So far, we have been exploring the connection between the concept of illness and values. Thomas Szasz claims that there is a connection between mental illness and values and uses that to attempt to deny the existence of that sort of illness. Physical illness, by contrast, is real because it is not value-laden.
Kendell and Boorse attempt to define illness in value-free terms and go on to argue that, because mental illness fits the definitions, it is value-free and real. But there is reason to doubt the definition of illness works.
Fulford argues that all illness is evaluative but no less real for that. The only reason that there is an anti-psychiatry movement but no anti-cardiology movement is that we all agree about the values for a good heart but not for a good mind / life.
If Fulford is right, however, that the very idea of illness is value-laden that prompts two further questions. Is he justified in thinking that illness (both mental and physical ) is real? Some people think that beauty is value-laden and that it lies merely ‘in the eye of the beholder’. That suggests that whilst finding someone to be beautiful or thinking of them as beautiful may be very psychologically striking, the person isn’t really either beautiful or not. They are merely beautiful relative to some observers and not relative to others. If illness is similarly value-laden, does illness status also lie merely in the eye of the beholder? And if so, is it really real?
Second, if it is value-laden in this way, whose values count to decide whether something is a value? Until 1973, the American Psychiatric Association classed homosexuality as a disease. In the C19, plantation salves who ran away were thought to suffer from the illness of ‘drapetomania’. If illness is a matter of what we value and disvalue, who is the ‘we’ who should decide and how?
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Still to come!