When is a disease not a disease? No quibbling academic riddle this, but a problem increasingly pressing upon medical practice and ethics alike. So many questions crowd in. Is it valid to talk of a person being ill without a disease, or having a disease without being sick? When and how do we draw dividing-lines between conditions, disabilities and abnormalities, on the one hand, and diseases, on the other? This can be a crucial issue when it comes to final authority in deciding the fate of severely-malformed babies. If, say, Down's Syndrome is a disease, then, arguably, it's the doctor's dilemma; if not, not.

LRB 25 January 1990 | PDF Download