TY - JOUR
T1 - Harm as a Necessary Component of the Concept of Medical Disorder
T2 - Reply to Muckler and Taylor
AU - Wakefield, Jerome C.
AU - Conrad, Jordan A.
N1 - Publisher Copyright:
© 2020 The Author(s) 2020. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: [email protected].
PY - 2020/5/21
Y1 - 2020/5/21
N2 - Wakefield's harmful dysfunction analysis asserts that the concept of medical disorder includes a naturalistic component of dysfunction (failure of biologically designed functioning) and a value (harm) component, both of which are required for disorder attributions. Muckler and Taylor, defending a purely naturalist, value-free understanding of disorder, argue that harm is not necessary for disorder. They provide three examples of dysfunctions that, they claim, are considered disorders but are entirely harmless: mild mononucleosis, cowpox that prevents smallpox, and minor perceptual deficits. They also reject the proposal that dysfunctions need only be typically harmful to qualify as disorders. We argue that the proposed counterexamples are, in fact, considered harmful; thus, they fail to disconfirm the harm requirement: incapacity for exertion is inherently harmful, whether or not exertion occurs, cowpox is directly harmful irrespective of indirect benefits, and colorblindness and anosmia are considered harmful by those who consider them disorders. We also defend the typicality qualifier as viably addressing some apparently harmless disorders and argue that a dysfunction's harmfulness is best understood in dispositional terms.
AB - Wakefield's harmful dysfunction analysis asserts that the concept of medical disorder includes a naturalistic component of dysfunction (failure of biologically designed functioning) and a value (harm) component, both of which are required for disorder attributions. Muckler and Taylor, defending a purely naturalist, value-free understanding of disorder, argue that harm is not necessary for disorder. They provide three examples of dysfunctions that, they claim, are considered disorders but are entirely harmless: mild mononucleosis, cowpox that prevents smallpox, and minor perceptual deficits. They also reject the proposal that dysfunctions need only be typically harmful to qualify as disorders. We argue that the proposed counterexamples are, in fact, considered harmful; thus, they fail to disconfirm the harm requirement: incapacity for exertion is inherently harmful, whether or not exertion occurs, cowpox is directly harmful irrespective of indirect benefits, and colorblindness and anosmia are considered harmful by those who consider them disorders. We also defend the typicality qualifier as viably addressing some apparently harmless disorders and argue that a dysfunction's harmfulness is best understood in dispositional terms.
KW - anosmia
KW - colorblindness
KW - commensal virus
KW - concept of medical disorder
KW - concept of mental disorder
KW - conceptual foundations of medicine
KW - cowpox
KW - definition of disorder
KW - disease
KW - disorder
KW - harm
KW - harmful dysfunction
KW - mononucleosis
KW - naturalism
KW - normativism
KW - philosophy of medicine
UR - http://www.scopus.com/inward/record.url?scp=85085156915&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85085156915&partnerID=8YFLogxK
U2 - 10.1093/jmp/jhaa008
DO - 10.1093/jmp/jhaa008
M3 - Article
C2 - 32437578
AN - SCOPUS:85085156915
SN - 0360-5310
VL - 45
SP - 350
EP - 370
JO - Journal of Medicine and Philosophy (United Kingdom)
JF - Journal of Medicine and Philosophy (United Kingdom)
IS - 3
ER -