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Beyond Conceptual Analysis: Social Objectivity and Conceptual Engineering to Define Disease
J Med Philos. 2024 Feb 29:jhae002. doi: 10.1093/jmp/jhae002. Online ahead of print.ABSTRACTIn this article, I side with those who argue that the debate about the definition of "disease" should be reoriented from the question "what is disease" to the question of what it should be. However, I ground my argument on the rejection of the naturalist approach to define disease and the adoption of a normativist approach, according to which the concept of disease is normative and value-laden. Based on this normativist approach, I defend two main theses: (1) that conceptual analysis is not the right method to define disease and that...
Source: The Journal of Medicine and Philosophy - February 29, 2024 Category: Medical Ethics Authors: Anne-Marie Gagn é-Julien Source Type: research

Unfreedom or Mere Inability? The Case of Biomedical Enhancement
J Med Philos. 2024 Feb 28:jhae007. doi: 10.1093/jmp/jhae007. Online ahead of print.ABSTRACTMere inability, which refers to what persons are naturally unable to do, is traditionally thought to be distinct from unfreedom, which is a social type of constraint. The advent of biomedical enhancement, however, challenges the idea that there is a clear division between mere inability and unfreedom. This is because bioenhancement makes it possible for some people's mere inabilities to become matters of unfreedom. In this paper, I discuss several ways that this might occur: first, bioenhancement can exacerbate social pressures to en...
Source: The Journal of Medicine and Philosophy - February 28, 2024 Category: Medical Ethics Authors: Ji Young Lee Source Type: research

Reference-Class Problems Are Real: Health-Adjusted Reference Classes and Low Bone Mineral Density
J Med Philos. 2024 Feb 28:jhae005. doi: 10.1093/jmp/jhae005. Online ahead of print.ABSTRACTElselijn Kingma argues that Christopher Boorse's biostatistical theory (the BST) does not show how the reference classes it uses are objective and naturalistic. Recently, philosophers of medicine have attempted to rebut Kingma's concerns. I argue that these rebuttals are theoretically unconvincing, and that there are clear examples of physicians adjusting their reference classes according to their prior knowledge of health and disease. I focus on the use of age-adjusted reference classes to diagnose low bone mineral density in childr...
Source: The Journal of Medicine and Philosophy - February 28, 2024 Category: Medical Ethics Authors: Nicholas Binney Source Type: research

The Phenomenology of the Face-to-Facetime: A Levinasian Critique of the Virtual Clinic
J Med Philos. 2024 Feb 28:jhae003. doi: 10.1093/jmp/jhae003. Online ahead of print.ABSTRACTIn order to promote social distancing during the recent COVID-19 pandemic, physicians and healthcare systems have made efforts to replace in-person with virtual clinic visits when feasible. While these efforts have been well received and seem compatible with sound clinical practice, they do not perfectly replicate the experience of a face-to-face exchange between doctor and patient. This essay attempts to describe features of the virtual visit that distinguish it from its face-to-face analog and considers the phenomenological work of...
Source: The Journal of Medicine and Philosophy - February 28, 2024 Category: Medical Ethics Authors: Daniel C O'Brien Source Type: research

Interventionism and Intelligibility: Why Depression Is Not (Always) a Brain Disease
J Med Philos. 2024 Feb 28:jhae004. doi: 10.1093/jmp/jhae004. Online ahead of print.ABSTRACTMajor depressive disorder (MDD) is a serious condition with a large disease burden. It is often claimed that MDD is a "brain disease." What would it mean for MDD to be a brain disease? I argue that the best interpretation of this claim is as offering a substantive empirical hypothesis about the causes of the syndrome of depression. This syndrome-causal conception of disease, combined with the idea that MDD is a disease of the brain, commits the brain disease conception of MDD to the claim that brain dysfunction causes the symptoms of...
Source: The Journal of Medicine and Philosophy - February 28, 2024 Category: Medical Ethics Authors: Quinn Hiroshi Gibson Source Type: research

The Disease Loophole: Index Terms and Their Role in Disease Misclassification
J Med Philos. 2024 Feb 28:jhae006. doi: 10.1093/jmp/jhae006. Online ahead of print.ABSTRACTThe 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...
Source: The Journal of Medicine and Philosophy - February 28, 2024 Category: Medical Ethics Authors: Alex N Roberts Source Type: research