 The second stage, the question about whether life is worsened by a malfunction, is omitted by simple naturalism. Simple naturalists say that all there is to disease is the failure of someone’s physiology (or psychology) to work normally. The view has fewer adherents, but as noted above, Szasz (1987) uses simple objectivism about disease to justify his claims that mental disorder is a myth, and Boorse has long advocated such a view, as does Williams (2007). The popularity of hybrid accounts, though, is a problem for scholars like Glackin (2019, p. 258), who argues that the debate exists between “normativists, who think the concept is inherently evaluative, and naturalists who think it is purely empirical”. But it is possible to think that there is an empirical question about the causal basis of disease and a further normative question about the judgments made on that basis, which hybrid theorists also think are necessary for disease. 