11/26

Response to Christopher Boorse's Health as a Theoretical Concept

1. What is the difference between a normativist account of

disease and a functionalist one?
- The normative account states that disease is defined
statistically, and only statistically. It accounts for variables, such
as the ones listed: height, weight, pulse and respiration, blood
pressure, vital capacity, basal metabolism, sedimentation rate,
etc, and any aberration from the "standard range" within these
variables are commonly regarded as, at the very least, negative
abnormalities, if not phenomena resulting from disease. However,
this is flawed, as a short person or a person with freckles may be
outside the "statistical normality," but can be considered entirely
healthy. Statistical abnormality alone, Boorse suggests, is not a
legitimate basis for defining disease. The functional account
states that disease is essentially anything that contradicts man's
ability to lead a good life and preserve his kind. Basically, it views
disease as any obstacle to man in performing a function.

2. How does boorse object to the "value account" of disease,

according to which a disease is any condition we find
disagreeable?
- He states that this view of disease is dispensable, as it would
fluctuate indefinitely among person to person. The obvious
problem with this is that it would violate the need for a universal,
value-free understanding of disease, one of the objectives of
Boorse's essay (though it acknowledges such a thing is somewhat
beyond the scope of the essay).

3. How does Boorse object to the "medical treatment" account?

Boorse states that a disease is sometimes defined by it's
treatability, which is flawed, as there are many known conditions
that are untreatable, such as fatigue from lack of sleep, which are
not defined as disease, while there are others that are. This, he
states, is flawed, and scrutiny reveals that there are
inconsistencies in the way we view certain conditions.
 4. In what way does he think the "pain and suffering" account is
inadequate?
- There are those who would like to classify diseases by their
presentation of pain. However, Boorse states that there is no
reason to believe that a disease must reveal itself to its bearer
through painful means. He states that normal processes, such as
teething, menstruation, and childbirth all bear pain, and thus
cannot be labeled "diseases."

5. In your own words, explain what Boorse thinks disease is.

- Boorse views health to be normal functioning, where the
normality is determined statistically, and the functioning is
biological. He believes disease to be a condition that is
statistically abnormal, with negative effects when viewed in
isolation(as opposed to its interaction with other diseases), and
results the bearer to function at a level that is below what is
typical for the species. He also thinks that to label something as a
"disease" should be a decision that is not tainted by values, as
then the classification of something as a disease would fluctuate
depending on the circumstances.

6. Discuss pregnancy in relation to some of the accounts of

disease we have considered.
- Pregnancy is a normal process, yet it is not without its set of
"symptoms." The process yields such things as pain, modified
appetites, mood swings, etc. By the criteria of the "pain and
suffering" account, this would technically be defined as disease.
However, all involved observers, even advocates of the account,
would state that pregnancy is not a disease, and that is rather a
normal process. It is a useful exception to the rule, illustrating
that not all conditions that present with pain are necessarily
diseases. Furthermore, pregnancy may encounter some
uncertainty when faced with the "value account" as well. Though
childbirth is indefinitely a period of hardship, there are those who
would be hesitant in labeling the event as a "disease." Some may,
Boorse cites, cherish sterility, in the event that the designated
supporting family is unable to support further children. It would be
difficult, using both these accounts, to classify conditions
effectively.
 7. Discuss myopia in relation to some of the accounts of disease
we have considered.
- Myopia, or nearsightedness, is another condition that is without
technical treatment (this is assuming that optic aids such as
glasses or contacts are more modes of circumvention, rather than
actual treatments). By the "medical treatment" account, this
would likely not be considered a disease, as this account focuses
on the practicing aspect of medicine, and myopia is a condition
that lacks known treatment. Also, by the "pain and suffering"
account, this condition would not be considered a disease, as it
does not present with pain. However, by the "value" account, it
may be, as there are certainly those who would find
nearsightedness undesirable, and undesirability is the
determining factor of whether or not a condition is a "disease" in
this account. On the other hand, by the very same account, it
may not be, if, for example, myopia allowed a potential soldier to
avoid the infantry in a draft. Myopia, like pregnancy, is another
condition that lingers on the line between disease and not. It goes
to show that such accounts are ineffective in classifying a
condition as a disease.

8. Discuss cowpox in relation to some of the accounts of disease

we have considered.
-Cowpox is another condition of questionable classification. Many
would, at introduction, label cowpox a disease indefinitely.
However, the "value" account may come into play, and we can
see that in the case of a smallpox epidemic, cowpox can aid in
actually overcoming smallpox, in which case it certainly is most
desirable. It, like the previous two examples, goes to prove the
ineffectiveness of these accounts.