Health, Disease, and Illness: Concepts in Medicine

Front Cover
Arthur L. Caplan, James J. McCartney, OSA, Dominic A. Sisti
Georgetown University Press, Jun 17, 2004 - Medical - 328 pages

In the 1850s, "Drapetomania" was the medical term for a disease found among black slaves in the United States. The main symptom was a strange desire to run away from their masters. In earlier centuries gout was understood as a metabolic disease of the affluent, so much so that it became a badge of uppercrust honor—and a medical excuse to avoid hard work. Today, is there such a thing as mental illness, or is mental illness just a myth? Is Alzheimer's really a disease? What is menopause—a biological or a social construction?

Historically one can see that health, disease, and illness are concepts that have been ever fluid. Modern science, sociology, philosophy, even society—among other factors—constantly have these issues under microscopes, learning more, defining and redefining ever more exactly. Yet often that scrutiny, instead of leading toward hard answers, only leads to more questions. Health, Disease, and Illness brings together a sterling list of classic and contemporary thinkers to examine the history, state, and future of ever-changing "concepts" in medicine.

Divided into four parts—Historical Discussions; Characterizing Health, Disease, and Illness; Clinical Applications of Health and Disease; and Normalcy, Genetic Disease, and Enhancement: The Future of the Concepts of Health and Disease—the reader can see the evolutionary arc of medical concepts from the Greek physician Galen of Pergamum (ca. 150 ce) who proposed that "the best doctor is also a philosopher," to contemporary discussions of the genome and morality. The editors have recognized a crucial need for a deeper integration of medicine and philosophy with each other, particularly in an age of dynamically changing medical science—and what it means, medically, philosophically, to be human.

From inside the book

Selected pages

Contents

Suffering and the Social Construction of Illness The Delegitimation of Illness Experience in Chronic Fatigue Syndrome
163
The Premenstrual Syndrome A Brief History
176
The Politics of Menopause The Discovery of a Deficiency Disease
187
Aging Culture and the Framing of Alzheimer Disease
201
The Medicalization of Aesthetic Surgery
221
The Quest for Medical Normalcy Who Needs It?
225
The Concept of Genetic Disease
233
Concepts of Disease after the Human Genome Project
243

On the Distinction between Disease and Illness
77
Malady A New Treatment of Disease
90
Health A Comprehensive Concept
104
The Distinction between Mental and Physical Illness
110
The Unnaturalness of Aging Give Me Reason to Live
117
Diagnosing and Defining Disease
128
Ambiguous Sex or Ambivalent Medicine?
137
The Discovery of Hyperkinesis Notes on the Medicalization of Deviant Behavior
153
From Enhancing Cognition in the Intellectually Intact
263
Treatment Enhancement and the Ethics of Neurotherapeutics
268
Whats Morally Wrong with Eugenics?
278
Acknowledgments
289
Contributors
291
Permissions and Credits
295
Index
297
Copyright

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Page 30 - It is this defective hematosis, or atmospherization of the blood, conjoined with a deficiency of cerebral matter in the cranium, and an excess of nervous matter distributed to the organs of sensation and assimilation, that is the true cause of that debasement of mind, which has rendered the people of Africa unable to take care of themselves.
Page 50 - ... psychopathology." The potentiality for universal human happiness, in this form at least, seems to me but another example of the I-wish-it-were-true type of fantasy. I do believe that human happiness or well-being on a hitherto unimaginably large scale, and not just for a select few, is possible. This goal could be achieved, however, only at the cost of many men, and not just a few being willing and able to tackle their personal, social, and ethical conflicts. This means having the courage and...
Page 32 - Cursed be Canaan; a servant of servants shall he be unto his brethren. 26. And he said, Blessed be JEHOVAH THE GOD of Shem ; and Canaan shall be his servant. 27. GOD shall enlarge Japheth, and he shall dwell in the tents of Shem; arid Canaan shall be his servant.
Page 49 - real" in exactly the same sense in which witches existed or were "real." CHOICE, RESPONSIBILITY, AND PSYCHIATRY While I have argued that mental illnesses do not exist, I obviously did not imply that the social and psychological occurrences to which this label is currently being attached also do not exist. Like the personal and social troubles which people had in the Middle Ages, they are real enough. It is the labels we give them that concerns us and, having labelled them, what we do about them....
Page 50 - Our adversaries are not demons, witches, fate, or mental illness. We have no enemy whom we can fight, exorcise, or dispel by "cure." What we do have are problems in living — whether these be biologic, economic, political, or sociopsychological. In this essay I was concerned only with problems belonging in the last mentioned category, and within this group mainly with those pertaining to moral values. The field to which modern psychiatry addresses itself is vast, and I made no effort to encompass...
Page 45 - excessive repression" or "acting out an unconscious impulse" illustrate the use of psychological concepts for judging (so-called) mental health and illness. The idea that chronic hostility, vengefulness, or divorce are indicative of mental illness would be illustrations of the use of ethical norms (that is, the desirability of love, kindness, and a stable marriage relationship). Finally, the widespread psychiatric opinion that only a mentally ill person would commit homicide illustrates the use of...
Page 84 - A disease is an illness only if it is serious enough to be incapacitating, and therefore is (i) undesirable for its bearer; (ii) a title to special treatment; and (iii) a valid excuse for normally criticizable behavior. The motivation for condition (ii) needs no explanation. As for (iii), the connection between illness and diminished responsibility has often been argued,16 and I shall mention here only one suggestive point. Our notion of illness belongs to the ordinary conceptual scheme of persons...
Page 149 - ... performed on a person in labor or who has just given birth and is performed for medical purposes connected with that labor or birth by a person licensed in the place it is performed as a medical practitioner, midwife, or person in training to become such a practitioner or midwife.
Page 46 - Two basic answers may be offered: (a) It may be the person himself (that is, the patient) who decides that he deviates from a norm. For example, an artist may believe that he suffers from a work inhibition; and he may implement this conclusion by seeking help for himself from a psychotherapist, (b) It may be someone other than the patient who decides that the latter is deviant (for example, relatives, physicians, legal authorities, society generally, etc.). In such a case a psychiatrist may be hired...
Page 36 - When driven to labor by the compulsive power of the white man, he performs the task assigned to him in a headlong, careless manner, treading down with his feet or cutting with his hoe the plants he is put to cultivate — breaking the tools he works with, and spoiling everything he touches that can be injured by careless handling. Hence the overseers call it 'rascality,' supposing that the mischief is intentionally done.

About the author (2004)

Arthur L. Caplan is Emmanuel and Robert Hart Professor of Bioethics, Chair of the Department of Medical Ethics, and director of the Center for Bioethics at the University of Pennsylvania.

James J. McCartney is associate professor in the department of philosophy at Villanova University, an associate fellow at the Center for Bioethics at the University of Pennsylvania, and an adjunct professor at the Villanova University School of Law.

Dominic A. Sisti is a researcher at the Center for Bioethics at the University of Pennsylvania, associate ethicist at Holy Redeemer Health System, and adjunct instructor at Villanova University.

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