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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.
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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.