Is the Disease Concept Enough?

Redefining Health and Disease Through Conceptual Engineering

Authors

  • Robert Scott Taylor Department of History and Philosophy of Science, University of Cambridge, Cambridge, United Kingdom https://orcid.org/0009-0001-1773-7493

DOI:

https://doi.org/10.5195/pom.2026.228

Keywords:

Disease, Health, Depression, Addiction

Abstract

In the philosophy of medicine, the debate surrounding accounts of health and disease is typically centered on attempts to provide a proper conceptual analysis of a singular medicalized label, such as “disease,” that is meant to represent all pathological states. Instead of engaging in conceptual analysis, I attempt to redefine our concepts of health and disease through the process of conceptual engineering. To do so, I propose a novel hybrid account of health and disease and demonstrate how, by combining aspects of naturalist and constructionist accounts and distinguishing between two different medicalized labels—“disease” and “health condition”—my account can better serve the purposes of these concepts.

References

Andrews, Paul W., and J. Anderson Thomson. 2009. “The Bright Side of Being Blue: Depression as an Adaptation for Analyzing Complex Problems.” Psychological Review 116, no. 3: 620–654. https://doi.org/10.1037/a0016242.

Bains, Navneet, and Sara Abdijadid. 2023. “Major Depressive Disorder.” In StatPearls [Internet]. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK559078/.

Barnes, Elizabeth. 2023. Health Problems: Philosophical Puzzles About the Nature of Health. Oxford University Press.

Bayer, Ronald. 1987. Homosexuality and American Psychiatry: The Politics of Diagnosis, with a New Afterword on AIDS and Homosexuality. Princeton University Press.

Berridge, Kent C. 2017. “Is Addiction a Brain Disease?” Neuroethics 10, no. 1: 29–33. https://doi.org/10.1007/s12152-016-9286-3.

Boorse, Christopher. 1977. “Health as a Theoretical Concept.” Philosophy of Science 44, no. 4: 542–573. https://doi.org/10.1086/288768.

Bynum, Bill. 2002. “Discarded Diagnoses.” Lancet (London, England) 359, no. 9309, article 898. https://doi.org/10.1016/s0140-6736(02)07963-1.

Carel, Havi. 2008. Illness: The Cry of the Flesh. The Art of Living Series. Acumen.

———. 2016. Phenomenology of Illness. Oxford University Press.

Conrad, Peter, and Joseph W. Schneider. 1992. Deviance and Medicalization: From Badness to Sickness. Expanded edition. Temple University Press.

Cooper, Rachel. 2002. “Disease.” Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences 33, no. 2: 263–282. https://doi.org/10.1016/S0039-3681(02)00018-3.

———. 2020. “The Concept of Disorder Revisited: Robustly Value-Laden Despite Change." Aristotelian Society Supplementary Volume 94, no. 1: 141–161. https://doi.org/10.1093/arisup/akaa010.

Davey, Melissa. 2015. “Marc Lewis: The Neuroscientist Who Believes Addiction Is Not a Disease.” The Guardian, 30 August. https://www.theguardian.com/culture/2015/aug/30/marc-lewis-the-neuroscientist-who-believes-addiction-is-not-a-disease.

Duffin, Jacalyn M. 2021. History of Medicine: A Scandalously Short Introduction. Third edition. University of Toronto Press.

Engelhardt, H. Tristam, Jr. 1974. “The Disease of Masturbation: Values and the Concept of Disease.” Bulletin of the History of Medicine 48, no. 2: 234–248. https://www.jstor.org/stable/44447545.

Fagerberg, Harriet. 2022. “Against the Generalised Theory of Function.” Biology & Philosophy 37, no. 4, article 30. https://doi.org/10.1007/s10539-022-09861-2.

———. 2023. “What We Argue About When We Argue About Disease.” Philosophy of Medicine 4, no. 1: 1–20. https://doi.org/10.5195/pom.2023.172.

Filatova, Elena V., Maria I. Shadrina, and Petr A. Slominsky. 2021. “Major Depression: One Brain, One Disease, One Set of Intertwined Processes.” Cells 10, no. 6, article 1283. https://doi.org/10.3390/cells10061283.

Foddy, Bennett, and Julian Savulescu. 2010. “A Liberal Account of Addiction.” Philosophy, Psychiatry, & Psychology 17, no. 1: 1–22. https://doi.org/10.1353/ppp.0.0282.

Garson, Justin. 2021. “The Developmental Plasticity Challenge to Wakefield’s View.” In Defining Mental Disorder: Jerome Wakefield and His Critics, edited by Luc Faucher and Denis Forest. MIT Press. https://doi.org/10.7551/mitpress/9949.003.0021.

