Download Lecture 3 - What is Health?

Philosophy 2803 – Lecture III
What is Health?
WHO Definition
 “Health is a state of complete physical, mental and
social well-being and not merely the absence of
disease or infirmity.” (p. 24)
 Note the links drawn between health and peace.
– Compare to discussions today of the root causes of
terrorism.
– “the health of all peoples is fundamental to the attainment of
peace and security” (p. 24)
Criticisms of the WHO Definition
 Too grand
 Vague (“well-being”)
 Seems to medicalize too many things
(including happiness)
 Overestimates the importance of doctors
 Doesn’t leave enough room for individual
responsibility (“it’s not my fault, I’m sick”)
– See Callahan for more details
A Better Definition?
 Callahan: “Health is a state of physical
well-being” (p. 34)
– Note: Not complete well-being
– Not social or mental
Medicine vs. Health
 A case can be made that health is a broader concept
than medicine
 Likewise, a case can be made that having a disease,
injury or impairment and being healthy are not
incompatible
– E.g., sterility is an impairment, but does it mean one is
unhealthy?
– See Whitbeck for both points
The Normative Element of Health,
Medicine, etc.
 We won’t worry about a precise definition of
health vs. medicine
 What is important is the way that judgments
about being healthy inevitably involve value
judgments
– i.e., they’re normative claims
– See Whitbeck for a detailed discussion of this
Case #1
 Johnny is a short 11-year-old boy with documented
Growth Hormone (GH) deficiency resulting from a
brain tumor.
 His parents are of average height.
 His predicted adult height without GH treatment is
approximately 160 cm (5 feet 3 inches).
 With GH treatment, it is predicted that he will grow
several inches taller.
 His parents want Johnny treated with GH.
– Should we follow his parent’s wishes?
Case #2
 Billy is a short 11-year-old boy with normal GH
secretion according to current testing methods.
 However, his parents are extremely short.
 He has a predicted adult height of 160 cm (5 feet 3
inches).
 With GH treatment, it is predicted that he will grow
several inches taller.
 His parents want Billy treated with GH.
– Should we follow his parent’s wishes?
Is There a Moral Difference Between
the Two Cases?
 Most will consider it OK to treat the GH
deficient child
 What about the child who is likely to turn out
to be short for other reasons?
– Suggestion: Our answer will ultimately depend,
on whether we consider his short stature a bad
thing.
– I.e., it will involve a value judgment about how bad
it is to be a 5’3’’ boy.
So What?
 Most of the time, the fact that health is a
value-laden term is not problematic since
most of the time we can agree about to
evaluate a particular condition
– E.g., heart attack = bad
 Problems do arise, however, in some cases
in which it is not clear how we should
evaluate a particular condition
What Should We Treat?
 Would it be OK to use hormones to fix
someone’s height?
 Would it be OK to surgically correct
deafness?
 Would it be OK to lighten someone’s skin?
– What’s the difference between these cases?
The Point
 Be careful of assuming that health care
is an objective, value-free enterprise
 It’s full of value judgments. This is
simply hidden by the fact that we often
agree on the judgments.