Disease, illness, sickness, health, healing and wholeness: exploring some elusive concepts

Probably not a substantial claim: may not pass S3 (load-bearing).

Munchausen's syndrome is a diagnostic label for people who repeatedly present to hospitals with convincing symptoms, often demanding and sometimes undergoing surgery that reveals no organic disorder.

“A classic example is Munchausen's syndrome, the diagnostic label applied to people who repeatedly present themselves to hospitals with convincing symptoms, often demanding and sometimes undergoing surgery which reveals no organic disorder.”

• cites [6] Walton J, Barondess JA, Lock L, eds. The Oxford medical companion. Oxford: Oxford University Press, 1994: 611. sourceCould not verify

  The cited paper’s “Second Edition” section reviews the Oxford Companion to Medicine but does not discuss Munchausen’s syndrome or describe repeated hospital presentations, surgery, or the absence of organic disease. Searches for the syndrome and those diagnostic features found no relevant passage in our copy. (LLM, conf=0.78)

  Experimental — accuracy not yet measured
• cites [7] Youngson RM. Collins dictionary of medicine. Glasgow: HarperCollins, 1992: 406.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Classified as probably not a substantial claim.

Dictionary definitions of disease, illness and sickness are circular in an unhelpful way.

“There is a rather unhelpful circularity about these dictionary definitions.”

• cites [1] Brown L, ed. The new shorter English dictionary. Oxford: Clarendon Press, 1993.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S2 (checkable).

Concepts such as disease and health are difficult to define precisely, partly because they involve value judgments and are rooted in metaphor.

“Concepts such as disease and health can be diYcult to define precisely.Part of the reason for this is that they embody value judgments and are rooted in metaphor.”

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

The precise meanings of health, healing and wholeness are likely to remain elusive because first-person experience, including religion, cannot be reduced to third-person explanations, including science.

“The precise meaning of terms like health, healing and wholeness is likely to remain elusive, because the disconcerting openness of the outlook gained from experience alone resists the reduction of first-person judgments (including those of religion) to third-person explanations (including those of science).”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Marinker characterizes disease as a pathological process, often physical, identified by deviation from a biological norm, with an objectivity doctors can see, touch, measure and smell.

“Disease ... is a pathological process, most often physical as in throat infection, or cancer of the bronchus, sometimes undetermined in origin, as in schizophrenia.The quality which identifies disease is some deviation from a biological norm.”

• cites [2] 1975, Journal of Medical EthicsNot matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing).

The security of the sick role depends on several factors, not least possession of a disease.

“The security of this role depends on a number of factors, not least the possession of that much treasured gift, the disease.”

• cites [2] 1975, Journal of Medical EthicsNot matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

Sickness is the external and public mode of unhealth, a social role or status negotiated between the person called sick and society.

“Sickness ... is the external and public mode of unhealth.Sickness is a social role, a status, a negotiated position in the world, a bargain struck between the person henceforward called 'sick', and a society which is prepared to recognise and sustain him.”

• cites [2] 1975, Journal of Medical EthicsNot matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

Sickness based on illness alone is a very uncertain status.

“Sickness based on illness alone is a most uncertain status.”

• cites [2] 1975, Journal of Medical EthicsNot matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

Illness is a personal, interior experience of unhealth; it may accompany disease or occur when no disease is found.

“Illness ... is a feeling, an experience of unhealth which is entirely personal, interior to the person of the patient.Often it accompanies disease, but the disease may be undeclared, as in the early stages of cancer or tuberculosis or diabetes.Sometimes illness exists where no disease can be found.”

• cites [2] 1975, Journal of Medical EthicsNot matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Classified as probably not a substantial claim.

English dictionaries usually aim to describe word origins and historical usage, not conceptual clarity.

“But dictionaries of the English language usually only aim to tell us the origins of words and how they have been used historically.They do not aim at the much more contestable goal of conceptual clarity.”

Probably not a substantial claim: may not pass S2 (checkable).

What health means for a particular body depends on that person's aims, outlook, energies, drives, mistakes, and especially the ideals and fantasies of their soul.

“Even the determination of what health means for your body depends on your goal, your horizon, your energies, your drives, your errors, and above all on the ideals and phantasms of your soul.”

• cites [14] Nietzsche F. The gay science. [Translated by W Kaufmann.] New York: Vintage Books, 1974: book III, section 120.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

Even after taking all factors into account, one cannot quantify how healthy an individual is with precision; this is not only because the sum is complex but because the components include value judgments.

