| More

Defining health and disease: Self-knowledge as a standard of health

Views: 571 Downloads: 118
Γρηγόρης Αθανασιάδης (Grigoris Athanasiadis)
Γρηγόρης Αθανασιάδης (Grigoris Athanasiadis)


A central issue in the philosophy of medicine is to solve the problem of determining the nature of the concepts of health and disease. Some theorists claim that health and disease are purely value-free and descriptive concepts that are discoverable and grounded in the biological and medical sciences. Others claim that health and disease are essentially value-laden concepts, i.e. healthy states are those states we (individuals, groups, societies) desire or value and diseased states are those we want to avoid or disvalue.

Considering the longtime disagreement among physicians, theorists of health and philosophers about the essential characteristics of health and disease, the aim in the first part of this paper is to briefly present four different philosophical approaches of health and disease in an attempt to introduce the readers to the debate. This article begins with the Biostatistical theory of Christopher Boorse. It turns to the Malady theory of Danner Clouser, Charles Culver and Bernard Gert, the holistic theory of Lennart Nordenfelt and finally the adaptation theory of József Kovács.

In the second part of the paper, some objections will be stated to each theory. In the third and last part, a completely different account of health will be given, which holds that self-knowledge is a criterion of human health. Health, unlike disease, is not a state or a condition of the organism but an endless process. Its essence can be better captured in philosophical rather than medical terms and it should be applied only to human beings.


philosophical approaches of health and disease; Danner Clouser; Charles Culver; Bernard Gert; Lennart Nordenfelt; József Kovács


Boorse C. On The Distinction between Disease and Illness. Philosophy & Public Affairs. 1975, 5(1): 49-68.

Boorse C. What a theory of mental health should be. Journal for the Theory of Social Behavior. 1976a, 6(1): 61-84.

Boorse C. Health as a Theoretical Concept. Philosophy of Science. 1977, 44(4): 542-573.

Boorse C. A Rebuttal on Health. στο Humber, J. & Almeder R. (eds.) What Is Disease? Humana Press, 1997, σ.1-135.

Boorse C. A Second Rebuttal on Health. Journal of Medicine and Philosophy. 2014, 39(6): 683-724.

Clouser D. Culver C. & Gert B. Malady: A New Treatment of Disease, στο Caplan A. McCartney J. Sisti D. Health, Disease and Illness: Concepts in Medicine, Georgetown University Press. 2004, σ.90-104.

Clouser D. Culver C. & Gert B. Malady, στο Humber, J. & Almeder R. (eds.) What Is Disease? Humana Press, 1997, σ.173-219.

Cooper R. Disease. Stud. Hist. Phil. Biol. & Biomed. Sci. 2002, 33, 263-282.

Culver C. Gert B. Philosophy in Medicine. Conceptual and Ethical Issues in Medicine and Psychiatry. Oxford, 1982.

Daniels N. Health Care needs and Distributive Justice. Philosophy and Public Affairs, 1981, 10(2):146-179.

Engelhardt Tr. Jr. Concepts of health and disease, στο Engelhardt, Tristram Jr. & Spicker, Stuart, D (eds.). Evaluation and Explanation in the Biomedical Sciences. Reidel Publishing Company, Dordrecht, Holland, 1974, σ.125-141.

Ereshefsky M. Defining health and disease. Stud Hist Philos Biol Biomed Sci. 2009, 40(3):221-7.

Feinberg, J. Freedom and Fulfillment. Philosophical Essays. Princeton University Press. 1992.

Fulford, K.W. M. Moral theory and Medical practice, Cambridge University Press, New York, 1989: 72-87.

Goosens, W. Values, Health and Medicine. Philos Sci. 1980, 47: 100-115.

Hesslow G. Do we need a concept of disease? Theor Med. 1993, 14(1): 1–14.

Kass L. Toward a More Natural Science. Biology and Human Affairs. The Free Press, New York, 1985.

Kass, L. Life, Liberty and the Defense of Dignity. The Challenge for Bioethics. Encounter Books. 2002.

King C. D. The Meaning of Normal. The Yale Journal of Biology and Medicine.1945, 17(3):493-501.

Kingma E. What is it to be healthy? Analysis. 2007, 67(294): 128-133.

Kovacs J. The Concept of Health and Disease. Med Health Care Philos. 1998, 1(1):31-39.

Lenk C. Therapie und Enhancement. Ziele und Grenzen der modernen Medizin. Lit, 2002.

Margolis J. The Concept of Disease. The Journal of Medicine and Philosophy, 1976, 1, 3.

Martin M. Malady and menopause. Journal of Medicine and Philosophy. 1985, 10, 329-337.

McKenny G. Human Enhancement Uses of Biotechnology, Ethics, Therapy vs. Enhancement, στο Encyclopedia of Ethical, Legal and Policy Issues in Biotechnology. (Ed.) Murray Th., Mehlman M. New York: Wiley, 2000: 507-515.

Mordacci R. Sobel R. Health: A Comprehensive Concept, στο Caplan A. McCartney J. Sisti D. Health, Disease and Illness: Concepts in Medicine, Georgetown University Press, 2004, σ.104-110.

Nordenfelt L. On the relevance and importance of a notion of disease. Theor Med. 1993, 14(1):15-26.

Nordenfelt L. On the Nature of Health. An Action – Theoretic Approach. D. Reidel, 1987.

Nordenfelt L. Action, ability and health: Essays in the philosophy of action and welfare. Springer, 2000.

Nordenfelt L. On the goals of medicine, Health enhancement and social welfare. Health Care Analysis 2001, 9(1):15-23.

Nordenfelt L. The Logic of Health Concepts, στο Khushf G. (ed.) Handbook of Bioethics, Kluwer, Netherlands, 2004, σ.205-222.

Nordenfelt L. The concepts of health and illness revisited. Med Health Care Philos. 2007, 10(1):5-10.

Ουλής Π. Η φύση της ψυχικής νόσου. Μια φιλοσοφική-επιστημονική διερεύνηση. Εξάντας, 2003.

Parens, E. Is Better Always Good? The Enhancement Project, στο Parens Erik (ed.). Enhancing Human Traits. Ethical and Social Implications. Georgetown University Press, 1998, σ. 1-28.

Reznek L. The Nature of Disease. Routledge, 1987.

Ruse M. Defining disease. The Question of Sexual Orientation, στο Humber, James M. & Almeder, Robert F. (eds.) What Is Disease? Humana Press, 1997, σ.137-143.

Sade M. R. A Theory of Health and Disease: The Objectivist-Subjectivist Dichotomy. The Journal of Medicine and Philosophy. 1995, 20, 513-525.

Schramme T. A qualified defense of a naturalist theory of health, Med Health Care Philos. 2007, 10(1):11-17.

Stempsey W. A pathological view of disease. Theoretical Medicine, 2000, 21:321-330.


  • There are currently no refbacks.

Copyright (c) 2019 Bioethica