Health, Disease, and Illness

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328 pp., 7 x 10
ISBN: 9781589010147 (1589010140)

ISBN: 9781589013384

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June 2004
LC: 2003019797


Table of Contents

Health, Disease, and Illness
Concepts in Medicine
Arthur L. Caplan, James J. McCartney, and Dominic A. Sisti
Foreword byEdmund D. Pellegrino

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.

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.

"This welcome anthology, encompassing an admirably broad variety of perspectives, ancient and modern, on the fundamental categorical and moral questions embedded in definitions of human health and disorder, is sure to become an essential resource forall who think seriously about the theory and practice of medicine."—Margaret E. Mohrmann, MD, PhD, Harrison Professor of Pediatrics, University of Virginia

"The articles in this collection present remarkably lucid, well-reasoned discussions of the issues at the junction of philosophy and medicine. An excellent overview of the history of medicine's central concepts (including health and disease) is put into fascinating perspective through significant discussions of how current developments in genetics and theories in biomedicine are changing both the face of medicine and its interface with philosophy. A very valuable collection that should be read by everyone involved in bioethics, the medical humanities and philosophy of medicine."—Richard M. Zaner, Ann Geddes Stahlman Professor Emeritus of Medical Ethics & Philosophy of Medicine, Vanderbilt University Medical Center

"This is an important collection of provocative essays about health and disease. It is the most comprehensive collection of its kind, bringing together in one volume historical works by figures such as Maimonides, late 20th century philosophical works by figures such as Boorse, sociological essays about contemporary diagnoses such as the chronic fatigue syndrome, and recent essays exploring the impact of the new genetics on our conceptions of health and disease. It will make an excellent resource for classes in the philosophy of medicine and wonderful reading for anyone interested in the relationship between the philosophy of medicine and medical ethics. I hope that its publication will spark a renewed interest in the philosophy of medicine among those scholars who can see that this is the direction bioethics must take to meet the challenges of the 21st century."—Daniel P. Sulmasy, OFM, MD, PhD, professor of medicine and director of the Bioethics Institute, New York Medical College

Table of Contents
Foreword: Renewing Medicine's Basic Concepts
Edmund D. Pellegrino

Part I: Historical Discussions of Health, Disease, and Illness

1. From "On the Natural Faculties II, VIII"

2. Diseases of the Soul

3. Prometheus's Vulture: The Renaissance Fashioning of Gout
Roy Porter and G.S. Rousseau

4. Report on the Diseases and Physical Peculiarities of the Negro Race
Samuel A. Cartwright

5. The Normal and the Pathological—Introduction to the Problem
Georges Canguilhem

6. The Myth of Mental Illness
Thomas S. Szasz

7. The Need for a New Medical Model: A Challenge for Biomedicine
George L. Engel

8. When Do Symptoms Become a Disease?
Robert A. Aronowitz

Part II: Characterizing Health, Disease, and Illness

9. On the Distinction between Disease and Illness
Christopher Boorse

10. Malady: A New Treatment of Disease
K. Danner Clouser, Charles M. Culver, and Bernard Gert

11. Health: A Comprehensive Concept
Roberto Mordacci and Richard Sobel

12. The Distinction between Mental and Physical Illness
R. E. Kendell

13. The "Unnaturalness" of Aging—Give Me Reason to Live!
Arthur L. Caplan

14. Diagnosing and Defining Disease
Winston Chiong

Part III: Clinical Applications of Concepts of Health and Disease: Controversies/Consensus

15. "Ambiguous Sex"—or Ambivalent Medicine?
Alice Domurat Dreger

16. The Discovery of Hyperkinesis: Notes on the Medicalization of Deviant Behavior
Peter Conrad

17. Suffering and the Social Construction of Illness: The Delegitimation of Illness Experience in Chronic Fatigue Syndrome
Norma C. Ware

18. The Premenstrual Syndrome: A Brief History
John T. E. Richardson

19. The Politics of Menopause: The "Discovery" Of A Deficiency Disease
Frances B. McCrea

20. Aging, Culture, and the Framing of Alzheimer Disease
Martha Holstein

Part IV: Normalcy, Genetic Disease, and Enhancement: The Future of the Concepts of Health and Disease

21. The Medicalization of Aesthetic Surgery
Sander Gilman

22. The Quest for Medical Normalcy—Who Needs It?
George C. Williams

23. The Concept of Genetic Disease
David Magnus

24. Concepts of Disease after the Human Genome Project
Eric T. Juengst

25.From "Enhancing Cognition in the Intellectually Intact"
Peter J. Whitehouse, Eric T. Juengst, Maxwell Mehlman, and Thomas H. Murray

26. Treatment, Enhancement, and The Ethics of Neurotherapeutics
Paul Root Wolpe

27. What's Morally Wrong with Eugenics?
Arthur L. Caplan