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a scope that lies beyond an analytic analysis of the field of medicine. Furthermore,
both, Kleinman and Foucault are starting off a psychiatric vantage point and then
move generalizing towards the whole of medicine. Incertitude about the correct
diagnosis, stigmatization, the power of imposing normality and the political dimen-
sion of medical truths are more virulent in the psychiatric field than elsewhere in
medicine. Sadegh-Zadeh acknowledges the special role of psychiatry in the field
of medicine; and he points to a conceptual problem in psychiatry, which puts him
in surprising proximity to Foucault, when he states that “something in the concep-
tual basis of psychiatry and psychosomatics must be defective.” [13, p. 722] The
psychiatric diseases are actually to be understood from the social rather than the
psychic field: “The pathogenic forces come not from the psyche, but rather from
the social structure and values of the group and community in which an individual
interacts with others, as well as from the mode of their interaction.” ([13], p. 732)
Psychosomatic, so the argument goes, should be replaced by sociosomatics.
Such insights gained through an analytic approach to the philosophy of medicine
can provide new avenues and a better understanding of the medical field. And
looked at the Handbook from this vantage point, the differences seem smaller. It is
such insights as well as the conceptual clarification of the concepts of health, illness
and disease that provide an important contribution to the philosophy of medicine.
Taking into account the perspective of medical anthropology of Kleinman and the
critical stance of Foucault can then help to put modern medicine in a certain context
and remind us of the importance of the subjective side of medicine. Taking the sub-
jective side in terms of the patient's explanatory model of illness more serious might
not only addresses the trust issue haunting modern medicine; it might actually be a
remedy for the problem of misdiagnosis, too.
References
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2. Boorse, C.: A Rebuttal on Health. In: Humber, J., Almeder, R. (eds.) What is Disease?,
pp. 1-134. Humana Press, Totowa (1997)
3. Foucault, M.: The Birth of the Clinic. Pantheon Books, New York (1973)
4. Khushf, G.: An Agenda for Future Debate on Concepts of Health and Disease. Medicine,
Health Care and Philosophy 10, 19-27 (2007)
5. Kleinman, A., Benson, P.: Anthropology in the Clinic: The Problem of Cultural Compe-
tency and How to Fix it. PLoS Medicine 3(10), 1673-1676 (2006)
6. Kleinman, A., et al.: Culture, Illness, and Care. Focus 4(1), 140-149 (2006)
7. Kleinman, A.: Patients and Healers in the Context of Culture. University of California
Press, Berkeley (1980)
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(2001)
10. Nordenfelt, L.: The Concepts of Health and Illness Revisited. Medicine, Health Care
and Philosophy 10, 5-10 (2007)
11. O'Neill, O.: Autonomy and Trust in Bioethics. CUP, Cambridge (2002)
