The Context of Disease
One of the difficulties of writing about disease is that our understanding of disease changes with time. We tend to think of the scientific core of medicine as unchanging. Medicine, as a science, speaks about what is, not about what may be for the moment but inevitably will change. However, much has been made recently of the changing character of medicine and science. As the contributions of Ludwik Fleck (1979 ) and Thomas Kuhn (1970 ) to the history and philosophy of science and of medicine have shown, there are no such things as neutral, naked, and bare facts. Facts always appear interpreted within the embrace of theoretical frameworks, whether or not these frameworks are formally or informally developed as scientific accounts. In addition, they are always given in a particular socio-historical context. There is no timeless or contextless account of reality, including disease, or at least there is no such interpretation available to humans. This chapter argues that disease is contextual. In so doing, it explores the character of contextualism in medicine, why contextualism is not relativism, and how conflicts among competing interpretations of disease may be resolved. In the end, a localized account of disease is offered.
KeywordsAnorexia Nervosa American Psychiatric Association Medical Knowledge Universal Feature Public Health Official
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