———. 2022. Madness: A Philosophical Exploration. Oxford University Press.

Gartlehner, Gerald, Gernot Wagner, Nina Matyas, et al. 2017. “Pharmacological and Non-Pharmacological Treatments for Major Depressive Disorder: Review of Systematic Reviews.” BMJ Open 7, no. 6, e014912. https://doi.org/10.1136/bmjopen-2016-014912.

Griffiths, Paul E., and John Matthewson. 2018. “Evolution, Dysfunction, and Disease: A Reappraisal.” British Journal for the Philosophy of Science 69, no. 2: 301–327. https://doi.org/10.1093/bjps/axw021.

Heather, Nick. 2019. “The Routledge Handbook of Philosophy and Science of Addiction, Hanna Pickard & Serge H. Ahmed (Eds), London and New York: Routledge, 2019, ISBN 978–1–138‐90928‐1 (Hbk), ISBN 978–1–315‐68919‐7 (Ebk).” Addiction 114, no. 10 (2019): 1891–1892. https://doi.org/10.1111/add.14701.

Hofmann, Bjørn. 2016. “Obesity as a Socially Defined Disease: Philosophical Considerations and Implications for Policy and Care.” Health Care Analysis: Journal of Health Philosophy and Policy 24, no. 1: 86–100. https://doi.org/10.1007/s10728-015-0291-1.

Horwitz, Allan V., and Jerome C. Wakefield. 2007. The Loss of Sadness: How Psychiatry Transformed Normal Sorrow into Depressive Disorder. Oxford University Press.

Hundertmark, Fabian. 2026. “What Health Is: The Blueprint View”. Philosophy of Medicine 7, no. 1: 1–25. https://doi.org/10.5195/pom.2026.260.

Kukla, Quill R. 2024. “Healthism, Elite Capture, and the Pitfalls of an Expansive Concept of Health.” In A Pragmatic Approach to Conceptualization of Health and Disease, edited by Maartje Schermer and Nicholas Binney. Springer International Publishing. https://doi.org/10.1007/978-3-031-62241-0_21.

Kukla, Rebecca. 2014. “Medicalization, ‘Normal Function,’ and the Definition of Health.” In The Routledge Companion to Bioethics, edited by John D. Arras, Elizabeth Fenton, and Rebecca Kukla. Routledge. https://doi.org/10.4324/9780203804971.

Leader, Darian, and David Corfield. 2008. Why Do People Get Ill? Penguin.

Lewis, Marc. 2017. “Addiction and the Brain: Development, Not Disease.” Neuroethics 10, no. 1: 7–18. https://doi.org/10.1007/s12152-016-9293-4.

Litofsky, N. Scott, and Andrew G. Resnick. 2009. “The Relationships Between Depression and Brain Tumors.” Journal of Neuro-Oncology 94, no. 2: 153–161. https://doi.org/10.1007/s11060-009-9825-4.

Liu, Yihao, and Lee Hogarth. 2025. “The Compulsive Brain Disease Model of Addiction Lowers Problematic Alcohol Drinkers’ Confidence to Reduce Their Addictive Behaviour.” International Journal of Mental Health and Addiction. https://doi.org/10.1007/s11469-025-01544-9.

Martindale, Sarah L., Anna S. Ord, Lakeysha G. Rule, and Jared A. Rowland. 2021. “Effects of Blast Exposure on Psychiatric and Health Symptoms in Combat Veterans.” Journal of Psychiatric Research 143 (November): 189–195. https://doi.org/10.1016/j.jpsychires.2021.09.021.

Maté, Gabor. 2008. In the Realm of Hungry Ghosts: Close Encounters with Addiction. Knopf Canada.

Miller, Mark, Julian Kiverstein, and Erik Rietveld. 2020. “Embodying Addiction: A Predictive Processing Account.” Brain and Cognition 138 (February), article 105495. https://doi.org/10.1016/j.bandc.2019.105495.

Nado, Jennifer. 2021. “Re-engineering Knowledge: A Case Study in Pluralist Conceptual Engineering.” Inquiry, 30 March: 1–26. https://doi.org/10.1080/0020174X.2021.1903987.

Neander, Karen. 1991. “Functions as Selected Effects: The Conceptual Analyst’s Defense.” Philosophy of Science 58, no. 2: 168–184. https://doi.org/10.1086/289610.

Nesse, Randolph M. 2019. Good Reasons for Bad Feelings: Insights from the Frontier of Evolutionary Psychiatry. Dutton.

