 Normative considerations, on this account, inform our judgments about disease but do not have the conceptual priority accorded them by constructivists. We make judgments that someone is suffering in ways we associate with inner malfunction. We also see people who are suffering but who we don’t think are ill or injured, because we do not regard their bodily dysfunction as symptoms of disease: vaccination, surgical incisions, ear-piercing or childbirth are examples. Or imagine a skin condition that in some cultures causes the sufferer to be worshiped as a god, or become a sought-after sexual partner. The two-stage picture is designed to distinguish between the physical abnormality and the difference it makes to the life of the person who has it. The idea is that whether someone’s body is not functioning correctly is a separate question from whether it is bad to be like that. Stegenga (2018, p.23) calls such a theory a hybrid account, as it argues both that "there is a constitutive causal basis of disease and a normative basis of disease." He also adds a fourth alternative, which he calls eliminativist, arguing for replacing the notion of disease with successor notions tied more closely to the science. This goes beyond what has here been called revisionist naturalism, in that it advocates getting rid of the disease concept altogether, rather than just liberating it from commonsense constraints. Hybrid accounts have been very popular among naturalists since at least the dissemination of Wakefield’s (1992) influential discussion of mental disorder 