caa a22 4500 467896860 CHVBK 20180406152806.0 cr unu---uuuuu 170328e20061201xx s 000 0 eng 10.1007/s11019-006-9007-5 doi (NATIONALLICENCE)springer-10.1007/s11019-006-9007-5 The causation of disease - The practical and ethical consequences of competing explanations [Elektronische Daten] [Ulla Räisänen, Marie-Jet Bekkers, Paula Boddington, Srikant Sarangi, Angus Clarke] The prevention, treatment and management of disease are closely linked to how the causes of a particular disease are explained. For multi-factorial conditions, the causal explanations are inevitably complex and competing models may exist to explain the same condition. Selecting one particular causal explanation over another will carry practical and ethical consequences that are acutely relevant for health policy. In this paper our focus is two-fold; (i) the different models of causal explanation that are put forward within current scientific literature for the high and rising prevalence of the common complex conditions of coronary artery disease (CAD) and type 2 diabetes mellitus (T2D); and (ii) how these explanations are taken up (or not) within national health policy guidelines. We examine the causal explanations for these two conditions through a systematic database search of current scientific literature. By identifying different causal explanations we propose a three-tier taxonomy of the most prominent models of explanations: (i) evolutionary, (ii) lifecourse, and (iii) lifestyle and environment. We elaborate this taxonomy with a micro-level thematic analysis to illustrate how some explanations are semantically and rhetorically foregrounded over others. We then investigate the uptake of the scientific causal explanations in health policy documents with regard to the prevention and management recommendations of current National Service Frameworks for CAD and T2D. Our findings indicate a lack of congruence between the complexity and frequent overlap of causal explanations evident in the scientific literature and the predominant focus on lifestyle recommendations found in the mainstream health policy documents. Springer Science+Business Media, Inc., 2006 causal explanations nationallicence common complex disorders nationallicence coronary artery disease nationallicence ethics nationallicence health policy nationallicence thematic and textual analysis nationallicence type 2 diabetes nationallicence Räisänen Ulla Health Communication Research Centre, Cardiff University, Cardiff, Wales, UK aut Bekkers Marie-Jet Health Communication Research Centre, Cardiff University, Cardiff, Wales, UK aut Boddington Paula Department of Medical Genetics, Institute of Medical Genetics, University Hospital of Wales, Cardiff University, Heath Park, CF 14 4XN, Cardiff, Wales, UK aut Sarangi Srikant Health Communication Research Centre, Cardiff University, Cardiff, Wales, UK aut Clarke Angus Department of Medical Genetics, Institute of Medical Genetics, University Hospital of Wales, Cardiff University, Heath Park, CF 14 4XN, Cardiff, Wales, UK aut Medicine, Health Care and Philosophy Springer Netherlands 9/3(2006-12-01), 293-306 1386-7423 9:3<293 2006 9 11019 https://doi.org/10.1007/s11019-006-9007-5 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s11019-006-9007-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Räisänen Ulla Health Communication Research Centre, Cardiff University, Cardiff, Wales, UK aut NATIONALLICENCE 700 1- Bekkers Marie-Jet Health Communication Research Centre, Cardiff University, Cardiff, Wales, UK aut NATIONALLICENCE 700 1- Boddington Paula Department of Medical Genetics, Institute of Medical Genetics, University Hospital of Wales, Cardiff University, Heath Park, CF 14 4XN, Cardiff, Wales, UK aut NATIONALLICENCE 700 1- Sarangi Srikant Health Communication Research Centre, Cardiff University, Cardiff, Wales, UK aut NATIONALLICENCE 700 1- Clarke Angus Department of Medical Genetics, Institute of Medical Genetics, University Hospital of Wales, Cardiff University, Heath Park, CF 14 4XN, Cardiff, Wales, UK aut NATIONALLICENCE 773 0- Medicine, Health Care and Philosophy Springer Netherlands 9/3(2006-12-01), 293-306 1386-7423 9:3<293 2006 9 11019 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer