On the concept of disease
A new concept of disease is proposed under the Systems Theory of Levels of Complexity. The objective reality of pathological lesions and organic and mental dysfunctions is admitted as characteristic of the individual level of organization. Diseases, though, are defined as social constructs of collective nature. Current definitions of disease fail to recognize the fact that diseased and diseases belongs to distinct levels of complexity. The question of anachronism in diagnosing pathological conditions in the past is addressed. Defining disease and health is both a necessity and a challenge. It has been attempted by anthropologists, sociologists, philosophers, biologists, and medical doctors. The very need for a definition has been questioned recently (Hesslow, 1993), but a clear theoretical concept and an operational definition are certainly needed. Seedhouse (1993) and Nordenfelt (1993a, 1993b) justified that need not only as a matter of purely philosophical speculation and applied philosophical research, but also for pragmatic reasons, as a reference for legal litigations and health care policies. It is also a requisite to allow doctors and patients to understand each other. A growing body of literature addresses this question, but a thorough bibliographic review will show that the failure to distinguish between phenomena pertaining to distinct levels of complexity has so far confused the actual issue and led frequently to fruitless arguments.
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