title: How to make real, constructive, progress in medicine.
abstract: BACKGROUND
  One's understanding of medical progress - what it is, how it is pursued and how it is assessed - may be deeply dependent on one's understanding of the metaphysics of medicine, and of diseases in particular.
  
  
  OBJECTIVE
  In this paper I present a new account of the nature of diseases, neither realist nor constructivist, and describe what progress in medicine looks like if we understand diseases in this way.
  
  
  CONCLUSIONS
  This new account, Constructive Realism, may provide a better account of medicine than either realism or constructivism.
authors.affiliation: Department of Medicine, Center for Bioethics, Columbia University, College of Physicians and Surgeons, New York, NY 10032, USA. js1115@columbia.edu
authors.forename: Jeremy R
authors.initials: JR
authors.lastname: Simon
mesh_terms: D035843:Biomedical Research / Q000458:organization & administration*; D003550:Cystic Fibrosis / Q000503:physiopathology; D006801:Humans; D010686:Philosophy, Medical