4.3 Article

'What is (mental) disease?': an open letter to Christopher Boorse

Journal

JOURNAL OF MEDICAL ETHICS
Volume 27, Issue 2, Pages 80-85

Publisher

BMJ PUBLISHING GROUP
DOI: 10.1136/jme.27.2.80

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This open letter to Christopher Boorse is a response to his influential naturalist (value-excluding) analysts of disease from the perspective of linguistic-analytic value theory. The hey linguistic-analytic point against Boorse (and other naturalists) is that, although defining disease value free, he land they) continue to use the term with clear evaluative,e connotations. A descriptivist (value-entailing) analysis of disease would allow value-free definition consistently with value-laden use: but descriptivism fails when applied to mental disorder because it depends on shared values whereas the values relevant to mental disorders are highly diverse. A parr-function analysis, similarly, although initially persuasive for physical disorders,fails with the psychotic mental disorders because these, characteristically, involve disturbances of the rationality of the person as a whole. The difficulties encountered in applying: naturalism to mental disorders point, linguistic-analytically, to the possibility that there is, after all, an evaluative element of meaning, deeply hidden bur still logically operative, in the concept of disease.

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