NIDDK (National Institute of Diabetes and Digestive and Kidney Diseases). 2019. “Acute Hepatic Necrosis.” In LiverTox®: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.ncbi.nlm.nih.gov/books/NBK548560/.

Noble, Samara, Carissa Bonner, Jolyn Hersch, Jesse Jansen, Kevin McGeechan, and Kirsten McCaffery. 2019. “Could Disease Labelling Have Positive Effects? An Experimental Study Exploring the Effect of the Chronic Fatigue Syndrome Label on Intended Social Support.” Patient Education and Counseling 102, no. 3: 486–493. https://doi.org/10.1016/j.pec.2018.10.011.

Pickard, Hanna. 2017. “Responsibility Without Blame for Addiction.” Neuroethics 10, no. 1: 169–180. https://doi.org/10.1007/s12152-016-9295-2.

Pickard, Hanna, and Lisa Ward. 2013. “Responsibility Without Blame: Philosophical Reflections on Clinical Practice.” In The Oxford Handbook of Philosophy and Psychiatry, edited by K.W.M. Fulford, Martin Davies, Richard G.T. Gipps, et al. Oxford University Press. https://doi.org/10.1093/oxfordhb/9780199579563.013.0066.

Schroder, Hans S., Andrew Devendorf, and Brian J. Zikmund-Fisher. 2023. “Framing Depression as a Functional Signal, Not a Disease: Rationale and Initial Randomized Controlled Trial.” Social Science & Medicine 328 (July), article 115995. https://doi.org/10.1016/j.socscimed.2023.115995.

Strickland, Justin C., and Kirsten E. Smith. 2021. “Comment on Heilig et al.: The Centrality of the Brain and the Fuzzy Line of Addiction.” Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology 46, no. 10: 1703–1704. https://doi.org/10.1038/s41386-021-01000-x.

Substance Abuse and Mental Health Services Administration (US) and Office of the Surgeon General (US). 2016. “Chapter 2: The Neurobiology of Substance Use, Misuse, and Addiction.” In Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health [Internet]. US Department of Health and Human Services. https://www.ncbi.nlm.nih.gov/books/NBK424849/.

Turner, James. 2023. “Low Mood: Evolution, Cognition, and Disorder.” PhD diss., University of Sheffield. https://etheses.whiterose.ac.uk/id/eprint/34117/.

———. 2024. “Bad Feelings, Best Explanations: In Defence of the Propitiousness Theory of the Low Mood System.” Erkenntnis 90, no. 5: 1695–1720. https://doi.org/10.1007/s10670-023-00773-5.

Ulvestad, Elling. 2018. “Subjectivity and Illness.” Tidsskrift for Den Norske Legeforening 138. https://doi.org/10.4045/tidsskr.17.1040.

Venkatapuram Sridhar. 2013. “Health, Vital Goals, and Central Human Capabilities. Bioethics 27, no. 5: 271–279. https://doi.org/10.1111/j.1467-8519.2011.01953.x.

Wakefield, Jerome C. 1992. “The Concept of Mental Disorder: On the Boundary Between Biological Facts and Social Values.” American Psychologist 47, no. 3: 373–388. https://doi.org/10.1037//0003-066x.47.3.373.

———. 2014. “The Biostatistical Theory Versus the Harmful Dysfunction Analysis, Part 1: Is Part-Dysfunction a Sufficient Condition for Medical Disorder?” Journal of Medicine and Philosophy 39, no. 6: 648–682. https://doi.org/10.1093/jmp/jhu038.

WHO (World Health Organization). 2025. “Depressive Disorder (Depression).” 29 August. https://www.who.int/news-room/fact-sheets/detail/depression.

Wiens, Thomas K., and Lawrence J. Walker. 2015. “The Chronic Disease Concept of Addiction: Helpful or Harmful?” Addiction Research & Theory 23, no. 4: 309–321. https://doi.org/10.3109/16066359.2014.987760.

Wilkinson, Sam. 2023. Philosophy of Psychiatry: A Contemporary Introduction. Routledge.

Yrondi, Antoine, David Brauge, Johanne LeMen, Christophe Arbus, and Jérémie Pariente. 2017. “Depression and Sports-Related Concussion: A Systematic Review.” Presse Medicale (Paris, France: 1983) 46, no. 10: 890–902. https://doi.org/10.1016/j.lpm.2017.08.013.

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Published

2026-05-29

How to Cite

Taylor, R. S. (2026). Is the Disease Concept Enough? Redefining Health and Disease Through Conceptual Engineering. Philosophy of Medicine, 7(1). https://doi.org/10.5195/pom.2026.228

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Section

Original Research Articles (health, disease and illness)