Welcome to another episode of The Words Matter Podcast. 

We continue the clinical reasoning series, and I hope you enjoyed the first two episodes with Roger Kerry and Mark Jones where we covered how we can think about our practice, evidence and our patients.

However, given that the series is exploring clinicians’ reasoning around people with disease, it would seem prudent to consider what disease is both as a concept and phenomena but also the ethical and moral issues tied to and emanating from it and which motivate us to begin to reason about it.

As such, I’m speaking again to Prof. Bjørn Hofmann. I spoke with Bjørn in November last year – on Episode 55: about Dediagnosing- with his co-author Dr Marianne Lea.

Today we speak about his work on bioethics and talk around and about a recent paper of his titled 'Acknowledging and addressing the many ethical aspects of disease'. This is a two-part episode where the second part of the conversation focuses on his work on overdiagnosis and follows nicely from this episode.

Bjørn is a scholar in philosophy of medicine and bioethics with a special interest in the relationship between epistemology and ethics.

He is affiliated with the Department of Health Science at the Norwegian University of Science and Technology (NTNU) and the Centre for Medical Ethics at the University of Oslo. Bjørn's  main fields of interests include the basic concepts for health care including disease, causality, (over)diagnosis, medicalization and severity.

In this episode we speak about:

• What we mean when we say ‘disease’?
• Disease as both a concept and phenomena and how the concept of disease provides us with knowledge and guides our actions.
• Disease from a biological perspective, the experience of disease which we term called illness, and the societal perspective we call sickness.
• How these perspectives interact and how they might at times be in conflict with each other.
• We consider disease an an experienced phenomenon with a scientific description and a moral imperative
• We discuss the the moral functions, and why are they of great importance to patients and us as health professionals?
• And finally we touch on how the science and the ethics of disease relate.

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