학술논문

Truth or Spin? Disease Definition in Cancer Screening.
Document Type
Journal Article
Author
Source
Journal of Medicine & Philosophy. Aug2017, Vol. 42 Issue 4, p385-404. 20p.
Subject
*EARLY detection of cancer
*CANCER diagnosis
*MEDICAL screening
*PHILOSOPHY of medicine
*PATHOLOGICAL physiology
*PHILOSOPHY of biology
Language
ISSN
0360-5310
Abstract
Are the small and indolent cancers found in abundance in cancer screening normal variations, risk factors, or disease? Naturalists in philosophy of medicine turn to pathophysiological findings to decide such questions objectively. To understand the role of pathophysiological findings in disease definition, we must understand how they mislead in diagnostic reasoning. Participants on all sides of the definition of disease debate attempt to secure objectivity via reductionism. These reductivist routes to objectivity are inconsistent with the Bayesian nature of clinical reasoning; when they appeal to the sciences, they are inconsistent with what philosophy of biology tells us about its natural kinds. Proposals that we narrow the scope of our claims in the disease definition debates (proposing adoption of a specific disease paradigm for a specific context) are useful, but paradigms can still distort our reasoning in particular cases, even when we are self-conscious about their status. [ABSTRACT FROM AUTHOR]