WHAT Is DISEASE?
BOARD OF EDITORS William Bechtel Washington University St. Louis, Missouri William J. Curran Harvard School of Public Health Boston, Massachusetts Kurt Hirschhorn The Mount Sinai Medical Center New York, New York Richard Hull State Univ. of New York, Buffalo Amherst, New York James Muyskens University System of Georgia Atlanta, Georgia James Rachels University of Alabama Birmingham, Alabama George Rainbolt Georgia State University Atlanta, Georgia Richard Wasserstrom University of California Santa Cruz, California Thomas H. Murray Case Western Reserve University Cleveland, Ohio
BIOMEDICAL ETHICS REVIEWS WHAT Is DISEASE? Edited by James M. Humber and Robert F. Almeder Georgia State Universitv Atlanta, Georgia * Springer Science+Business Media, LLC
Copyright 1997 by Springer Science+Business Media New York Originally published by Humana Press Inc. in 1997 Softcover reprint ofthe hardcover 1st edition 1997 All rights in any form whatsoever reserved. No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means (electronic, mechanical, photocopying, microfilming, recording, or otherwise) without written permission from the publisher. All authored papers, comments, opinions, conclusions, or recommendations are those of the author(s) and do not necessarily reflect the views of the publisher. This publication is printed on acid-free paper. Gi> ANSI Z39.48-1984 (American National Standards Institute) Permanence of Paper for Printed Library Materials. Cover design by Patricia F. Cleary. Photocopy Authorizatlon Policy: Authorization to photocopy items for internal or personal use, or the internal or personal use of specific clients, is granted by Springer Science+Business Media, LLC, provided that the base fee of US $8.00 per copy, plus US $00.25 per page, is paid directly to the Copyright Clearance Center at 222 Rosewood Drive, Danvers, MA 01923. For those organizations that have been granted a photocopy license from the CCC, a separate system of payment has been arranged and is acceptable to Springer Science+Business Media, LLC. The fee code tor users ofthe Transactional Reporting Service is: [0742-1796/97 $8.00 + $00.25]. ISBN 978-1-61737-015-1 DOI 10.1007/978-1-59259-451-1 ISBN 978-1-59259-451-1 (ebook) The Library of Congress has cataloged this serial title as foliows: Biomedical ethics reviews-1983- Totowa, NJ: Humana Press, c1982- v.; 25 cm-{contemporary issues in biomedicine, ethics, and society) Annual. Editors: James M. Humber and Robert F. Almeder. ISSN 0742-1796 = Biomedical ethics reviews. 1. Medical ethics--periodicals. I. Humber, James M. 11. Almeder, Robert F. 111. Series. [DNLM: Ethics, Medical-periodicals. W1 B615 (P)] R724.B493 174'.2'0~c19 84-640015 AACR2 MARC-S
Contents vii ix Preface Contributors 1 A Rebuttal on Health Christopher Boorse 135 Defming Disease: The Question of Sexual Orientation Michael Ruse 173 Malady K. Danner Clouser, Charles M. Culver, and Bernard Gert 219 Toward a Pragmatic Theory ofdisease George J. Agich 247 Defining Disease: Praxis Makes Perfeet John D. Banja 269 Disease: Definition and Objectivity Frederik Kau/man 287 Disease and Subjectivity Stan van Hooft 325 The Concept ofdisease in Alternative Medicine Mark B. Woodhouse 357 Index v
Preface This book is the fourteenth volume in aseries designed to review and update the literature on issues of central importance in bioethics today. Each annual volume of BiomedicaZ Ethics Reviews is organized around a central theme. This year the topic for discussion is the concept of disease. What Is Disease? opens with a lengthy essay by Christopher Boorse. Some 20 years ago, Boorse wrote aseries of artic1es in which he offered what many consider to be the canonical defense of the view that disease is a value-free scientific concept. This view, which has come to be called naturalism or neutralism, gave rise to numerous objections. In his essay,"a Rebuttal on Health," Boorse responds to all those who have criticized his theory, and in the process both c1arifies and modifies his early views. Boorse's artic1e is followed by a number of essays in which nonnaturalistic theories of disease are analyzed, developed, and oftentimes defended. We greatly hope our readers will find the present volume of Biomedical Ethics Reviews to be both enjoyable and informative, and that they wi11look forward with anticipation to the publication ofnext year's volume, Issues in Alternative Medicine. James M. Humber Robert F. Almeder Vll
Contributors George Agich School of Medicine, Southem Illinois University, Springfield, Illinois John D. Banja Center for Rehabilitation Medicine, Emory University, Atlanta, Georgia Christopher Boorse Department ofphilosophy, University of Delaware, Newark, Delaware K. Danner Clouser Hershey Medical Center, Pennsylvania State University, Hershey, Pennsylvania Charles M. Culver Florida College of Physician Assistants, Miami, Florida Bernard Gert Department ofphilosophy, Dartmouth College, Hanover, New Hampshire Frederik Kau/man Department of Philosophy and Religion, Ithaca College, Ithaca, New York Michael Ruse Departments ofphilosophy and Zoology, University of Guelph, Guelph, Ontario, Canada Stan van Hooft School of Social Inquiry, Deakin University, Toorak, Malvem, Australia Mark Woodhouse Department of Philosophy, Georgia State University, Atlanta, Georgia IX