What Is Disease?

George Khushf

The book opens with a lengthy essay by Christopher Boorse, who is the most prominent representative of the view that disease is a value-neutral scientific concept, established as a matter of fact by pathology. Clinical medicine works with "disease-plus" categories, which involve values associated with treatment. Remaining authors all disagree with Boorse, although they differ among themselves about the degree to which values are universal and objectivity can be obtained. Michael Ruse considers whether homosexuality is a disease. K. Danner Clouser, Charles Culver, and Bernard Gert develop a concept of malady that depends on harms a rational person would seek to avoid. Frederik Kaufman also develops a similar position. George Agich, John Banja, and Stan van Hooft provide weak normative accounts in which disease concepts depend on values associated with culture and individual experience, and they are specified in relation to particular clinical ends. The final essay by Mark Woodhouse considers the relation between alternative and traditional medical disease concepts. The purpose of the book is to promote an understanding of disease and consider the role that values play in medical science. This book is most pertinent for philosophers of medicine. Those working on ethical issues in health care will find helpful the general discussion about the role of values in the construction of medical reality. For similar reasons, anyone in biomedical research may benefit. Pathologists may find Boorse's discussion of the foundational role of pathology in medicine especially interesting. The book has few illustrations, tables, or figures. The index is only moderately helpful. Overall, theprinting is of good quality and the book well bound. There is much at stake in the debate about the role of values in the construction of medical nosologies. If Boorse is correct, then medical science should seek to identify and eliminate values; any role they play signifies a prescientific remnant. If weak normativists are correct, ethical reflection becomes a constitutive moment of the scientific enterprise itself, and the task is to incorporate the right values. The importance of the issue can be seen in the debates about screening mammography, homosexuality, and alternative medicine. Medical and university libraries should purchase the book; it will be important reading for anyone interested in the philosophy of medicine or bioethics; it is also of value to those in health policy and biomedical research.

From The Critics

Reviewer: George Khushf, PhD(University of South Carolina)
Description: The book opens with a lengthy essay by Christopher Boorse, who is the most prominent representative of the view that disease is a value-neutral scientific concept, established as a matter of fact by pathology. Clinical medicine works with "disease-plus" categories, which involve values associated with treatment. Remaining authors all disagree with Boorse, although they differ among themselves about the degree to which values are universal and objectivity can be obtained. Michael Ruse considers whether homosexuality is a disease. K. Danner Clouser, Charles Culver, and Bernard Gert develop a concept of malady that depends on harms a rational person would seek to avoid. Frederik Kaufman also develops a similar position. George Agich, John Banja, and Stan van Hooft provide weak normative accounts in which disease concepts depend on values associated with culture and individual experience, and they are specified in relation to particular clinical ends. The final essay by Mark Woodhouse considers the relation between alternative and traditional medical disease concepts.
Purpose: The purpose of the book is to promote an understanding of disease and consider the role that values play in medical science.
Audience: This book is most pertinent for philosophers of medicine. Those working on ethical issues in health care will find helpful the general discussion about the role of values in the construction of medical reality. For similar reasons, anyone in biomedical research may benefit. Pathologists may find Boorse's discussion of the foundational role of pathology in medicine especially interesting.
Features: The book has few illustrations, tables, or figures. The index is only moderately helpful. Overall, the printing is of good quality and the book well bound.
Assessment: There is much at stake in the debate about the role of values in the construction of medical nosologies. If Boorse is correct, then medical science should seek to identify and eliminate values; any role they play signifies a prescientific remnant. If weak normativists are correct, ethical reflection becomes a constitutive moment of the scientific enterprise itself, and the task is to incorporate the right values. The importance of the issue can be seen in the debates about screening mammography, homosexuality, and alternative medicine. Medical and university libraries should purchase the book; it will be important reading for anyone interested in the philosophy of medicine or bioethics; it is also of value to those in health policy and biomedical research.

3 Stars from Doody