Abstract

Many philosophers and medical scientists assume that disease categories or entities used to classify concrete cases of disease are often defined by disease mechanisms or causal processes. Others suggest that diseases should always be defined in this manner. This paper discusses these standpoints critically and concludes that they are untenable, not only when 'disease mechanism' refers to an objective mechanism, but also when 'mechanism' refers to a pragmatically demarcated part of the total "objective" causal structure of diseases. As an alternative to principles that use the concept of disease mechanism or analogous concepts, a pragmatic approach is suggested and described.