'Disorder' and Its Evaluative Implications for Psychiatry

Abstract

The proper definition of the concept of ‘disorder’ could resolve the existing issues in psychiatry today. Christopher Boorse and R.E. Kendell, as proponents of the medical model, aim at defining the concept in scientific and value-free terms. K.W.M. Fulford develops the fact-plus-value model which integrates the factual and evaluative elements. John Z. Sadler applies the Fulfordian account to diagnostic manuals to resolve their inconsistencies. I find Fulford’s initial and later arguments incongruent. His account is also too evaluative given the absence of any restrictions on the place and role of values. Furthermore, it is relatively easy to conclude that given the prominent position of values, facts need not exist as they are essentially evaluative terms with merely an overt factual connotation. Moreover, values provide the benchmark against which facts are assessed (for their degree of value-ladenness) and identified; and this makes facts dependent on and a subclass of values.