The concept of disease: ethical challenges and relevance to dentistry and dental education.

Modern medicine and dentistry face fundamental ethical challenges. To treat or not to treat, that is the question! Can these challenges be met with a rigorous and consistent concept of disease? This is the key question of this article and the ensuing debate is of fundamental importance in the teaching of ethics to medical and dental students. The investigation of traditional concepts of disease reveals that they are flawed and do not withstand ethical challenges. An alternative concept of human ailment is elaborated on, based on the triad disease, illness and sickness. This model is applied to representative cases in medicine in general and dentistry in particular. It is argued that the concepts of disease, illness and sickness represent a framework for analysing and coping with inherent ethical challenges. This reveals that medicine and dentistry are concerned both with biological explanations and with questions of the virtuous life, i.e., both with science and with ethics. These considerations pose challenges for the health professions as a whole, but particularly for those concerned with educating the practitioners of the future.