As a psychiatrist, I see many patients who have come from a stressful situation involving some dispute with an employer, such as the armed services, health services, police etc. When the argument is going badly for them, they sometimes appeal to a set of symptoms which they claim represent an illness, for which the employer is held responsible. If the diagnosis is ratified, the grounds of the dispute radically change, with various financial and other privileges applying to the patient who now occupies the 'sick role'.

If the illness has objective measures which can validate it, all well and good. But in much of psychiatry, there are no objective verification procedures that can validate or disprove the claim.

I doubt that the nature of the problem is adequately captured by the idiom of judging the 'fine line' between illness and health. Rather I think the two domains of 'dispute' and 'sickness' overlap, and that a decisive shift occurs when the matter moves (with medical ratification) from one domain to the other.

I am interested in understanding some of the philosophical issues raised by this problem.

See this link for some examples of how the problem appears in a clinical setting.

http://tinyurl.com/qhucekb