Defining disease in the context of overdiagnosis

Mary Walker, Wendy Rogers

    Research output: Contribution to journalArticle

    6 Citations (Scopus)

    Abstract

    Recently, concerns have been raised about thephenomenon of 'overdiagnosis', the diagnosis of a conditionthat is not causing harm, and will not come to causeharm. Along with practical, ethical, and scientific questions,overdiagnosis raises questions about our concept ofdisease. In this paper, we analyse overdiagnosis as anepistemic problem and show how it challenges manyexisting accounts of disease. In particular, it raises questionsabout conceptual links drawn between disease anddysfunction, harm, and risk. We argue that 'disease' shouldbe considered a vague concept with a non-classical structure.On this view, overdiagnosed cases are 'borderline'cases of disease, falling in the zone between cases that areclearly disease, and cases that are clearly not disease. Wethen develop a pre´cising definition of disease designed toprovide practical help in preventing and limiting overdiagnosis.We argue that for this purpose, we can definedisease as dysfunction that has a significant risk of causingsevere harm to the patient.
    Original languageEnglish
    Pages (from-to)269–280
    Number of pages12
    JournalMedicine, Healthcare and Philosophy
    Volume20
    Issue number2
    Early online dateNov 2016
    DOIs
    Publication statusPublished - Jun 2017

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