Advertisement

Theoretical Medicine and Bioethics

, Volume 40, Issue 1, pp 1–19 | Cite as

The harm of medical disorder as harm in the damage sense

  • David G. LimbaughEmail author
Article
  • 60 Downloads

Abstract

Jerome Wakefield has argued that a disorder is a harmful dysfunction. This paper develops how Wakefield should construe harmful in his harmful dysfunction analysis (HDA). Recently, Neil Feit has argued that classic puzzles involved in analyzing harm render Wakefield’s HDA better off without harm as a necessary condition. Whether or not one conceives of harm as comparative or non-comparative, the concern is that the HDA forces people to classify as mere dysfunction what they know to be a disorder. For instance, one can conceive of cases where simultaneous disorders prevent each other from being, in any traditional sense, actually harmful; in such cases, according to the HDA, neither would be a disorder. I argue that the sense of harm that Wakefield should employ in the HDA is dispositional, similar to the sense of harm used when describing a vile of poison: “Be careful! That’s poison. It’s harmful.” I call this harm in the damage sense. Using this sense of harm enables the HDA to avoid Feit’s arguments, and thus it should be preferred to other senses when analyzing harmful dysfunction.

Keywords

Disorder Disease Harm Systematic harm Dispositions Philosophy of psychiatry Philosophy of medicine Philosophy of biology Philosophy of science 

Notes

Acknowledgements

For helpful feedback on earlier versions of this paper, I am very grateful to James Delany, Neil Feit, David Hershenov, Robert Kelly, Steven Kershnar, Danielle Z. Limbaugh, Kathryn E. Limbaugh, Sean Marzolf, Travis Timmerman, Neil E. Williams, and the fellows at the Romanell Center for Clinical Ethics and the Philosophy of Medicine. A special thanks to the anonymous referees at this journal for their helpful and thorough comments.

References

  1. 1.
    Wakefield, Jerome C. 1992. The concept of mental disorder: On the boundary between biological facts and social values. American Psychologist 47: 373–388.CrossRefGoogle Scholar
  2. 2.
    Boorse, Christopher. 1977. Health as a theoretical concept. Philosophy of Science 44: 542–573.CrossRefGoogle Scholar
  3. 3.
    Boorse, Christopher. 2014. A second rebuttal on health. Journal of Medicine and Philosophy 39: 683–724.CrossRefGoogle Scholar
  4. 4.
    Wakefield, Jerome C. 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: 648–682.CrossRefGoogle Scholar
  5. 5.
    Feit, Neil. 2017. Harm and the concept of medical disorder. Theoretical Medicine and Bioethics 38: 367–385.CrossRefGoogle Scholar
  6. 6.
    Bradley, Ben. 2012. Doing away with harm. Philosophy and Phenomenological Research 85: 390–412.CrossRefGoogle Scholar
  7. 7.
    Spear, Andrew D., Werner Ceusters, and Barry Smith. 2016. Functions in basic formal ontology. Applied Ontology 11: 103–128.CrossRefGoogle Scholar
  8. 8.
    Holtug, Nils. 2002. The harm principle. Ethical Theory and Moral Practice 5: 357–389.CrossRefGoogle Scholar
  9. 9.
    Norcross, Alistair. 2003. Harming in context. Philosophical Studies 123: 149–173.CrossRefGoogle Scholar
  10. 10.
    Hanser, Matthew. 2008. The metaphysics of harm. Philosophy and Phenomenological Research 77: 421–450.CrossRefGoogle Scholar
  11. 11.
    Shiffrin, Seana Valentine. 2012. Harm and its moral significance. Legal Theory 18: 357–398.CrossRefGoogle Scholar
  12. 12.
    Feit, Neil. 2015. Plural harm. Philosophy and Phenomenological Research 90: 361–388.CrossRefGoogle Scholar
  13. 13.
    Page, Richard L., Thomas W. Tilsch, Stuart J. Connolly, Daniel J. Schnell, Stephen R. Marcello, William E. Wilkinson, Edward L.C. Pritchett, and Azimilide Supraventricular Arrhythmia Program Investigators. 2003. Asymptomatic or “silent” atrial fibrillation: frequency in untreated patients and patients receiving azimilide. Circulation 107: 1141–1145.CrossRefGoogle Scholar
  14. 14.
    Harman, Elizabeth. 2009. Harming as causing harm. In Harming future persons: Ethics, genetics and the nonidentity problem, ed. Melinda A. Roberts and David T. Wasserman, 137–154. Dordrecht: Springer.CrossRefGoogle Scholar
  15. 15.
    Shiffrin, Seana Valentine. 1999. Wrongful life, procreative responsibility, and the significance of harm. Legal Theory 5: 117–148.CrossRefGoogle Scholar
  16. 16.
    Nagel, Thomas. 1970. Death. Philosophy and Public Affairs 4: 73–80.Google Scholar
  17. 17.
    Parfit, Derek. 1984. Reasons and persons. Oxford: Oxford University Press.Google Scholar
  18. 18.
    Vetter, Barbara. 2015. Potentiality. New York: Oxford University Press.CrossRefGoogle Scholar
  19. 19.
    Keyes, Daniel. 1959. Flowers for Algernon. San Diego: Harcourt.Google Scholar
  20. 20.
    Hursthouse, Rosalind. 1991. Virtue theory and abortion. Philosophy and Public Affairs 20: 223–246.Google Scholar
  21. 21.
    Hershenov, David. 2016. Death, dignity, and moral status. University Faculty for Life and Learning 26: 119–142.Google Scholar
  22. 22.
    Bradley, Ben. 2009. Well-being and death. New York: Oxford University Press.CrossRefGoogle Scholar
  23. 23.
    Timmerman, Travis. 2016. Your death might be the worst thing ever to happen to you (but maybe you shouldn’t care). Canadian Journal of Philosophy 46: 18–37.CrossRefGoogle Scholar

Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Department of PhilosophyState University of New York at BuffaloBuffaloUSA
  2. 2.Romanell Center for Clinical Ethics and the Philosophy of MedicineState University of New York at BuffaloBuffaloUSA

Personalised recommendations