“But even when we have taken all these factors into account, we cannot quantify how healthy an individual is with any precision.That is not just because the sum is complex.It is also, Downie concludes, agreeing with Hare, because the components include value judgments.”

• cites [11] Downie RS, Fyfe C, Tannahill A. Health promotion: models and values. Oxford: Oxford University Press, 1992. sourceNot checked — no full text of the source

May combine two claims.

Modern physics recognises that observation affects the object, so knowledge cannot be gained about an object kept strictly isolated.

“the object is aVected by our observation.You cannot obtain any knowledge about an object while leaving it strictly isolated”

• cites [17] Schrödinger E. What is life? Cambridge: Cambridge University Press 1967: 118f.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

Being healthy does not mean matching a fixed standard; it means making the most of one's life in any circumstances, even those that fixed standards would call severely impaired or unhealthy.

“to be healthy is not to correspond with some fixed norm, but to make the most of one's life in whatever circumstances one finds oneself, including those which in terms of some fixed norms may seem severely impaired or unhealthy.”

• cites [15] Canguilhem G. The normal and the pathological. New York: Zone Books, 1991: 196f.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites [16] See reference 15: 201.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S2 (checkable).

Accepting such counterintuitive meanings depends on giving the conscious subject's viewpoint at least as much weight as the clinical observer's.

“Whether such counterintuitive meanings are entertained of course, depends on whether the viewpoint of the conscious knowing subject is given at least as much weight as that of the clinical observer.”

Probably not a substantial claim: may not pass S2 (checkable).

Canguilhem's account of the organism as a living being without pre-established harmony with its environment is the correct account of normality.

“The latter, Canguilhem argues, is the true view of normality.”

• cites [15] Canguilhem G. The normal and the pathological. New York: Zone Books, 1991: 196f.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S2 (checkable).

Whether religious experience and expectancy are more than psychological remains part of the unsettling openness of experience, which neither scientific experiment nor religious dogma can conclusively close.

“But whether or not religious experience and expectancy represent more than psychological reality, remains part of the disconcerting openness of human experience, which can be closed or rounded oV no more conclusively by scientific experiment than by religious dogma.”

Probably not a substantial claim: may not pass S2 (checkable).

Bodies have countless forms of health.

“Thus there are innumerable healths of the body”

• cites [14] Nietzsche F. The gay science. [Translated by W Kaufmann.] New York: Vintage Books, 1974: book III, section 120.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

Whether someone is ill is ultimately decided by that person.

“Whether or not someone is ill, is something the person concerned ultimately must decide for him-or her-self.”

Probably not a substantial claim: may not pass S2 (checkable).

The important part played by metaphor in the development of thought and language helps explain why definitions of health are elusive.

“Another way of understanding this, I think, has to do with the important part played by metaphor in the development of thought and language.”

May combine two claims.

Fitness is not sufficient for health; athletic training fitness can be detrimental to physical health, and maximising physical fitness as an end in itself may become an unhealthy obsession.

“Nor is fitness suYcient: the kind of fitness sought in athletic training, indeed, is sometimes detrimental to physical health; and the desire to maximise physical fitness as an end in itself may become an unhealthy obsession.”

• cites [11] Downie RS, Fyfe C, Tannahill A. Health promotion: models and values. Oxford: Oxford University Press, 1992. sourceNot checked — no full text of the source

Classified as probably not a substantial claim. May combine two claims.

Religion sees healing both as natural tissue repair, sometimes aided by medicine, and as any process that brings greater spiritual wholeness.

“Healing is understood by religion not only as the natural process of tissue regeneration sometimes assisted by medical means, but also as whatever process results in the experience of greater wholeness of the human spirit.”

Classified as probably not a substantial claim. May combine two claims.

Value judgments help determine what we mean by disease, health, illness and sickness, which is one reason their definitions are often frustratingly elusive.

“One reason then, why definitions of disease and health are sometimes so frustratingly elusive is the part played by value judgments in determining what we mean by disease and health as well as what we mean by illness and sickness.”

• AssumptionRests on an assumption: Most people in our society make the same or similar value judgments about what disease, illness, sickness, and health words mean and what are examples of what they mean.
• AssumptionRests on an assumption: There is a common core of ideas about what disease is or what health is.

Probably not a substantial claim: may not pass S2 (checkable).

Health does not mean returning from illness; it means recovering and possibly surpassing one's previous state.

“health is not a matter of getting back from illness, but getting over and perhaps beyond it.”

• cites [15] Canguilhem G. The normal and the pathological. New York: Zone Books, 1991: 196f.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

A physically dependent patient at peace with his past and coming death may feel closer to wholeness than ever and might even be called healthy.

