Critique and Refinement of the Wakefieldian Concept of Disorder: An Improvement of the Harmful Dysfunction Analysis

Journal of Medicine and Philosophy 47 (4):530-539 (2022)
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Abstract

One way in which bioethicists can benefit the medical community is by clarifying the concept of disorder. Since insurance companies refer to the DSM for whether a patient should receive assistance, one must consider the consequences of one’s concept of disorder for who should be provided with care. I offer a refinement of Jerome Wakefield’s hybrid concept of disorder, the harmful dysfunction analysis. I criticize both the factual component and the value component of Wakefield’s account and suggest how they might be improved. I propose that the factual component should be statistical variation analyzed in multilevel and chronological compilations of physiological data. I propose that the value component should prioritize the individual’s authority regarding the experience of suffering from a physiological condition. My account preserves the insight of using a factual and a value component while avoiding the problems that Wakefield’s original account faces.

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Bioethics and the Contours of Autonomy.Derek Estes - 2022 - Journal of Medicine and Philosophy 47 (4):495-502.

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