This paper argues that the medical conception of health as absence of disease is a value-free theoretical notion. Its main elements are biological function and statistical normality, in contrast to various other ideas prominent in the literature on health. Apart from universal environmental injuries, diseases are internal states that depress a functional ability below species-typical levels. Health as freedom from disease is then statistical normality of function, i.e., the ability to perform all typical physiological functions with at least typical efficiency. (...) This conception of health is as value-free as statements of biological function. The view that health is essentially value-laden, held by most writers on the topic, seems to have one of two sources: an assumption that health judgments must be practical judgments about the treatment of patients, or a commitment to "positive" health beyond the absence of disease. I suggest that the assumption is mistaken, the commitment possibly misdescribed. (shrink)

In a previous paper the concept of disease was fuzzy-logically analyzed and a sketch was given of a prototype resemblance theory of disease (Sadegh-Zadeh (2000). J. Med. Philos., 25:605–38). This theory is outlined in the present paper. It demonstrates what it means to say that the concept of disease is a nonclassical one and, therefore, not amenable to traditional methods of inquiry. The theory undertakes a reconstruction of disease as a category that in contradistinction to traditional views is not based (...) on a set of common features of its members, that is individual diseases, but on a few best examples of the category, called its prototypes, and a similarity relationship such that a human condition is considered a disease if it resembles a prototype. It enables new approaches to resolving many of the stubborn problems associated with the concept of disease. (shrink)

Medical practice is practiced morality, and clinical research belongs to normative ethics. The present book elucidates and advances this thesis by: 1. analyzing the structure of medical language, knowledge, and theories; 2. inquiring into the foundations of the clinical encounter; 3. introducing the logic and methodology of clinical decision-making, including artificial intelligence in medicine; 4. suggesting comprehensive theories of organism, life, and psyche; of health, illness, and disease; of etiology, diagnosis, prognosis, prevention, and therapy; and 5. investigating the moral and (...) metaphysical issues central to medical practice and research. Many systems of (classical, modal, non-classical, probability, and fuzzy) logic are introduced and applied. Fuzzy medical deontics, fuzzy medical ontology, fuzzy medical concept formation, fuzzy medical decision-making and biomedicine and many other techniques of fuzzification in medicine are introduced for the first time. -/- . (shrink)

The notions of health, illness, and disease are fuzzy-theoretically analyzed. They present themselves as non-Aristotelian concepts violating basic principles of classical logic. A recursive scheme for defining the controversial notion of disease is proposed that also supports a concept of fuzzy disease. A sketch is given of the prototype resemblance theory of disease.

inheritance reasoning in semantic networks allowing for multiple inheritance with exceptions. The approach leads to a definition of iaheritance that is..

During the last decades it has emerged that concepts probably do not constitute a homogeneous set of entities from a psychological point of view. Various divides can be drawn between different types of concepts. Probably, the main empirical achievement in this field has been the inadequacy of the so-called “classical view”: most concepts cannot be characterised in terms of sets of necessary and sufficient conditions; rather, they exhibit typicality effects. In this chapter I will suggest that typicality effects, far from (...) being a symptom of some homogeneous underlying cognitive structure, are more plausibly the consequence of some “ecological constraints” acting on the mind. In other words, typicality effects could be the effect of some form of “convergent evolution” between heterogeneous mental structures. This should have important consequences on the role of the notion of “concept” itself: the status of the concept of “concept” in cognitive science should be similar to that of the concept of “fat plant” in botany, which can be of some utility in certain cases, but does not correspond to a genuine botanical kind. (shrink)

This paper examines what it is for a condition to be a disease. It falls into two sections. In the first I examine the best existing account of disease (as proposed by Christopher Boorse) and argue that it must be rejected. In the second I outline a more acceptable account of disease. According to this account, by disease we mean a condition that it is a bad thing to have, that is such that we consider the afflicted person to have (...) been unlucky, and that can potentially be medically treated. All three criteria must be fulfilled for a condition to be a disease. The criterion that for a condition to be a disease it must be a bad thing is required to distinguish the biologically different from the diseased. The claim that the sufferer must be unlucky is needed to distinguish diseases from conditions that are unpleasant but normal, for example teething. Finally, the claim that for a condition to be a disease it must be potentially medically treatable is needed to distinguish diseases from other types of misfortune, for example economic problems and legal problems. (shrink)

This essay replies to critics since 1995 of my “biostatistical theory” of health. According to the BST, a pathological condition is a state of statistically species-subnormal biological part-functional ability, relative to sex and age. Theoretical health, the total absence of pathological conditions, is then a value-free scientific notion. Recent critics offer a mixture of old and new objections to this analysis. Some new ones relate to choice of reference class, situation-specificity of function, common diseases and healthy populations, improvements in population (...) health, the practice of pathologists, “Cambridge changes” in health status, and comparative vs. absolute health concepts. I make no changes in doctrine, except to consider treating “normal aging” as pathological by taking young adults as the standard for all adults. (shrink)

The reconciliation of theories of concepts based on prototypes, exemplars, and theory-like structures is a longstanding problem in cognitive science. In response to this problem, researchers have recently tended to adopt either hybrid theories that combine various kinds of representational structure, or eliminative theories that replace concepts with a more finely grained taxonomy of mental representations. In this paper, we describe an alternative approach involving a single class of mental representations called “semantic pointers.” Semantic pointers are symbol-like representations that result (...) from the compression and recursive binding of perceptual, lexical, and motor representations, effectively integrating traditional connectionist and symbolic approaches. We present a computational model using semantic pointers that replicates experimental data from categorization studies involving each prior paradigm. We argue that a framework involving semantic pointers can provide a unified account of conceptual phenomena, and we compare our framework to existing alternatives in accounting for the scope, content, recursive combination, and neural implementation of concepts. (shrink)

It seems to me that the ingredients of most theories both in Artificial Intelligence and in Psychology have been on the whole too minute, local, and unstructured to account–either practically or phenomenologically–for the effectiveness of common-sense thought. The "chunks" of reasoning, language, memory, and "perception" ought to be larger and more structured; their factual and procedural contents must be more intimately connected in order to explain the apparent power and speed of mental activities.

The present paper constitutes a development of the position that illness, whether bodily or mental, should be analyzed as an incapacitating failure of bodily or mental capacities, respectively, to realize their functions. The paper undertakes this development by responding to two critics. It addresses first Szasz’s continued claims that (1) physical illness is the paradigm concept of illness and (2) a philosophical analysis of mental illness does not shed any light on the social and legal role of the idea. Then, (...) in reply to Wakefield, the aim is to defend the account as an interpretation of Aristotle and to argue that this Aristotelian view of mental illness is preferable to one that rests on a supposed value free account of human function. More generally the discussion points to the fact that both Wakefield and Szasz rely on a number of metaphysical assumptions about the supposedly empirical nature of medical diagnosis, about the relation between facts and values, and about mind and body (among others), which are open to challenge. In particular the paper indicates an aristotelian approach to the fusion, in the natural world, of so-called facts and values, and the relevance of this fusion to the analysis of the concept of illness. This suggests the debate over distinct conceptions of that concept must both illumine and be illuminated by these deeper metaphysical questions. (shrink)