Contrary to the bio-medical sciences most philosophers of medicine regard disease as an evaluative concept. C. Boorse’s well- known naturalist attempt to conceptualize disease exclusively on the basis of physiological fact seems highly plausible at first sight, since on this Supposition it is possible to make use of the impressive explanatory knowledge of modern medicine. But critical examination of his meta- physiological notion of “disease” as subnormal functioning shows that it does not conform to licensed medical disease-judgements. Furthermore his doctrine seems unjustified since it’s empirical implementability is highly questionable. This suggests that medicine is a naturalist enterprise that is guided by evaluation. An alternative conception of disease is advanced that tries to make the ‘nexus’ of physiological fact and evaluation intelligible: Disease is (extensionally) the class of physiological processes that (actually or prospectively) undermine the physiological conditions of human well-being.
© 1990 by Lucius & Lucius, Stuttgart