Disease is a fluid concept influenced by societal and cultural attitudes

游客2025-02-22 25

问题       Disease is a fluid concept influenced by societal and cultural attitudes that
change diachronically in response to new scientific and medical discoveries.
Historically, doctors defined a disease according to a cluster of symptoms, and
as their clinical descriptions became more sophisticated, they started to classify
(5)  diseases into separate groups, so that from this medical taxonomy came new
insights into disease etiology. Before the 20th century, schizophrenia and
syphilitic insanity were treated as the same disease, but by early 1900 it became
evident that psychoses without associated dementia represented a separate
disease for which the term schizophrenia was then coined. The definition of
(10) schizophrenia continues to evolve from the psychiatric disease of the 1960s to an
illness with a suspected genetic etiology, though the existence of such an
etiology remains uncertain. While an optimistic hunt is still on for the genes
involved, we must continue to define schizophrenia in terms of the presence or
absence of "positive" and "negative" symptoms.
(15)    Labeling someone as diseased, however, has enormous individual, social,
financial, and physical implications, for irrespective of disease symptoms, the
label itself may lead to significant distress.  Individuals with asymptomatic
conditions, including genetic variations, may be perceived by themselves or
others as having a disease. It is not that labeling someone as diseased is always
(20) positive—it does have severe ramifications, affecting decisions to have children
or resulting in unjust treatment by life, medical, and disability insurers--but it
can be beneficial,  legitimizing symptoms,  clarifying issues of personal
responsibility,  and improving accessibility to health care.  Nevertheless,
deviations from normal that are not associated with risk should not be
(25) considered synonymous with disease. Two schools—nominalist and essentialist
or reductionist—have debated the clinical criteria used to label a patient as
diseased. Nominalists label symptoms with a disease name, such as
schizophrenia, and do not offer an explanation of the underlying etiology, while
essentialists contend that for every disease there is an underlying pathological
(30) etiology, and now argue that the essential lesion defining the disease state is a
genetic abnormality.
      It has been suggested that diseases defined according to the essentialist
tradition may be precisely wrong, whereas those defined in the nominalist
traditional may be roughly accurate. But in labeling a disease state, we must
(35) consider both the phenotype (symptoms) or the genotype (genetic
abnormality), for the former describes a state that places individuals at some
definable risk of adverse consequences, while the latter helps suggest specific
genetic or pharmacologic therapies. Thus, both clinical criteria and genetic
abnormalities should be used to define a disease state, and the choice of a
(40) disease definition will vary according to what one wishes to achieve, the genetic
counseling of family members or the effective treatment of the patient.

选项 A、revealing a commonly ignored distinction
B、proposing a return to a traditional taxonomical system
C、describing an way to resolve a taxonomical dilemma
D、assessing the success of a new taxonomical method
E、predicting a change in future taxonomy

答案 C

解析

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