 The most philosophically sophisticated recent constructionist view is Glackin’s (2019, p.260). He distinguishes the constitution question, which asks for the physical basis of a person’s condition, from the status question, which asks what makes a physical configuration a disease? This way of carving the terrain, and the importance of both status and constitution, is standard among most people who write about disease. The distinctive feature of social construction, in Glackin’s sense, is the priority of value judgements. Glackin uses the grounding relation to supply an answer to the problem of the relation between constitution and status. That is, the frame for grounding is fundamentally evaluative; the normative has a metaphysical priority. As Glackin (p. 262) puts it, disease states are grounded by the underlying biology or behaviour, but this grounding relation exists in virtue of a set of normative facts that provide the frame (in the sense of Epstein 2015: a set of possible worlds that fix the grounding conditions for social facts). 