Literature DB >> 25976770

Disease prioritarianism: a flawed principle.

Karim Jebari1.   

Abstract

Disease prioritarianism is a principle that is often implicitly or explicitly employed in the realm of healthcare prioritization. This principle states that the healthcare system ought to prioritize the treatment of disease before any other problem. This article argues that disease prioritarianism ought to be rejected. Instead, we should adopt 'the problem-oriented heuristic' when making prioritizations in the healthcare system. According to this idea, we ought to focus on specific problems and whether or not it is possible and efficient to address them with medical means. This has radical implications for the extension of the healthcare system. First, getting rid of the binary disease/no-disease dichotomy implicit in disease prioritarianism would improve the ability of the healthcare system to address chronic conditions and disabilities that often defy easy classification. Second, the problem-oriented heuristic could empower medical practitioners to address social problems without the need to pathologize these conditions. Third, the problem-oriented heuristic clearly states that what we choose to treat is a normative consideration. Under this assumption, we can engage in a discussion on de-medicalization without distorting preconceptions. Fourth, this pragmatic and de-compartmentalizing approach should allow us to reconsider the term 'efficiency'.

Keywords:  Cost-benefit analysis; Disease; Medical ethics; Medicalization; Prioritization

Mesh:

Year:  2016        PMID: 25976770     DOI: 10.1007/s11019-015-9649-2

Source DB:  PubMed          Journal:  Med Health Care Philos        ISSN: 1386-7423


  19 in total

1.  Selling sickness: the pharmaceutical industry and disease mongering.

Authors:  Ray Moynihan; Iona Heath; David Henry
Journal:  BMJ       Date:  2002-04-13

2.  On defining "mental disorder": purposes and conditions of adequacy.

Authors:  Bengt Brülde
Journal:  Theor Med Bioeth       Date:  2010-02

3.  The health care costs of smoking.

Authors:  J J Barendregt; L Bonneux; P J van der Maas
Journal:  N Engl J Med       Date:  1997-10-09       Impact factor: 91.245

Review 4.  The medicalization of body size and women's healthcare.

Authors:  Sharon Wray; Ruth Deery
Journal:  Health Care Women Int       Date:  2008-03

5.  Insomnia: Medicalization of sleep may be needed.

Authors:  Sam Fleishman
Journal:  Nature       Date:  2012-11-22       Impact factor: 49.962

6.  Do we need a concept of disease?

Authors:  G Hesslow
Journal:  Theor Med       Date:  1993-03

7.  Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication.

Authors:  Ronald C Kessler; Patricia Berglund; Olga Demler; Robert Jin; Kathleen R Merikangas; Ellen E Walters
Journal:  Arch Gen Psychiatry       Date:  2005-06

Review 8.  The concept of mental disorder. On the boundary between biological facts and social values.

Authors:  J C Wakefield
Journal:  Am Psychol       Date:  1992-03

9.  Positive association between attention-deficit/ hyperactivity disorder medication use and academic achievement during elementary school.

Authors:  Richard M Scheffler; Timothy T Brown; Brent D Fulton; Stephen P Hinshaw; Peter Levine; Susan Stone
Journal:  Pediatrics       Date:  2009-05       Impact factor: 7.124

Review 10.  'Cut down to quit' with nicotine replacement therapies in smoking cessation: a systematic review of effectiveness and economic analysis.

Authors:  D Wang; M Connock; P Barton; A Fry-Smith; P Aveyard; D Moore
Journal:  Health Technol Assess       Date:  2008-02       Impact factor: 4.014

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