Browsing by Subject "Conceptual analysis"

The thesis examines various claims about value-ladenness of the medical concept of disease. The focus is on the discussion about the boundaries of normality originating in the controversies around psychiatry in the 1960s and 1970s and currently still active. Primarily, the analysis is centered upon Christopher Boorse’s Biostatistical Model (BST) which aims at setting the boundaries between health and disease. The BST is a naturalist account portraying health and disease as scientific and value-free concepts. The critics of the BST either view health and disease as essentially normative concepts or just provide claims about the BST’s covert normativity ignoring the question of the correct account of the concepts. The main question considered is whether the BST or the concept of disease it analyzes are value-laden. Secondly – but even more importantly – it is assessed what it means for a scientific concept such as disease to be value-laden and what might be the implications of such value-ladenness. Conceptual analysis is applied throughout the thesis. The validity of different arguments for and against the value-freeness of disease and the BST is assessed. The primary argument is that disease as defined by the BST is value-laden even though the concept may be given a description in value-free terms. The values enter on the level of choice of either the goals of biological organisms or the reference classes applied in the BST. Given different values, alternative goals or reference classes could have been chosen. Choosing alternative goals or reference classes would lead to a different concept of disease. Hence, values affect the concept of disease that results from the BST and thus disease may be considered value-laden. The secondary argument is that while disease as defined by the BST may be considered value-laden, the value of this consideration is rather limited in the absence of further elaboration. From the observation that disease is value-laden in the way described above, it does not follow that the concept is not scientific or that the medical science and the concepts it applies are flawed. Moreover, the sort of value-ladenness in question does not necessarily imply any normative flaws in medical theory, the BST or the concept of disease. It is concluded that if the values driving the choices medicine and the BST make are shared enough, then the value-ladenness resulting from those choices may be considered inconsequential. The problematic issues would only arise in contexts where values are diverse and competing. Determining the correct role and meaning of values in construction of medical concepts is still a work in progress.