The Trouble with Normal.ppt

The Trouble with Normal ISD II – Endocrinology Jan. 22, 2002 Andrew Latus When Should Physicians Treat Someone? “To some, treating disease and restoring health, the ‘well-working of the organism as a whole,’ is the proper aim of medicine.” The question then is whether the patient “has a disease, ‘an abnormal functioning of an organism that impairs normal physiological functioning.’” (Allen Fost, 1990, 18) In Other Words… When Should Physicians Treat Someone? If X has an abnormal condition and that condition impairs normal physiological functioning and X wants the condition corrected and we can do so then it’s morally OK, maybe even required, to treat the condition What’s Normal? Notice that the idea of what’s normal does a lot of work in the answer just given. But what’s normal? Is normal a statistical notion? i.e., is it a purely descriptive idea? Is it a normative notion? i.e., does any assessment of something as normal or abnormal involve an evaluation of the thing as somehow good or bad? Normal Isn’t a Purely Statistical Notion At least for medical purposes, the idea of what’s normal doesn’t seem to be a purely statistical notion Suppose we discovered a way of correcting a heart problem that will eventually occur in 51% of the population (assuming they live long enough) Now suppose we have a patient who has lived long enough that this condition threatens his life Are we not morally required (or even not permitted) to operate because this condition is not abnormal, statistically speaking? A Further Problem with the Statistical Idea of Normal Even if we try to treat normal as a purely statistical notion, there is still room for evaluative considerations to creep in via the frame of reference we pick E.g., when we ask whether a height of 5’ 3’’ is abnormal, what comparison group should we have in mind? All people? All males? All white males? All protestant males? All Canadian males? Normal is a ‘Mixed’ Notion Statistical assessments of the com