On the concept of disease

About the project

The concept of disease is one of the most basic concepts in health care with both factual and normative aspects, and important practical implications. A disease merits scientific scrutiny, health care attention, relief from social obligations (work), justification of economic support, as well as excuse from moral obligation (family). 

Objectives

• To analyze and clarify the normative and factual, the social and scientific, aspects of human ailment.
• To study various dimensions of human ailment, such as illness, sickness and disease.

Outcomes

Publications in national and international scientific literature.

Background

The project started as a PhD project funded by the Norwegian Research Council in 1998 resulting in the thesis The technological invention of disease - On disease, technology and values (2002).

Sub-projects

• Theories of human malady:
  • Complexity of the concept of disease as shown through rival theoretical frameworks
• Disease, Illness and Sickness: On perspectives on human malady
  • Outcomes:
    • Disease. In: Encyclopedia of Global Bioethics
    • Disease, Illness, and Sickness In: The Routledge Companion to Philosophy of Medicine
    • Undermining autonomy and consent: the transformative experience of disease
    • Do health professionals have a prototype concept of disease? The answer is no
    • What makes some diseases more typical than others? A survey on the impact of disease characteristics and professional background on disease typicality
    • Exit exceptionalism: mental disease is like any other medical disease
    • The concept of disease: ethical challenges and relevance to dentistry and dental education
    • Hva er "psyk-dom"? Sykdomsbegrepets etikk
    • Hofmann B. Hva er sykdom? [What is disease?] Gyldendal Akademisk, 2008, 2014.
• Disease and Health: On the relationship between the concepts of health and disease
  • Outcomes:
    • Does disease incite a stronger moral appeal than health?
    • Adressing the paradox: Health expansion threatening sustainable healthcare
    • Simplified models of the relationship between health and disease
    • How to Draw the Line Between Health and Disease? Start with Suffering
    • "Om jeg er frisk? Vent litt, jeg skal bare sjekke appen" Helsebegreper for vår tid
• Sickness dynamics: What influences the concept of sickness in work absence?
  • Outcome: Hofmann B. On the dynamics of sickness in work absence. In: Nordby H, Rønning R, Tellnes G, editors. Social aspects of illness, disease and sickness absence. Oslo: Unipub forlag; 2011. p. 47-62.
• Technology and human malady:
  • Technology and disease: How technology influences the conception of disease and what is the role of values.
    • Outcomes:
      • The technological invention of disease
      • Is there a technological imperative in health care?
  • Technology and illness: How technology influences the experience of illness.
    • Outcomes: How medical technologies shape the experience of illness
• Ethical aspects of the disease concept
  • Outcomes:
    • Acknowledging and addressing the many ethical aspects of disease
    • Expanding disease and undermining the ethos of medicine
    • Severity as a moral qualifier for malady
    • On the Ethics of Witholding and Withdrawing Unwarranted Diagnoses
    • Looking for trouble? Diagnostics expanding disease and producing patients
    • Hofmann B. Sykdommens etikk. In: Magelssen M, editor. Etikk i helsetjenesten. Oslo: Gyldendal Akademisk; 2020. p. 50-60.
• Epistemic and normative aspects of diagnosis and diagnostics:
  • Outcomes:
    • Temporal uncertainty in disease diagnosis
    • New diagnostic tests: more harm than good(BMJ)
    • Too much of a good thing is wonderful? A conceptual analysis of excessive examinations and diagnostic futility in diagnostic radiology
• Normal and natural in human and veterinary medicine (with Henrik Lerner, Linköping University)
  • Outcome: Normality and naturalness: A comparison of the meanings of concepts used within veterinary medicine and human medicine
• Existential and identity-related aspects of human ailment
  • Outcomes:
    • Sykdom som dannelse–en studie av Thomas Manns roman Trolldomsfjellet
    • Identitetens sykdom og sykdommens identitet
• Overdiagnosis: See own research project

Other outcomes (publications)

Hofmann B. The technological invention of disease. J Med Ethics: Medical Humanities 2001;27:10-19.

Hofmann B. Do we need a concept of health to treat disease? European Journal of Medicine, Health Care and Philosophy. Abstract. 1999; 2: 93.

