Building an epistemically democratic concept of disease

The received perspective on diseases positions the nursing unit, the diagnostic unit, and the intervention unit as parallel, if not equal, and follows a disease essentialism. If recent developments in biology, especially evolutionary medicine, are followed, one can have a much more socially differentiated and individualized understanding of diseases.

The conventional conception of diseases is based on an essentialist concept of disease that views care, diagnosis, and intervention as tantamount or equally linked. However, recent advances in biology, particularly in evolutionary medicine, have shown that a socially differentiated and individualized view of disease is possible. Such a differentiated perspective could have epistemic consequences for health care and require us to recognize and address inequities in dealing with essentialist conceptions of disease. In this context, such concepts could help to (a) develop medical research and public health approaches for social groups that have historically been oppressed and excluded from health care, and (b) promote an individualized understanding of illness that better accommodates patients with different contexts and needs than the essentialist concept of illness can.