Disease viewed as a symbolic category

Horacio Fabrega

pp. 79-106

in: Tristram Engelhardt, Stuart Spicker (eds), Mental health: philosophical perspectives, Berlin, Springer, 1978

Abstract

The essays in this volume address some of the social and philosophical problems which surround the phenomenon of psychiatric disease in contemporary society. This is all being handled by reference to notions such as "mental health" or "mental illness," terms which I tend not to use. Nonetheless, the problems are quite "real," have caused me concern, and have been influential in motivating my academic work. Not surprisingly, as a physician I have concentrated my work on the meaning of "disease." I have tried to develop a general frame of reference about disease. Interested in the beliefs, orientations and actions of various people — people from cultures far different from our own — I have studied and compared how disease is viewed and handled. In this paper I would like to summarize some of my thinking on this topic. An underlying theme in my work has been that, by comparing how different people think of disease, we will be able to develop a broad perspective about what disease means andthe role it plays and has played in the lives of different people. Such a perspective may provide us with clues about the sources of some of the problems involving disease and medical care which exist in our own society.