Normativism holds that there is a close conceptual link between disease and disvalue. We challenge normativism by advancing an argument against a popular normativist theory, Jerome Wakefield's harmful dysfunction account. Wakefield maintains that medical disorders are breakdowns (dysfunctions) in evolved mechanisms that cause significant harm to the organism. We argue that Wakefield's account is not a promising way to distinguish between disease and health because being harmful is neither necessary nor sufficient for a dysfunction to be a disorder. Counterexamples to the harmful dysfunction account are considered, such as mild infections, perceptual deficits, and beneficial illnesses. Then we consider two ways of amending the harmful dysfunction account to address these cases and argue that the proposed amendments raise even more serious problems for this account. These problems apply generally to any normativist theory and raise doubts about the entire normative approach to the philosophy of health and disease.

中文翻译：

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危害与疾病理论无关。

规范主义认为，疾病与贬值之间存在紧密的概念联系。我们通过提倡反对流行的规范主义理论（Jerome Wakefield的有害功能障碍）的论点来挑战规范主义。韦克菲尔德坚持认为，医学疾病是对生物体造成重大伤害的进化机制中的崩溃（功能障碍）。我们认为，韦克菲尔德的说法并不是区分疾病和健康的有前途的方法，因为对功能障碍而言，有害既不是必需的也不是充分的。考虑到有害功能障碍的反例，例如轻度感染，知觉缺陷和有益疾病。然后，我们考虑了两种修改有害功能障碍帐户以解决这些情况的方法，并认为，拟议的修订对该帐户提出了甚至更严重的问题。这些问题通常适用于任何规范主义者的理论，并引起人们对健康和疾病哲学的整个规范方法的怀疑。