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This chapter relates the problem of demarcating the pathological from the non-pathological in psychiatry to the general problem of defining ‘disease’ in the philosophy of medicine. Section 2 revisits three prominent debates in medical nosology: naturalism versus normativism, the three dimensions of illness, sickness, and disease, and the demarcation problem. Sections 3–5 reformulate the demarcation problem in terms of semantic vagueness. ‘Disease’ exhibits vagueness of degree by drawing no sharp line in a continuum and is combinatorially vague because there are several criteria for the term’s use that might fall apart. Combinatorial vagueness explains why the other two debates appear hopeless: Should we construe ‘disease’ in a naturalistic or in a normative way? Neither answer is satisfactory. How should we balance the three dimensions of pathology? We do not have to, because illness, sickness and disease (narrowly conceived) are non-competing criteria for the application of the cluster term ‘disease’.

Current moral philosophy has serious problems with the concept of human dignity. Although it seems to be an almost inevitable ingredient of every day moral judgments, philosophers have difficulties to find an analysis of the concept that could support this central role. One way out of these difficulties consists in a closer look at the various areas where the concept is used so widely and naturally, in the attempt to extract inductively an adequate understanding of human dignity from these contexts. In the article, this strategy is used to glean features of human dignity from the history of psychiatry, condense them into a plausible understanding of human dignity and finally sketch some practical implications for modern psychiatric ethics.

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