| ABSTRACT | One
of the cornerstones of modern medicine is the search for what causes diseases
to develop. A conception of multifactorial disease causes has emerged over the
years. Theories of disease causation, however, have not quite been developed in
accordance with this view. It is the purpose of this paper to provide a fundamental
explication of aspects of causation relevant for discussing causes of disease.
The first part of the analysis will discuss discrimination between singular and
general causality. Singular causality, as in the specific patient, is a relation
between a concrete sequence of causally linked events. General causation, e.g.
as in disease etiology, means various categories of causal relations between event
types. The paper introduces the concept of a reference case serving as a source
for causal inference, reaching beyond the concept of general causality. The second
part of the analysis provides exemplification of a theory of causation suitable
for discussing singular causation. The chain of events that induce a disease state
can be identified as effective causal complexes, each complex composed of non-redundant
components, which separately contribute to the effect of the complex, without
the individual component being necessary or sufficient in itself to produce the
effect. In the third part of the analysis the theory is elaborated further. Causes,
defined as non-redundant components, can furthermore be differentiated according
to their avoidability, according to theories about human error or by the potential
of eradication. Multifactorial models of disease creates a need for systematic
approaches to causal factors. The paper proposes a taxonomical terminology that
serves this purpose. Author. |
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