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  1. A definition and ethical evaluation of overdiagnosis.Stacy M. Carter, Chris Degeling, Jenny Doust & Alexandra Barratt - 2016 - Journal of Medical Ethics 42 (11):705-714.
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  • Diagnosis, narrative identity, and asymptomatic disease.Mary Jean Walker & Wendy A. Rogers - 2017 - Theoretical Medicine and Bioethics 38 (4):307-321.
    An increasing number of patients receive diagnoses of disease without having any symptoms. These include diseases detected through screening programs, as incidental findings from unrelated investigations, or via routine checks of various biological variables like blood pressure or cholesterol. In this article, we draw on narrative identity theory to examine how the process of making sense of being diagnosed with asymptomatic disease can trigger certain overlooked forms of harm for patients. We show that the experience of asymptomatic disease can involve (...)
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  • Conséquences du surdiagnostic en cancérologie : vers une refonte du vocabulaire médical.Alexandra Larocque - 2020 - Ithaque 27 (Automne 2020):1-19.
    Dans le diagnostic du cancer, la précocité du diagnostic est généralement un élément valorisé. Selon la croyance commune, un cancer détecté tôt aura plus de chance d’être traitable. Or, cette conception des avantages du diagnostic précoce mène dans certains cas au phénomène de surdiagnostic, soit le fait de diagnostiquer un cancer à des individus qui n’en ont pas encore un et qui sont potentiellement en voie de le développer. Dans cet article, nous défendrons d’abord que le phénomène de surdiagnostic est (...)
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  • Trust in health care and vaccine hesitancy.Elisabetta Lalumera - 2018 - Rivista di Estetica 68:105-122.
    Health care systems can positively influence our personal decision-making and health-related behavior only if we trust them. I propose a conceptual analysis of the trust relation between the public and a healthcare system, drawing from healthcare studies and philosophical proposals. In my account, the trust relation is based on an epistemic component, epistemic authority, and on a value component, the benevolence of the healthcare system. I argue that it is also modified by the vulnerability of the public on healthcare matters, (...)
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  • Analysing the ethics of breast cancer overdiagnosis: a pathogenic vulnerability.Wendy A. Rogers - 2019 - Medicine, Health Care and Philosophy 22 (1):129-140.
    Breast cancer screening aims to help women by early identification and treatment of cancers that might otherwise be life-threatening. However, breast cancer screening also leads to the detection of some cancers that, if left undetected and untreated, would not have damaged the health of the women concerned. At the time of diagnosis, harmless cancers cannot be identified as non-threatening, therefore women are offered invasive breast cancer treatment. This phenomenon of identifying non-harmful cancers is called overdiagnosis. Overdiagnosis is morally problematic as (...)
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  • Current Dilemmas in Defining the Boundaries of Disease.Jenny Doust, Mary Jean Walker & Wendy A. Rogers - 2017 - Journal of Medicine and Philosophy 42 (4):350-366.
    Boorse’s biostatistical theory states that diseases should be defined in ways that reflect disturbances of biological function and that are objective and value free. We use three examples from contemporary medicine that demonstrate the complex issues that arise when defining the boundaries of disease: polycystic ovary syndrome, chronic kidney disease, and myocardial infarction. We argue that the biostatistical theory fails to provide sufficient guidance on where the boundaries of disease should be drawn, contains ambiguities relating to choice of reference class, (...)
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  • (1 other version)Defining disease in the context of overdiagnosis.Mary Jean Walker & Wendy Rogers - 2017 - Medicine, Health Care and Philosophy 20 (2):269-280.
    Recently, concerns have been raised about the phenomenon of ‘overdiagnosis’, the diagnosis of a condition that is not causing harm, and will not come to cause harm. Along with practical, ethical, and scientific questions, overdiagnosis raises questions about our concept of disease. In this paper, we analyse overdiagnosis as an epistemic problem and show how it challenges many existing accounts of disease. In particular, it raises ques- tions about conceptual links drawn between disease and dysfunction, harm, and risk. We argue (...)