Hofmann B. [Technology creates disease] Teknologi skaper sykdom. Tidsskrift for forskning i sygdom og samfund 2009; (11): 13-29

Hofmann B. [Can technology create disease?] Kan teknologi skape sykdom? Utposten 2009; 8:7-13.

Hofmann, Bjørn. Sykeliggjøringens mange ansikter. Utposten 2007;36(1):10-13

Hofmann B. Hva er sykdom? - et helsefaglig og filosofisk spørsmål. Sykepleien 2004; 04: 38-42. [What is disease? - an issue for health care and philosophy]. http://www.sykepleien.no/News/NewsShow.asp?NewsID=5585

Hofmann B. Sykdom som dannelse – en analyse av Thomas Manns roman Trolldomsfjellet. [Disease and identity]. Tidsskr Nor Lægeforen 2003; 123: 3569-72. http://www.tidsskriftet.no/lts-pdf/pdf2003/3569-72.pdf

Hofmann B. Om nytten av sykdomsbegrepet. Tidsskr Nor Lægeforen 2003; 123: 1398. [The usefulness of the concept of disease].

Hofmann B. Trenger helsevesenet begrepet sykdom? Tidsskr Nor Lægeforen 2003;123: 487-90. [Does health care need the concept of disease?]

Hofmann B. Den perfekte sykdom. Utposten 2002; 2: 22-26. [The perfect disease].

Hofmann B. The technological invention of disease - on disease, technology and values. Thesis. Oslo: University of Oslo. Feb 28 2002.

Hofmann B. Simplified models of the relationship between health and disease. Theoretical Medicine and Bioethics 2005; 26(5): 355 - 377.

Hofmann B. On the triad disease, illness and sickness. Journal of Medicine and Philosophy 2002; 27(6): 651-74.

Hofmann B. Complexity of the concept of disease as shown through rival theoretical frameworks. Theoretical Medicine and Bioethics 2001; 22(3): 211-37.

Hofmann BM. Jeg er dårlig, men legen finner ikke noen sykdom. Er jeg da syk? Forskersonenno. 2021. http://dx.doi.orghttps://forskersonen.no/kronikk-medisin-og-helse-meninger/jeg-er-darlig-men-legen-finner-ikke-noen-sykdom-er-jeg-da-syk/1946133

Hofmann B. Identitetens sykdom og sykdommens identitet. [On the disease of identity and the identity of disease]. Tidsskrift for den Norske laegeforening 2018;12:138 https://tidsskriftet.no/2018/06/kommentar/identitetens-sykdom-og-sykdommens-identitet .

Hofmann B. Kjønn, identitet og sykdom. [Gender, identity, disease]. Tidsskrift for den Norske laegeforening. 2018;13:138. https://tidsskriftet.no/2018/07/kommentar/kjonn-identitet-og-sykdom

Hofmann B, Wilkinson SR. Mange betegnelser for sykdom. Tidsskrift for Den norske legeforening. 2016:1125-6. https://tidsskriftet.no/2016/07/sprakspalten/mange-betegnelser-sykdom

Hofmann B. Hva er sykdom? In: Kvale D, Ørn S, Bach-Gansmo E, editors. Sykdom og behandling: Gyldendal Akademisk; 2016. p. 27-33.

Hofmann B. Hva er sykdom?  Sykdom og behandling: Gyldendal Akademisk; 2011. p. 634.

Hofmann B. Teknologi skaper sykdom. Tidsskrift for forskning i sygdom og samfund. 2009;11:13-29. https://doi.org/10.7146/tfss.v6i11.2692

Hofmann B. Kan teknologi skape sykdom? Utposten. 2009;8:7-13. https://www.utposten.no/journal/2009/8/utposten-chapter-3/Kan_teknologi_skape_sykdom?

Frich JC, Hofmann B. Behov - sykdom uten grenser?  I: Wilmar B, Bruusgaard P, Frich JC, Fugelli P. Penger og verdier i helsetjenesten: Gyldendal Akademisk; 2009. p. 260.

Hofmann B. Helse, sykdom og kampen om 'det gode liv'. Nytt Norsk Tidsskrift. 1999(1):74-80. 

Financing

The project is financed by the ordinary budget of CME.

Start - Finish

1998 –