Epistemic Authority, Philosophical Explication, and the Bio-Statistical Theory of Disease

Abstract

Christopher Boorse’s (Philos Pub Aff 5:49–68, 1975; J Theory Soc Behav 6:61–84, 1976; Philos Sci 44:542–573, 1977; in: VanDeVeer and Regan (eds) Health care ethics: an introduction, Temple University Press, Philadelphia, pp 359–393, 1987; in Humber, Almeder, Totowa (eds) What is disease?, Humana Press (Biomedical Ethics Reviews), New York City, pp 1–134, 1997; J Med Philos, 39:683–724, 2014) Bio-Statistical Theory (BST) comprehends diseases in terms of departures from natural norms, which involve an objectively describable deviation from the proper physiological or psychological functioning of parts of the human organism. I argue that while recent revisions and additional considerations (Boorse 2014) shield the BST from a number of issues raised by critics, they give rise to significant new challenges. These are related to the attribution of epistemic authority, the possibility of multiple concepts in the authoritative literature, and the framing of BST as “philosophical explication.” The conclusion is that, in its current form, the BST is unable to provide a robust framework for a naturalist classification.