Principles behind definitions of diseases--a criticism of the principle of disease mechanism and the development of a pragmatic alternative.

摘要: Many philosophers and medical scientists assume thatdisease categories or entities used to classify concrete cases ofdisease, are often defined by disease mechanisms causalprocesses. Others suggest that diseases should always be definedin this manner. This paper discusses these standpoints criticallyand concludes they untenable, not only when `diseasemechanism' refers an objective mechanism, but also when`mechanism' a pragmatically demarcated part of thetotal ``objective'' causal structure diseases. As alternativeto principles use the concept mechanism oranalogous concepts, pragmatic approach is suggested anddescribed. has been before, inproblematic inadequate versions. proposes versioncompiled two ``pragmatic principles'' shows aremuch more adequate than principle mechanism. Withreference case study still ongoing internationaldiscussion various candidates for classification system formalignant lymphomas, including REAL (Revised European–AmericanClassification Lymphoid Neoplasms) in which ofdisease analogous concepts plays very small part,it shown just how pivotal canbe actual discussions definitions Finally, itis pointed out with regard modern philosophy languageit may, at least some cases, problematic distinguishbetween as stand.