ArticleEuropean journal of epidemiology2019
Expanding disease and undermining the ethos of medicine.
Article in European journal of epidemiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed.
- Underdiagnosis of Health: A Key Driver of Overdiagnosis of Disease.Journal of evaluation in clinical practice · 2026Article
- Selling Sickness or Helping Patients in the Age of Artificial Intelligence.Dentistry journal · 2026Article
- Addressing the overuse-underuse paradox in healthcare.Medicine, health care, and philosophy · 2025Article
- Bearing the Burdens of Medical Uncertainty.Journal of evaluation in clinical practice · 2025Article
- Intensive care of the very old - questioning the relationship between illness severity and the moral imperative to deliver life-saving care.Philosophy, ethics, and humanities in medicine : PEHM · 2025Article
- What Is a Disease for Doctors? A Realist Thematic Qualitative Analysis of the Interpretation of Clinical Vignettes.Healthcare (Basel, Switzerland) · 2024Article
- Pathologizing Ugliness: A Conceptual Analysis of the Naturalist and Normativist Claims in "Aesthetic Pathology".The Journal of medicine and philosophy · 2022Article
- Managing the moral expansion of medicine.BMC medical ethics · 2022Article
- The role of philosophy and ethics at the edges of medicine.Philosophy, ethics, and humanities in medicine : PEHM · 2021Article
- The ethics of machine learning-based clinical decision support: an analysis through the lens of professionalisation theory.BMC medical ethics · 2021Article
- Journalists' views on media coverage of medical tests and overdiagnosis: a qualitative study.BMJ open · 2021Article
- How to Draw the Line Between Health and Disease? Start with Suffering.Health care analysis : HCA : journal of health philosophy and policy · 2021Article
- [Overtreatment in intensive care medicine-recognition, designation, and avoidance : Position paper of the Ethics Section of the DIVI and the Ethics section of the DGIIN].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2021Review
- Nosology expansion: not always for health's sake.European journal of epidemiology · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The expansion of the concept of disease poses problems for epidemiology. Certainly, new diseases are discovered and more people are treated earlier and better. However, the historically unprecedented expansion is criticised for going too far. Overdiagnosis, overtreatment, and medicalization are some of the challenges heatedly debated in medicine, media, and in health policy making. How are we to analyse and handle the vast expansion of disease? Where can we draw the line between warranted and unwarranted expansion? To address this issue, which has wide implications for epidemiology, we need to understand how disease is expanded. This article identifies six ways that our conception of disease is expanded: by increased knowledge (epistemic), making more phenomena count as disease (ontological), doing more (pragmatic), defining more (conceptual), and by encompassing the bad (ethic) and the ugly (aesthetic). Expanding the subject matter of medicine extends its realm and power, but also its responsibility. It makes medicine accountable for ever more of human potential dis-eases. At the same time it blurs the borders and undermines the demarcation of medicine. Six specific advices can guide our action clarifying the subject matter of medicine in general and epidemiology in particular. To avoid unlimited responsibility and to keep medicine on par with its end, we need to direct the expansion of disease to what effectively identifies or reduces human suffering. Otherwise we will deplete medicine and undermine the greatest asset in health care: trust.
Indexed as
Identifiers
30796581What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.