- 學位論文
論「疾病」觀念的兩個進路：自然主義和實用論
On the Naturalistic and Pragmatic Approaches to the Notion of Disease
摘要
摘要 「疾病」觀念的本質為何？「疾病」觀念是否帶有價值判斷？克里斯多夫‧布爾斯(Christopher Boorse)的理論屬於自然主義(naturalism)，他認為「疾病」是一個純粹理論性的、描述性的觀念，不帶有價值判斷，所以，在分析「疾病」觀念時，布爾斯採取理論進路。所謂的「理論進路」就是在分析「疾病」觀念時，側重其理論的面向。相反地，喬治‧阿吉奇(George J. Agich)主張實用論，他認為「疾病」在本質上是一個實踐的、帶有價值判斷的觀念。阿吉奇認為，「疾病」觀念和「病痛」以及「生病」等實踐的觀念有直接的關係；「疾病」觀念是實踐的產物、受到實踐價值的形塑，因此，我們在分析「疾病」觀念時，應該採取實用進路，以實踐面向為基礎來了解「疾病」觀念。乍看之下，布爾斯和阿吉奇的理論似乎有所衝突，然而，一旦我們將布爾斯和阿吉奇各自所說的「疾病」觀念置於不同層次，我們將可以發現它們之間是沒有衝突的。 阿吉奇的實用的「疾病」觀念應該是基礎的「疾病」觀念，在這個實用的「疾病」觀念之下，可以發展出各種理論的、描述性的「疾病」觀念，布爾斯的理論的「疾病」觀念就是其中之一。而馬克‧伍德豪斯(Mark B. Woodhouse)談到的另類醫學(alternative medicine)中的「疾病」觀念是另一種描述性的「疾病」觀念。 在伍德豪斯的刻畫下，另類醫學裡的「疾病」觀念包含了生物醫學裡的「疾病」觀念，然而，據筆者了解，一些生物醫學視為「疾病」的情況，在傳統中醫的觀點下並非疾病。
並列摘要
Abstract In this thesis I investigate the conception of “disease”. What is the nature of the conception of “disease” ? Is the conception of “disease” value-free or value-laden? Christopher Boorse is a naturalist. Boorse thinks that the conception of “disease” is a purely theoretical, descriptive conception. Consequently, Boorse has taken the theoretical approach to analyzing the concept of “disease”. One who takes the theoretical approach focuses on the theoretical aspect of the conception of “disease”. In contrast, George J. Agich adopts a pragmatic approach to the conception of “disease”. Agich claims that the conception of “disease” is in its nature a practical concept and thus value-laden. Agich thinks the conception of “disease” is directly related to the practical concepts of “illness” and “sickness”. The conception of “disease” is cultivated in practice. Thus, we should use a pragmatic approach to the conception of “disease”. There are apparent conflicts between Boorse’s and Agich’s theories. However, once Boorse’s conception of “disease” and Agich’s conception of “disease” are placed on two different levels, the apparent conflicts will disappear. Agich’s pragmatic conception of “disease” should be the basis. Within the framework of the pragmatic conception of “disease”, a variety of descriptive notions of disease concepts can be developed. Boorse’s conception of “disease” is one of such descriptive concepts. The conception of “disease” in alternative medicine which Mark B. Woodhouse explores is another descriptive conception of “disease”. Woodhouse argues that the conception of “disease” in alternative medicine is an extension of the conception of “disease” in biomedical medicine. However, as far as I know, some of the physical states biomedical doctors regard as diseases are not diseases at all from the point of view of traditional Chinese medicine.