Haigused kui eksistentsiaalsed stsenaariumid

Nordic-Baltic Network of Philosophy of Medicine meeting, June 11-12, 2019, Tartu

Diseases as general scenarios to map individual existential routes

Andres Soosaar
University of Tartu

Concepts of health and disease belong to the very heart both medicine and philosophy of medicine, but pragmatic outcomes from their analyses are rather different. In philosophy a lot energy goes for comparative analysis of different theoretical approaches and there are several dimensions to describe different theories of disease, including objectivism-constructivism or naturalism-normativism axes and their hybrid combinations. At the same time in medical science the concept of disease is taken as an individual set of knowledge about prevalence (epidemiology), causation (etiology), processes (pathogenesis), recognition (diagnostics) and prevention, removal or modification (therapy) of unwanted stereotypical existential conditions. Through times the four cognitive aspects and 2-3 interventional aspects of a disease have been mutually interconnected. As amount of empirical information has had tendency to grow in all mentioned aspects of knowledge, the need to classify pathological conditions is obvious since very early days of medical practice. The newest general classification of diseases, WHO’s ICD-11, has several times more different  codes (in sum around 55 000) for injuries, diseases and causes of death compare to ICD-10, meaning the viability of the temptation to differentiate as exactly as possible pathological conditions. At same time modern IT tools are used with growing intensity to manage and analyse medical information, including conceptual frameworks of pathological conditions. Is it possible to build a bridge between philosophical and medical concepts of disease? An option to build this bridge is to take disease as common denominator for certain scenarios of human existence which may have both biological, mental and social aspects. The compromise between philosophical, IT and medical approaches seem to be different semantic ontologies, e.g. The Human Disease Ontology among several others. Constructing different theoretical ontologies gives possibility to manage big amounts medical information and create evidence based instructions of behavior for both patients, physicians and society.