Risk and disease

Perspectives in Biology and Medicine
Peter H Schwartz

Abstract

The way that diseases such as high blood pressure (hypertension), high cholesterol, and diabetes are defined is closely tied to ideas about modifiable risk. In particular, the threshold for diagnosing each of these conditions is set at the level where future risk of disease can be reduced by lowering the relevant parameter (of blood pressure, low-density lipoprotein, or blood glucose, respectively). In this article, I make the case that these criteria, and those for diagnosing and treating other "risk-based diseases," reflect an unfortunate trend towards reclassifying risk as disease. I closely examine stage 1 hypertension and high cholesterol and argue that many patients diagnosed with these "diseases" do not actually have a pathological condition. In addition, though, I argue that the fact that they are risk factors, rather than diseases, does not diminish the importance of treating them, since there is good evidence that such treatment can reduce morbidity and mortality. For both philosophical and ethical reasons, however, the conditions should not be labeled as pathological. The tendency to reclassify risk factors as diseases is an important trend to examine and critique.

Citations

Nov 16, 2014·The Journal of Medicine and Philosophy·Christopher Boorse
Sep 17, 2013·The Journal of Medicine and Philosophy·George Khushf
Jan 17, 2016·Annual Review of Clinical Psychology·Jerome C Wakefield
Apr 27, 2017·The Journal of Medicine and Philosophy·Wendy A Rogers, Mary Jean Walker
May 24, 2018·Journal of Evaluation in Clinical Practice·Bjørn Hofmann
Apr 19, 2017·The Journal of Medicine and Philosophy·Lynette Reid
Feb 26, 2016·Medicine, Health Care, and Philosophy·Bjørn Hofmann
Nov 17, 2016·Medicine, Health Care, and Philosophy·Mary Jean Walker, Wendy Rogers
Jun 25, 2009·Theoretical Medicine and Bioethics·Peter H Schwartz
May 9, 2015·Theoretical Medicine and Bioethics·Élodie Giroux
Sep 2, 2017·The Journal of Medicine and Philosophy·Peter H Schwartz
Feb 18, 2021·Theoretical Medicine and Bioethics·Maria Cristina Amoretti, Elisabetta Lalumera
Apr 17, 2021·Journal of Sleep Research·Emmanuel d'IncauJean-Arthur Micoulaud-Franchi
May 1, 2021·Health Care Analysis : HCA : Journal of Health Philosophy and Policy·Bjørn Hofmann

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