TITLE:
Who Are the Rightful Owners of the Concepts Disease, Illness and Sickness? A Pluralistic Analysis of Basic Health Concepts
AUTHORS:
Halvor Nordby
KEYWORDS:
Patient Interaction, Communication, Lay Conceptions of Disease and Illness, Wittgenstein, Language Games
JOURNAL NAME:
Open Journal of Philosophy,
Vol.9 No.4,
November
11,
2019
ABSTRACT: The article uses a producer-consumer theory from
philosophy of mind and language to analyse the
meaning of basic health concepts like disease, illness and sickness. The core idea of the producer-consumer perspective is
that a person who has an incomplete understanding of a term can associate it
with the same concept as a linguistic expert, if both of them are willing to
defer to the same contextual or general norms of meaning. Using “disease” as an example, the article argues that the producer-consumer theory
implies that if patients were normally willing to defer to a standard expert
concept of disease, it would be reasonable to assume that the concept of
disease is this concept. However, it is empirically well documented that many
patients are not willing to defer to health workers’ understanding of lay
health concepts like “disease”. This means that the overall conceptual analysis of disease and other
lay health concepts should be pluralistic—the concepts belong within what Wittgenstein
calls different language-games. This conceptual pluralism is inconsistent with
assumptions many theorists have made when attempting to develop general
definitions of basic concepts of ill health. Furthermore, the pluralistic
analysis has striking implications for how conceptions of meaning should be
accepted as sound; participants in health discourses are entitled to use basic health terms
like “health” and “illness” in accordance with their own language-games, and health workers should therefore
acknowledge a diversity of meaning in patient communication. Nevertheless, health
professionals can often secure a communicative platform of shared concepts by
understanding patients’ language games, and by achieving contextual aims of
agreement about meaning.