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  • A definition and ethical evaluation of overdiagnosis: response to commentaries.Stacy M. Carter, Chris Degeling, Jenny Doust & Alexandra Barratt - 2016 - Journal of Medical Ethics 42 (11):722-724.
    Overdiagnosis is an emerging problem in health policy and practice: we address its definition and ethical implications. We argue that the definition of overdiagnosis should be expressed at the level of populations. Consider a condition prevalent in a population, customarily labelled with diagnosis A. We propose that overdiagnosis is occurring in respect of that condition in that population when the condition is being identified and labelled with diagnosis A in that population ; this identification and labelling would be accepted as (...)
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  • Wakefield’s Harm-Based Critique of the Biostatistical Theory.Christopher Boorse - 2024 - Journal of Medicine and Philosophy 49 (4):367-388.
    Jerome Wakefield criticizes my biostatistical analysis of the pathological—as statistically subnormal biological part-functional ability relative to species, sex, and age—for its lack of a harm clause. He first charges me with ignoring two general distinctions: biological versus medical pathology, and disease of a part versus disease of a whole organism. He then offers 10 counterexamples that, he says, are harmless dysfunctions but not medical disorders. Wakefield ends by arguing that we need a harm clause to explain American psychiatry’s 1973 decision (...)
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  • Risk, Overdiagnosis and Ethical Justifications.Wendy A. Rogers, Vikki A. Entwistle & Stacy M. Carter - 2019 - Health Care Analysis 27 (4):231-248.
    Many healthcare practices expose people to risks of harmful outcomes. However, the major theories of moral philosophy struggle to assess whether, when and why it is ethically justifiable to expose individuals to risks, as opposed to actually harming them. Sven Ove Hansson has proposed an approach to the ethical assessment of risk imposition that encourages attention to factors including questions of justice in the distribution of advantage and risk, people’s acceptance or otherwise of risks, and the scope individuals have to (...)
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  • Casting the net too wide on overdiagnosis: benefits, burdens and non-harmful disease.Wendy A. Rogers & Yishai Mintzker - 2016 - Journal of Medical Ethics 42 (11):717-719.
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  • Wrongful Medicalization and Epistemic Injustice in Psychiatry: The Case of Premenstrual Dysphoric Disorder.Anne-Marie Gagné-Julien - 2021 - European Journal of Analytic Philosophy 17 (2):(S4)5-36.
    In this paper, my goal is to use an epistemic injustice framework to extend an existing normative analysis of over-medicalization to psychiatry and thus draw attention to overlooked injustices. Kaczmarek has developed a promising bioethical and pragmatic approach to over-medicalization, which consists of four guiding questions covering issues related to the harms and benefits of medicalization. In a nutshell, if we answer “yes” to all proposed questions, then it is a case of over-medicalization. Building on an epistemic injustice framework, I (...)
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  • (1 other version)The overdiagnosis of what? On the relationship between the concepts of overdiagnosis, disease, and diagnosis.Bjørn Hofmann - 2017 - Medicine, Health Care and Philosophy 20 (4):453-464.
    Overdiagnosis and disease are related concepts. Widened conceptions of disease increase overdiagnosis and vice versa. This is partly because there is a close and complex relationship between disease and overdiagnosis. In order to address the problems with overdiagnosis, we may benefit from a closer understanding this relationship. Accordingly, the objective of this article is to elucidate the relationship between disease and overdiagnosis. To do so, the article starts with scrutinizing how overdiagnosis can explain the expansion of the concept of disease. (...)
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  • Introduction: The Boundaries of Disease.Mary Jean Walker & Wendy A. Rogers - 2017 - Journal of Medicine and Philosophy 42 (4):343-349.
    Although health and disease occupy opposite ends of a spectrum, distinguishing between them can be difficult. This is the “line-drawing” problem. The papers in this special issue engage with this challenge of delineating the boundaries of disease. The authors explore different views as to where the boundary between disease and nondisease lies, and related questions, such as how we can identify, or decide, what counts as a disease and what does not; the nature of the boundary between the two categories; (...)
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