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질병 가치 적재성 논쟁의 역사적 재구성 - 논쟁의 맥락, 주제, 양식의 변화, 1970-2000

Historical Reconstruction of the Debate on the Value-Ladenness of Disease: Changes in Context, Themes, and Format, 1970–2000

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초록

이 글은 1970년대부터 2000년대까지 현대 영미 의학철학계에서 진행되었던 질병의 가치 적재성 논쟁을 역사적으로 재조명한다. 지금까지 질병과 건강이 가치 적재적 개념인지(규범주의) 또는 가치 중립적 개념인지(자연주의)를 두고 많은 논의가 진행되었다. 그러나 논쟁 속에서 제출된 그리고 논쟁을 정리한 글은 모두 공통으로 역사성의 결여라는 한계를 노정한다. 다시 말해 기존의 연구는 논쟁의 사회적 맥락을 소거한다는 점에서 외적 비역사성을, 논쟁 자체의 변화를 간과한다는 점에서 내적 비역사성을 노출한다. 이 글은 이와 같은 문제의식에 기반하여 가치 적재성 논쟁이 조형되었던 사회적배경을 규명하고, 논쟁에 참여한 이들의 구성과 논쟁의 세부 주제 및 양식의 변화를 포착하고자 한다. 더 나아가 비역사성이라는 기존 논의의 한계가 이와 같은 역사적 흐름의귀결임을 드러내려 한다.

Abstract

This article presents a historical analysis of the debate on the value-ladenness of disease in the contemporary Anglo-American philosophy of medicine, spanning the period from the 1970s to the 2000s. Numerous arguments have emerged concerning whether disease and health are value-laden (normative) or value-neutral (naturalistic) concepts. However, both the primary sources contributing to these debates and the secondary accounts summarizing them have been afflicted by a shared constraint: an absence of historical contextualization. Put differently, extant studies suffer from both external ahistoricity, wherein they fail to reveal the social backdrop influencing the debates, and internal ahistoricity, as they neglect to account for the transformations occurring within the debates themselves. By addressing these concerns, the primary objective of this article is twofold: firstly, to elucidate the social milieu in which the value-ladenness debate unfolded and to capture the evolving philosophical landscape and the changing themes and methodologies underpinning the arguments; secondly, to uncover the ahistorical nature of the existing debate as an outcome of these historical developments.

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