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Progress in Defining Disease: Improved Approaches and Increased Impact.

Peter H Schwartz1

  • 1Indiana University School of Medicine, Indianapolis, Indiana, USA.

The Journal of Medicine and Philosophy
|September 2, 2017
PubMed
Summary

This research proposes a new framework for defining "disease," distinguishing it from mere risk factors like high blood pressure. It addresses challenges in classifying dysfunction versus normal functioning.

Keywords:
biological normativitydiseasedysfunction-requiring accountline-drawing problemrisk factorscreening

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Area of Science:

  • Philosophy of Medicine
  • Conceptual Analysis
  • Medical Ethics

Background:

  • Current definitions of disease face challenges, particularly in distinguishing between normal functioning and dysfunction.
  • Previous work proposed viewing disease definitions as future-oriented proposals rather than traditional conceptual analyses.
  • The 'line-drawing' problem highlights the difficulty in differentiating low-normal functioning from pathological dysfunction.

Purpose of the Study:

  • To present a refined, dysfunction-requiring approach to defining disease.
  • To re-evaluate the classification of prevalent conditions like hypertension and high cholesterol.
  • To engage with and respond to critical analyses of previous work on disease definition.

Main Methods:

  • Conceptual analysis focusing on functional criteria for disease.
  • Argumentation based on a dysfunction-requiring model of disease.
  • Critical evaluation of existing and proposed disease definitions.

Main Results:

  • Disease definitions should be viewed as proposals for future use, not static analyses.
  • The 'line-drawing' problem can be addressed within a dysfunction-requiring framework.
  • Prevalent conditions such as high blood pressure, high cholesterol, and ductal carcinoma in situ are reclassified as risk factors, not diseases.

Conclusions:

  • A dysfunction-requiring approach offers a robust method for defining disease.
  • Distinguishing disease from risk factors is crucial for accurate medical classification and treatment.
  • Further dialogue is needed to refine disease definitions and their application in clinical practice.