Do we need a concept of disease?

Area of Science:

• Philosophy of Medicine
• Clinical Decision-Making
• Medical Ethics

Background:

• The terms "health", "disease", and "illness" are commonly used in clinical medicine and philosophy.
• Philosophical discourse often assumes these concepts are central to clinical thinking and decision-making.
• Decisions regarding treatment or moral responsibility are frequently linked to the presence of a disease.

Purpose of the Study:

• To critically examine the role of the concept of "disease" in clinical medicine.
• To argue that the health/disease distinction is often irrelevant for clinical decision-making.
• To advocate for a conceptual liberation from the "disease" concept for mature clinical practice.

Main Methods:

• Conceptual analysis of the terms "health", "disease", and "illness" in clinical contexts.
• Philosophical argumentation challenging the perceived importance of the disease concept.
• Critique of the assumption that disease status dictates clinical decisions.

Main Results:

• The crucial role attributed to the "disease" concept in clinical decision-making is illusory.
• The distinction between health and disease is irrelevant for a majority of clinical decisions.
• The concept of disease acts as a conceptual "straightjacket" on clinical reasoning.

Conclusions:

• Sophisticated and mature clinical decision-making requires moving beyond the concept of disease.
• Liberating clinical practice from the "disease" concept allows for more nuanced and effective patient care.
• The focus should shift from diagnosing disease to understanding individual patient states and contexts.