Abstract

In their concern with etiological questions, medical and behavioral scientists alike have overwhelmingly focused on the etiology of diseases. It is the thesis of this paper that the time has come to add to—though not to supplant—this focus by the serious consideration of the etiology of disease, in the singular. In order to avoid confusion, I propose to substitute the term “breakdown” to refer to the global entity which might be called disease. ‡ I argue that clarification and use of the breakdown concept will have fruitful implications for understanding the etiology of all those departures from the social norm we call health, for therapeutic purposes, for a more adequate structuring of the health professions, and for research in medical sociology. The concept of breakdown, I suggest, must be adopted as a fourth major step in the thinking of modern medicine.

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