Smart, Benjamin
(2014)
On the Classification of Diseases.
Theoretical Medicine and Bioethics, 35 (4).
pp. 251-269.
ISSN 1573-1200 (electronic)
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Abstract
Identifying the necessary and sufficient conditions for individuating and classifying
diseases is a matter of great importance in the fields of law, ethics, epidemiology, and
of course medicine. In this paper I first propose a means of achieving this goal,
ensuring that no two distinct disease-types could correctly be ascribed to the same
disease-token. I then posit a metaphysical ontology of diseases - that is, I give an
account of what a disease is. This is essential to providing the most effective means of
interfering with disease processes.
Following existing work in the philosophy of medicine and epidemiology (primarily
Boorse; Whitbeck; Broadbent), philosophy of biology (LaPorte; Hull), conditional
analyses of causation (JL Mackie; Lewis), and recent literature on dispositional
essentialism (Mumford and Anjum; Bird), I endorse a dispositional conception of
disease whereby (i) diseases are individuated by their causes, and (ii) diseases are
causal processes best seen as simultaneously acting sequences of mutually
manifesting dispositions - this, I claim, follows from the assumption that diseases
should be classified by consideration of both their clinical and pathological effects, and
importantly, events that can lead to the cessation of these symptoms.
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