论疾病的伤害性功能紊乱解释  

The Analysis of Harmful Dysfunction of Diseases

作　　者：史习[1] 

机构地区：[1]浙江大学哲学系,浙江杭州310012

出　　处：《自然辩证法通讯》2014年第3期12-17,125,共6页Journal of Dialectics of Nature

摘　　要：本文讨论韦克菲尔德(J.Wakefi eld)关于"疾病"概念的伤害性功能紊乱理论,并对其进行质疑。韦氏认为,当有机体的心理或生理机制处于不正常的状态,并因此造成伤害时,就可看作是一种病态。这里,所谓正常或失常的状态,是由生物进化的过程所确定的。作者认为,使用进化论对疾病概念进行解释是有问题的。医疗领域关注的是作为个体的患者的福祉,而进化论所讨论的对象是大量个体集合而成的种群或整个物种。不难假设,某种机制在物种繁衍的层面对有机体的生存有利,并因此在自然选择的过程中得到保存,但是,这一机制对于个体的有机体而言却是有害的。根据疾病的进化论解释,这样一种机制不应被看作是病态的,不过,在医疗领域中,遭受该机制伤害的个体仍会被看作是处于患病的状态。This paper fi rst discusses J. Wakefi eld's theory of harmful dysfunction of diseases, and then raises doubts about it. According to J. Wakefi eld, the concept of disease could be defi ned as a harmful dysfunction with the mechanism of an organism, and the function which the mechanism is supposed to perform is decided by natural selection, which is called the harmful dysfunction analysis(HDA). In this paper, the author discusses this theory, and suggests that the defi nition of disorder in HDA is problematic, because as for a particular mechanism, its function in an individual organism is different from its function in the history of natural selection. Hence, it is possible that the mechanism is well functional in an individual organism, but dysfunctional according to the theory of natural selection, and vice versa. So, the concept of disorder in medical understanding cannot be explained with the theory of natural selection in the way HDA suggested.

关 键 词：进化论 功能紊乱 疾病 

分 类 号：B029[哲学宗教—哲学理论]