“A physically dependent patient who has come to terms with his past life and his approaching death, for example, may well feel, and thus (because no one else is better placed to judge) be nearer to 'wholeness' than ever before.”

• cites [26] Boyd KM. Health care ethics, health and disease. In: Gillon R, ed. Principles of health care ethics. Chichester: John Wiley & Sons 1994: 812.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Classified as probably not a substantial claim.

One reason definitions of disease are elusive is that calling something a disease is a value judgment, relatively unproblematic when widely shared but more contentious when people disagree.

“This suggests one reason then, why definitions of disease can be so elusive.To call something a disease is a value judgment, relatively unproblematic in cases when it is widely shared, but more contentious when people disagree about it.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

In the case of disease, metaphorising seems to have been at work in the development of the more specific term as a particular instance of something causing dis-ease and making for lack of elbow room or freedom of movement.

“In the case of disease, I have already indicated how metaphorising seems to have been at work, in the development of this more specific term as a particular instance of something causing dis-ease and making for lack of elbow room or freedom of movement.”

Probably not a substantial claim: may not pass S2 (checkable).

If science could remove the religious or transcendent dimension from reality itself, it would also have to remove the first-person human dimension.

“If science were able to exclude the religious or transcendent dimension from reality (rather than just from the scientific picture of reality), it would be at the cost of excluding the first-person human dimension also.”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

Health is normally thought to have a positive as well as a negative dimension.

“It is also that we normally think of health as having a positive as well as a negative dimension.”

Classified as probably not a substantial claim.

In religion, wholeness and healing are closely connected.

“For religion, the two remaining words I mentioned at the outset-wholeness and healing-are intimately related.”

May combine two claims.

It is naive to think science has disproved religious ideas about the world; the historical reality is more complicated.

“A naïve, albeit widely-held view, is that religious ideas about the world have been disproved by science.What actually happened historically is more complex.”

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

Physicians must give up the notion of a normal health, a normal diet, and a normal course of illness.

“the more must the concept of a normal health, along with a normal diet and the normal course of an illness be abandoned by our physicians.”

• cites [14] Nietzsche F. The gay science. [Translated by W Kaufmann.] New York: Vintage Books, 1974: book III, section 120.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

Some diseases are less respectable than others.

“Some diseases, clearly, are less respectable than others.”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

Most patients most of the time can probably be classified as having a disease, feeling ill, or being recognised as sick.

“Most patients most of the time however, probably can be classified as having a disease, or feeling ill, or being recognised as sick.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

People labelled with Munchausen's syndrome may have succeeded in being recognised as sick, but not in the sense they intended; their sickness has low status in Marinker's terms.

“People labelled with Munchausen's syndrome then, may have succeeded in getting recognised as being sick, but not in the sense they intended.In Marinker's terms, their sickness has pretty low status.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

When existing terminology lacks adequate resources for a new experience or discovery, a metaphor from another area of experience used in a new way may help say what is meant.

“When we want to talk about some new experience or discovery for which our existing terminology has no adequate resources, a metaphor-a word or words from some other area of experience, but used in a new way-may help us to say what we mean.”

Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

Attested signs of hope may be viewed as traces of a transcendent wholeness that grounds human wholeness.

“These or other signs of hope, when attested, may be seen as traces of a transcendent or encompassing wholeness, in which human wholeness is grounded.”

Classified as probably not a substantial claim.

When a metaphor broadens, it typically adjusts rather than fundamentally changes thinking or action that other strong metaphors already shape.

“expanding metaphors usually only modify rather than radically alter thought or action already also oriented by other powerful metaphors.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims. The quote only partly states this claim.

Once metaphors get going, they can be hard to stop; because humans are highly imitative, successful metaphors tend to proliferate.

“Our imitative or mimetic tendency then, may be one of the reasons why successful metaphors tend to proliferate so successfully.”

• AssumptionRests on an assumption: Human beings are strongly imitative.

Probably not a substantial claim: may not pass S3 (load-bearing).

Whether someone has a disease or is sick may be disputed by doctors and others.

“But whether that person has a disease or is sick is something doctors and others may dispute.”

Classified as probably not a substantial claim. May combine two claims.

Past a shared core of ideas about disease and health, opinions diverge on whether a condition is a disease or who is healthy, and our concepts become fuzzy.

“But beyond that common core, judgments on whether a condition is a disease, or on what or who is healthy, begin to diverge, and our conceptions of disease and health begin to get fuzzy.”

• AssumptionRests on an assumption: There is a common core of ideas about what disease is or what health is.

