{"title":"The Disease Loophole: Index Terms and Their Role in Disease Misclassification.","authors":"Alex N Roberts","doi":"10.1093/jmp/jhae006","DOIUrl":null,"url":null,"abstract":"<p><p>The definitions of disease proffered by philosophers and medical actors typically require that a state of ill health be linked to some known bodily dysfunction before it is classified as a disease. I argue that such definitions of disease are not fully implementable in current medical discourse and practice. Adhering to the definitions would require that medical actors keep close track of the current state of knowledge on the causes and mechanisms of particular illnesses. Yet, unaddressed problems in medical terminology can make this difficult to do. I show that unrecognized misuse of \"heterogeneous,\" \"biomarker,\" and other important health terms-which I call index terms-can misrepresent the current empirical evidence on illness pathophysiology, such that unvalidated illness constructs become mistaken for diseases. Thus, implementing common definitions of disease would require closing this \"loophole\" in medical discourse. I offer a simple rule that, if followed, could help do just that.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Medicine and Philosophy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/jmp/jhae006","RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ETHICS","Score":null,"Total":0}
引用次数: 0
Abstract
The definitions of disease proffered by philosophers and medical actors typically require that a state of ill health be linked to some known bodily dysfunction before it is classified as a disease. I argue that such definitions of disease are not fully implementable in current medical discourse and practice. Adhering to the definitions would require that medical actors keep close track of the current state of knowledge on the causes and mechanisms of particular illnesses. Yet, unaddressed problems in medical terminology can make this difficult to do. I show that unrecognized misuse of "heterogeneous," "biomarker," and other important health terms-which I call index terms-can misrepresent the current empirical evidence on illness pathophysiology, such that unvalidated illness constructs become mistaken for diseases. Thus, implementing common definitions of disease would require closing this "loophole" in medical discourse. I offer a simple rule that, if followed, could help do just that.
期刊介绍:
This bimonthly publication explores the shared themes and concerns of philosophy and the medical sciences. Central issues in medical research and practice have important philosophical dimensions, for, in treating disease and promoting health, medicine involves presuppositions about human goals and values. Conversely, the concerns of philosophy often significantly relate to those of medicine, as philosophers seek to understand the nature of medical knowledge and the human condition in the modern world. In addition, recent developments in medical technology and treatment create moral problems that raise important philosophical questions. The Journal of Medicine and Philosophy aims to provide an ongoing forum for the discussion of such themes and issues.