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What Is Disease?

Kenneth V. Iserson, MD, MBA
JAMA. 1997;278(15):1293. doi:10.1001/jama.1997.03550150101052.
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Of all the questions we avoid asking ourselves, whether "disease" and "illness" remain valid concepts may be one of the most fascinating, especially for health care professionals and policy makers.

Is "disease" still a valid concept? Does it simply promote the medical profession or act as a powerful tool to enfranchise and disenfranchise different societal groups? Or, to some measure, do "disease" and "illness" perform all these functions?

The bioethical community displays its keen insights into modern medicine's politics and practices in this compendium of philosophical essays. Not designed for light reading, the essays constitute "an informed philosophical discussion." Comprising more than one third of the book, Christopher Boorse's "A Rebuttal on Health" briefly reviews his "biostatistical theory" of disease, which defines health as the absence of disease, saying that disease is, based on viewing populations, a "statistically species-subnormal biological part-function." One fascinating chart diagrams what experienced clinicians intrinsically know:


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