The line-drawing problem in disease definition

Wendy A. Rogers*, Mary Jean Walker

*Corresponding author for this work

Research output: Contribution to journalArticle

10 Citations (Scopus)
6 Downloads (Pure)

Abstract

Biological dysfunction is regarded, in many accounts, as necessary and perhaps sufficient for disease. But although disease is conceptualized as all-or-nothing, biological functions often differ by degree. A tension is created by attempting to use a continuous variable as the basis for a categorical definition, raising questions about how we are to pinpoint the boundary between health and disease. This is the line-drawing problem. In this paper, we show how the line-drawing problem arises within "dysfunction-requiring" accounts of disease, such as those of Christopher Boorse and Jerome Wakefield. We then provide several detailed examples to establish that biological dysfunction cannot provide a boundary. We examine potential ways of resolving the line-drawing problem, either by dropping one of the claims that generates it, or by appealing to additional criteria. We argue that two of these options are plausible, and that each of these can be applied with regard to different diseases.

Original languageEnglish
Pages (from-to)405-423
Number of pages19
JournalJournal of Medicine and Philosophy (United Kingdom)
Volume42
Issue number4
DOIs
Publication statusPublished - 1 Aug 2017

Bibliographical note

Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Keywords

  • definition
  • disease
  • dysfunction
  • threshold problem
  • vagueness

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    Defining disease: Addressing the problem of overdiagnosis

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