{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T15:15:33Z","timestamp":1772810133245,"version":"3.50.1"},"reference-count":66,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2024,6,17]],"date-time":"2024-06-17T00:00:00Z","timestamp":1718582400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Jerome Wakefield criticizes my biostatistical analysis of the pathological\u2014as statistically subnormal biological part-functional ability relative to species, sex, and age\u2014for its lack of a harm clause. He first charges me with ignoring two general distinctions: biological versus medical pathology, and disease of a part versus disease of a whole organism. He then offers 10 counterexamples that, he says, are harmless dysfunctions but not medical disorders. Wakefield ends by arguing that we need a harm clause to explain American psychiatry\u2019s 1973 decision to declassify homosexuality. I reply, first, that his two distinctions are philosophic fantasies alien to medical usage, invented only to save his own harmful-dysfunction analysis (HDA) from a host of obvious counterexamples. In any case, they do not coincide with the harmless\/harmful distinction. In reality, medicine admits countless chronic diseases that are, contrary to Wakefield, subclinical for most of their course, as well as many kinds of typically harmless skin pathology. As for his 10 counterexamples, no medical source he cites describes them as he does. I argue that none of his examples contradicts the biostatistical analysis: all either are not part-dysfunctions (situs inversus, incompetent sperm, normal-flora infection) or are indeed classified as medical disorders (donated kidney, Typhoid Mary\u2019s carrier status, latent tuberculosis or HIV, cherry angiomas). And if Wakefield\u2019s HDA fits psychiatry, the fact that it does not fit medicine casts doubt on psychiatry\u2019s status as a medical specialty.<\/jats:p>","DOI":"10.1093\/jmp\/jhae017","type":"journal-article","created":{"date-parts":[[2024,6,17]],"date-time":"2024-06-17T20:57:29Z","timestamp":1718657849000},"page":"367-388","source":"Crossref","is-referenced-by-count":5,"title":["Wakefield\u2019s Harm-Based Critique of the Biostatistical Theory"],"prefix":"10.1093","volume":"49","author":[{"given":"Christopher","family":"Boorse","sequence":"first","affiliation":[{"name":"University of Delaware , Newark, Delaware , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,6,17]]},"reference":[{"issue":"1","key":"2024071109112092800_CIT0001","doi-asserted-by":"crossref","first-page":"70","DOI":"10.2307\/2184255","article-title":"Wright on functions","volume":"85","author":"Boorse","year":"1976","journal-title":"The 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