Biological Criteria of Disease: Four Ways of Going Wrong

J Med Philos. 2017 Aug 1;42(4):447-466. doi: 10.1093/jmp/jhx004.


We defend a view of the distinction between the normal and the pathological according to which that distinction has an objective, biological component. We accept that there is a normative component to the concept of disease, especially as applied to human beings. Nevertheless, an organism cannot be in a pathological state unless something has gone wrong for that organism from a purely biological point of view. Biology, we argue, recognises two sources of biological normativity, which jointly generate four "ways of going wrong" from a biological perspective. These findings show why previous attempts to provide objective criteria for pathology have fallen short: Biological science recognizes a broader range of ways in which living things can do better or worse than has previously been recognized in the philosophy of medicine.

Keywords: biological function; biological normativity; disease; pathology.

MeSH terms

  • Diagnosis*
  • Disease*
  • Humans
  • Philosophy, Medical*