Grounded Disease: The Biological and the Social in Medicine

Abstract

Social Constructivism about the disease concept has generally been taken to ignore the fundamental biological reality underlying diseases, as well as to fall foul of several apparently compelling objections. In this paper I explain how the metaphysical relation of grounding can be used to tie a socially-constructed account of diseases and their classification to their underlying biological and behavioural states. I then generalise the position by disambiguating several varieties of normativism, including a particularly strong version of social constructivism, and showing that the grounding approach is available to each. I go on to provide what I believe to be the first attempt at a full semantics for diseasetalk and disagreement, before showing on that basis that the most troublesome objections to these positions can be avoided.