 One philosophical complication is that a naturalistic concept of disease, like Boorse’s, does not prevent social processes from altering the standards and practices of how the boundaries of these natural categories are drawn in practice. Chronic diseases such as cardiovascular diseases and type 2 diabetes have been targeted by drug companies to not only create new treatments but to redraw the boundaries between healthy vs. pathological, including boundary zones such as “prediabetes” (Greene 2006). These efforts are in part accomplished via the design of clinical trials, which have the dangerous distinction of having very high epistemic value in the biomedical community, while remaining highly susceptible to manipulations to the experimental setup that push the evidence one direction or another (González-Moreno, Saborido, &amp; Teira 2015).