A qualified defence of a naturalist theory of health

Abstract

The paper contrasts Lennart Nordenfelt's normative theory of health with the naturalists' point of view, especially in the version developed by Christopher Boorse. In the first part it defends Boorse's analysis of disease against the charge that it falls short of its own standards by not being descriptive. The second part of the paper sets out to analyse the positive concept of health and introduces a distinction between a positive definition of health ('health' is not defined as absence of disease but in positive terms) and a positive conception of health (health is seen as an ideal). An objection against Nordenfelt's account is developed by making use of a specific example of an ambitious athlete. It is stated that Nordenfelt's conceptualisation includes too many phenomena under the umbrella of ill health. An ideal conception of health like Nordenfelt's is in danger of supporting medicalization. In conclusion, although Nordenfelt's theory is not altogether rejected and even seen in congruence with Boorse's account, it is claimed that the naturalistic framework should obtain conceptual priority.

A living systems perspective on health

“…In 1946 the World Health Organization (WHO) defined health as a: “state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”(World Health Organization, 1946). By rejecting the biomedical view of health as absence-of-disease, this definition was a major advance in specifying what health may be, rather than merely saying what it is not.…”

“…On the other hand, the definition conflates health with happiness and life satisfaction, key dimensions of well-being (Awofeso, 2006; Saracci, 1997; Wachholtz & Sambamoorthi, 2011). Healthcare practitioners have been concerned about using this definition as a basis for delineating the scope of medicine, because it implies a broad set of phenomena well beyond the boundaries of conventional healthcare (Huber, Knottnerus, Green, van der Horst, Jadad, Kromhout et al, 2011; Schramme, 2007). The requirement of ‘complete well-being’ is not only utopian, it means that virtually no one can be healthy (Huber et al, 2011).…”

“…To determine whether an individual’s vital goals are being met requires that an examiner elicit these from each individual. Measurement is therefore difficult to implement, because different standards must be applied across individuals and cultures (Schramme, 2007). …”

Interdisciplinary Workshop on Concepts of Health and Disease: Report

“…Dr Elselijn Kingma, research fellow in philosophy of medicine at the CHH, introduced the two approaches to defining health and disease that dominate the philosophical literature: naturalism and normativism [3]. Naturalists attempt to define health and disease in a value-free way, by appealing to normal human biology [4][5][6][7][8][9][10]. Normativists claim that health and disease are fundamentally value-laden [11][12][13][14][15][16][17].…”

Health and Welfare in Animals and Humans

“…I will compare this idea with the American philosopher Christopher Boorse's (1977Boorse's ( , 1997 so-called bio-statistical theory of human health. This is clearly the most cited philosophical theory of human health and it has had quite a strong impact on the contemporary philosophical discussion in the area (Nordenfelt 2007;Schramme 2007). A comparison of this kind is striking.…”