Implications of alternative viewpoints for states of being if accepted or rejected as diseases
Categories of states of being Examples | Disease | Conceptualisation | Implications for action | Potential negative consequences/ramifications |
Addictions or possible addictions Alcoholism Drug addiction Gambling addiction | Yes | Biological health disorder | Harm reduction24
Public funding Medical treatment | Focus on individuals and treatments may cause social and moral aspects to be ignored10 25–27 |
No | Lack of self-control Moral failing | Abstinence through individual choice and self-discipline Punitive management strategies | Stigma and discrimination, neglect of harm reduction, neglect of social causes and increased suffering for the population25 26 41–43 | |
Social problem | Preventive social solutions: income redistribution, poverty reduction, education and social marketing | Effective medical treatment underused26 43 | ||
Medical diagnoses with uncertain biological/psychosocial basis Attention deficit hyperactivity disorder Panic disorder Personality disorder | Yes | Specific biological disorder | Label patients with a specific category. Diagnose and treat uniformly, possibly with drugs | Overdiagnosis and overtreatment with drugs, undertreatment with behavioural approaches4 20 28–30
Failure to recognise the diversity of illness19 44 45 |
No | Socially mediated adjustment problem | Seek underlying causes, modify environment Behavioural therapy Don’t attempt to pigeon-hole unusual presentations | Patients may feel stigmatised Effective medical treatment may be underused29 30 Acknowledgement of complexity may lead to inefficiency19 44 45 | |
Diminished function, often age-related Lack of sexual desire | Yes | Biological health disorder | Diagnose and treat, possibly with drugs Public funding | Overdiagnosis and medicalisation of society, with increased self-perception of illness and poorer coping with suffering that is part of life20 29–31 |
No | Normal consequence of living | Accept and adjust Responsibility on individual | Neglect of treatments that may reduce suffering and improve function29 30 | |
Patterns of behaviour Homosexuality Transsexualism | Yes | Biological health disorder | Diagnose and treat, possibly with drugs Negative social stigma | Adverse judgement and resulting stigma and discrimination46 |
No | Human diversity | No medical intervention | ||
No | Moral failing | Abstinence/modification of behaviour through individual choice/self-discipline Punitive strategies | Stigma and discrimination46 |