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)

Alan Sidelle's Necessity, Essence, and Individuation is a sustained defense of empiricism—or, more generally, conventionalism—against recent attacks by realists. Sidelle focuses his attention on necessity a posteriori, a kind of necessity which contemporary realists have taken to support realism over empiricism. Turning the tables against the realists, Sidelle argues that if there are in fact truths necessary a posteriori, it is not realism, but rather empiricism which provides the best explanation for them.

One obvious solution to the puzzles of apparently coincident objects is a sort of reductionism - the tree really just is the wood, the statue is just the clay, and nothing really ceases to exist in the purported non-identity showing cases. This paper starts with that approach and its underlying motivation, and argues that if one follows those motivations - specifically, the rejection of coincidence, and the belief that 'genuine' object-destroying changes must differ non-arbitrarily from accidental changes, that one can (...) plausibly be pushed to an extreme nihilism, that denies the existence of any objects at all. (shrink)

THE ARTICLE DEMONSTRATES FOR SOMATIC MEDICINE AS WELL AS PSYCHIATRY AND PSYCHOTHERAPY THAT THE CONCEPT OF DISEASE IS AT LEAST PARTIALLY DEPENDENT ON IDEOLOGICAL CONSIDERATIONS. THE PAPER SURVEYS REPRESENTATIVE VIEWS AND EXPLORES THE BEARING OF THE CONCEPTS OF NORMS, FUNCTIONS, VALUES ON THE SPECIFICATION OF DISEASE.

How should we define ‘health’ and ‘disease’? There are three main positions in the literature. Naturalists desire value-free definitions based on scientific theories. Normativists believe that our uses of ‘health’ and ‘disease’ reflect value judgments. Hybrid theorists offer definitions containing both normativist and naturalist elements. This paper discusses the problems with these views and offers an alternative approach to the debate over ‘health’ and ‘disease’. Instead of trying to find the correct definitions of ‘health’ and ‘disease’ we should explicitly talk (...) about the considerations that are central in medical discussions, namely state descriptions and normative claims . This distinction avoids the problems facing the major approaches to defining ‘health’ and ‘disease’, and it more clearly captures what matters in medical discussions. (shrink)