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

Abnormal states of mind may reflect minority, immoral or illegal desires that are not sick desires.

“Abnormal states of mind may reflect minority, immoral or illegal desires which are not sick desires.”

• cites [11] Downie RS, Fyfe C, Tannahill A. Health promotion: models and values. Oxford: Oxford University Press, 1992. sourceNot checked — no full text of the source

May combine two claims.

A psychopath may neither regard his state as unwanted nor experience it as incapacitating.

“On the other hand, a psychopath, for example, may neither regard his state as unwanted, nor experience it as incapacitating.”

• cites [11] Downie RS, Fyfe C, Tannahill A. Health promotion: models and values. Oxford: Oxford University Press, 1992. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

An unwanted condition is not sufficient for ill health, since it may be normal infirmity of old age; abnormality is not sufficient either, since a disability or deformity may be abnormal without the person being unhealthy.

“Nor is the fact that a condition is unwanted enough to describe it as ill health: it may be the normal infirmity of old age for example; and again a condition's abnormality is not enough either-a disability or deformity may be abnormal, but the person who has it may not be unhealthy; and much the same may apply to someone who has had an injury.”

• cites [11] Downie RS, Fyfe C, Tannahill A. Health promotion: models and values. Oxford: Oxford University Press, 1992. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S2 (checkable).

Religious arguments cannot conclusively settle whether life's struggle against death points to a deeper game.

“Religious arguments underdetermine any conclusive answer to this question.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Applying a diagnostic label such as Munchausen's syndrome commits doctors to hoping that someday they will understand in medical terms what makes these people act as they do.

“What I take Hare to mean by this, is that when doctors apply a diagnostic label like Munchausen's syndrome, for example, they are committing themselves to the hope that someday they will be able to understand-in medical terms (”

Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

Such questions can be answered only by or between conscious subjects who are actors in the interplay, not by detached observers.

“Such questions admit only answers given, not by detached scientific or religious observers, but by or between conscious knowing subjects, the actors in the interplay.”

May combine two claims.

Defining health simply as absence of disease or infirmity leads to difficulties because people can have a disease without feeling ill, and can have unwanted symptoms when no disease or disorder is present.

“To try to define health as simply the absence of disease or infirmity leads you into diYculties: ill health can't be defined simply in terms of disease, for example, because people can have a disease (especially one with minor symptoms) without feeling ill, and they can have unwanted symptoms (nausea, faintness, headaches and so on) when no disease or disorder seems to be present.”

• cites [11] Downie RS, Fyfe C, Tannahill A. Health promotion: models and values. Oxford: Oxford University Press, 1992. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

No single thing called health exists, and every attempt to define health in that manner has failed badly.

“there is no health as such, and all attempts to define anything in that way have been miserable failures.”

• cites [14] Nietzsche F. The gay science. [Translated by W Kaufmann.] New York: Vintage Books, 1974: book III, section 120.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S4 (based). May combine two claims.

Religion holds that encompassing wholeness is not merely a psychological projection and is usually encountered through expectancy, in life and before death.

“while for religion the encompassing wholeness is not reducible to a psychological projection, it is discovered most commonly in the mode of expectancy, both in the midst of life and in the face of death.”

Probably not a substantial claim: may not pass S2 (checkable).

The unsettling openness of experience is ultimately what makes health, healing and wholeness so elusive.

“This disconcerting openness perhaps is what, finally, makes the meaning of health, healing and wholeness so elusive.”

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

Human experience is fragmentary, so wholeness is never perfectly achieved.

“But wholeness is always imperfectly realised in the fragmentariness of human experience”

Probably not a substantial claim: may not pass S2 (checkable).

As long as the question of hope before death stays open, the meaning of health, healing and wholeness will probably remain elusive.

“as long as it does, the meaning of health, healing and wholeness seems likely to remain elusive.”

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

Defining health by fixed standards like biochemical norms or the athlete ideal assumes the objective observer's view is true and stops people from seeing themselves as agents rather than passive patients.

“The problem about conceiving health in terms of fixed norms such as those of biochemistry, or the ideal of the athlete, is that it assumes that the objective observer's viewpoint is the true one, and discourages those who adopt it from seeing themselves as actors or agents, rather than patients who are acted upon.”

May combine two claims.

When new scientific explanations fit the facts better, religion, more conservative than science, clung to old ideas, helping many people believe science would eventually explain everything.

“When these ideas were overtaken by new scientific explanations which seemed to fit the facts better, religion, being more conservative than science, was slow to give them up; and this helped to create the impression among many people that it was only a matter of time before science would explain everything.”