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6
Health, Illness, and Disease - Adjusting
the Coordinates
Lukas Kaelin
Abstract.
“Medicine is not concerned with illness and disease, but with suffering
human beings called patients.” (148) Rather than understanding the patient from
illness, Kazem Sadegh-Zadeh takes the inverse trajectory. A comprehensive the-
ory of the patients sheds light on the concepts of health, illness, and disease. In
such a perspective disease is not the opposite of health, and needs to be construed
as a nonclassical concept based on a number of prototype diseases. Dwelling upon
Wittgenstein's family resemblance theory and Eleanor Rosch's theory of categoriza-
tion, Sadegh-Zadeh's theory of prototype diseases allows for gradual membership in
the category of diseases. The boundary of diseases and non-diseases thus becomes
blurry and is construed as a matter of social definition depending on the cultural
context. Such a social construction of disease reorients the basic coordinates of the
philosophy of medicine. This paper will track the way the coordinates are reori-
ented and test them from perspectives at the edge respectively critical to orthodox
medicine such as Arthur Kleinman's medical anthropology and Michel Foucault's
archeology of medical institutions.
6.1
Introduction
Kazem Sadegh-Zadeh's book attempts to provide nothing less than a comprehensive
account of the philosophy of medicine in an analytic tradition. A titanic endeavor,
which also takes titanic proportions. Starting point is the observation on the en-
during high percentage of misdiagnosis with devastating effects. Why, one might
ask, is the complex medical system not able to significantly reduce the problem
of misdiagnosis including the incredible amount of suffering that follows? Why is
medical progress unable to solve the problem of misdiagnosis? The starting point,
thus, is a genuinely philosophical one - the naïve wondering at the world. The entire
book can be read as an attempt to rectify the conceptual medical self-understanding.
Part of the problem addressed is an inadequate understanding of the medical pro-
fession, a significant shortcoming of the philosophy of medicine. What is needed,
