harm to avoid these identified problems.