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Biomedical subjects

L Nordenfelt

Publications and source records attributed to L Nordenfelt.

At least 19 recordsLinked to original sources
PubMed2001

On the goals of medicine, health enhancement and social welfare.

Bengt Brülde in his article "The Goals of Medicine. Towards a Unified Theory" has proposed a normative theory of the goals of medicine within which the concept of quality of life plays a crucial role. In Brülde's analysis, however, the very concept of medicine is deliberately left quite vague and it is therefore difficult to see how the goals of medicine are related to the goals of closely allied enterprises such as health promotion and social welfare. In this reply I therefore propose an analysis of these related conceptual areas. I do this mainly in two respects. (1) Following the nomenclature in a previously published article (Nordenfelt, 1998) I propose a systematic conceptual framework for all varieties of health enhancement and distinguish different notions of medicine within this framework. A consequence of this analysis is, for instance, that the means and also the immediate goals of medicine in its broadest sense are more diversified than the means and immediate goals of medicine in its narrowest sense. (2) From this position I expand the topic further by comparing medicine and health enhancement with social welfare and try to trace the basic features between--as well as the common properties of--these different enterprises.

Clinical Medicine↗
PubMed2000

On the place of fuzzy health in medical theory.

This commentary on Sadegh-Zadeh's article 'Fuzzy health, illness and disease,' has its focus on the philosophical background for applying fuzzy logic to medical theory. I concentrate on four issues. First, I contest some of Sadegh-Zadeh's statements on the present state of the theory of medicine, in particular with regard to assumptions ascribed to contemporary theorists. Second, I consider Sadegh-Zadeh's interesting idea that a person can have a disease to varying degrees, from not having it at all to having it completely. I argue that there are difficulties pertaining to the definition of particular diseases, which obstruct the application of this idea. The following two points concern medical semantics and principles for definition in general. I take issue with Sadegh-Zadeh's description of the correct procedure for definition. I also contest his unconditional proposal for a social definition of health, illness and disease.

Disease↗
PubMed1999

On disability and illness. A reply to Edwards.

This paper is a reply to an article by Steven Edwards in a previous issue of Theoretical Medicine and Bioethics. In this paper Edwards discusses two types of problems which he finds to be inherent in my theory of disability, mainly as presented in my On the Nature of Health, Kluwer 1995. First, Edwards discerns a tension in my basic definition of health, a tension between my "subjectivistic" and my "objectivistic" aspirations in the definition. Second, he finds that my theory of disability does not allow for a distinction between disability due to illness or injury and disability which has no such (at least not immediate) background. In my answer to Edwards's arguments I claim that his first criticism must be due to a misunderstanding of my intentions. I find his second criticism to be more to the point. It raises important issues in the theory of health which partly concern our interpretation of the notion of illness. Edwards introduces the notion of capacity in order to separate between disability due to illness or injury and disability without such a background. In the last part of my paper I argue that this distinction, however, will not fulfil its purpose.

Persons with Disabilities↗
PubMed1998

On medicine and health enhancement--towards a conceptual framework.

This paper contains an attempt at constructing a semantic framework for the field of health enhancement. The latter is here conceived as an extremely general category covering the whole area of health care and health promotion. With this framework as a basis I attempt to define the place of medicine within the enterprise of health enhancement. I finally indicate some normative issues for the future, in particular problems and possible developments for medicine as a species of health enhancement.

Ethics, Medical↗
PubMed1997

The importance of a disability/handicap distinction.

This paper continues a discussion concerning the distinction between disability and handicap initiated in this volume by Steven D. Edwards. Edwards argues that the reasons advanced by the WHO for this distinction in its International Classification of Impairments, Disabilities and Handicaps (ICIDH) are not valid. Edwards also criticizes my own quite different grounds for distinguishing between the two concepts. His general conclusion is that the distinction is superfluous. In this paper I claim that Edwards's reasoning is invalid. I present five arguments for my case, viz., the arguments from: a) practical necessity, b) cost-effectiveness, c) clinical practice, d) the subject's vital goals, and e) the universal presence of some basic action. My own conclusion thus is that there is a need within health care for a distinction between disabilities and handicaps. I also indicate that there may be a need for further distinctions along the dimension of action-generation which is presented in the paper.

Persons with Disabilities↗
PubMed1997

Holism reconsidered: a reply to Täljedahl.

In his article Weak and Strong Holism, Inge-Bert Tljedahl criticises some modern theories of health which define health without reference to disease. As an alternative he suggests a kind of theory called Strong holism which emphasises the lawful interrelations between all ontological layers in the human being. In this reply it is argued (1) that Täljedahl does not accurately describe the contents and intentions of the criticised theories and (2) that he does not put forward any alternative theory of health. Strong holism, as characterised by Täljedahl, is a general biological and social-biological research programme, which is very fruitful for scientific research projects, but which does not suggest any particular theory of health.

Holistic Health↗
PubMed1995

On chronic illness and quality of life: a conceptual framework.

In this paper I focus on the topic of chronic illness in the context of quality of life. I offer a conceptual explanation of these notions and then try to systematise the various species of suffering connected with chronic illness. Suffering in illness rarely attracts systematic analysis. Part of the reason for this is that the topic is in a way an aspect of common sense. It has an air of self-evidence and seems not to require analysis. However, it is my contention that the nature of human suffering is not at all self-evident. In many ways we know very little about the content and extent of suffering. And, although it may not be sensible to borrow traditional scientific techniques for the study of suffering, we need as much intellectual penetration and rigorous analysis in order to clarify the nature of suffering as for any other scientific investigation. Moreover, there are good reasons for saying that we ought to direct much more of our attention to this humanistic aspect of medicine. We ought to remember that the existence of suffering is one of the main motives, if indeed not the most important motive, for undertaking the medical enterprise.

Attitude to Health↗
PubMed1995

On the general concepts of action and ability. A philosophical introduction to the theory of handicaps.

The main task of this paper is to contribute to the theory of disabilities and handicaps, in particular their characterization and classification. It presents an analysis of the conditions for the successful performance of actions. By this procedure a list of reasons for failure of action, i.e., for disability and handicap, is obtained. This list can be used for a detailed classification of disabilities and handicaps. Some theories in modern philosophical action theory serve as platforms for the analysis.

Behavior↗
PubMed1993

On the relevance and importance of the notion of disease.

This paper constitutes a defence of the basic philosophical enterprise of characterising concepts such as 'disease' and 'health', as well as other medical concepts. I argue that these concepts play important roles, not only in medical, but also in other scientific and social contexts. In particular, medical decisions about health and diseasehood have important ethical, social and economic consequences. The role played is, however, not always a rational one. But the greater is the need for a reconstruction of this network of concepts for the purpose of efficient and rational communication.

Decision Making↗
PubMed1993

On the nature and ethics of health promotion. An attempt at a systematic analysis.

This paper attempts to analyse the notion of health promotion and related conceptual issues within an action-theoretical framework. The purpose is both theoretical and ethical. The paper provides a taxonomy as well as a system for classifying various types of health promotion. This system is inspired by Professor G H von Wright's theory of action explanation. The theoretical framework is used in the ethical part of the paper where some major ethical dilemmas in health promotion are analysed. Particular attention is paid to the use of manipulation and force in health promotion. An attempt is made to define when such measures are justified in various health enhancing contexts.

Behavior Control↗