BACKGROUND Edmund Pellegrino lamented that the cultural climate of the industrialized West had called the fundamental means and ends of medicine into question, leading him to propose a renewed reflection on medicine's basic concepts, including health, disease, and illness. My aim in this paper is take up Pellegrino's call. I argue that in order to usher in this renewal, the concept of ambiguity should take on a guiding role in medical practice, both scientific and clinical. After laying out Pellegrino's vision, I focus on the concept of normality, arguing that it undergirds modern medicine's other basic concepts. I draw on critiques by scholars in disability studies that show the concept of normality to be instructively ambiguous. Discussing the cases of Deafness and body integrity identity disorder (BIID), I argue that if medicine is to uphold its epistemic authority and fulfill its melioristic goals, ambiguity should become a central medical concept. METHODS In this theoretical paper, I consider how central concepts in the philosophy of medicine are challenged by research on experiences of disability. In particular, the idea that medical knowledge produces universal truths is challenged and the importance of historical, cultural, and otherwise situated knowledge is highlighed. RESULTS I demonstrate how experiences of disability complicate dominant theories in the philosophy of medicine and why medical practice and the philosophy of medicine should make ambiguity a central concept. CONCLUSIONS If medical practitioners and philosophers of medicine wish to improve their understanding of the meaning and practice of medicine, they should take seriously the importance and centrality of ambiguity.

中文翻译：

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更新医学的基本概念：模棱两可。

背景技术埃德蒙·佩莱格里诺（Edmund Pellegrino）哀叹，西方工业化的文化气候使人们对医学的基本手段和目的产生了疑问，从而使他对医学的基本概念（包括健康，疾病和疾病）提出了新的思考。本文的目的是接听佩莱格里诺的电话。我认为，为了迎来这种更新，模棱两可的概念应该在科学和临床医学实践中起指导作用。在阐述了佩莱格里诺的愿景之后，我将重点放在正则性概念上，认为它是现代医学其他基本概念的基础。我参考了残疾研究中学者的评论，这些评论表明，正常性的概念具有启发性的歧义。讨论耳聋和身体完整性认同障碍（BIID）的病例，我认为，如果医学要维护其认知权威并实现其理想的目标，那么歧义应成为医学的中心概念。方法在这篇理论论文中，我考虑了通过残疾经验研究如何挑战医学哲学中的核心概念。特别是，医学知识产生普遍真理的观点受到了挑战，历史，文化以及其他情况下的知识的重要性也受到了高度重视。结果我证明了残疾的经历如何使医学哲学中的主流理论复杂化，以及为什么医学实践和医学哲学应使歧义成为中心概念。结论如果医学从业人员和医学哲学家希望增进他们对医学意义和实践的理解，