Health as a Theoretical Concept

TLDR

Health is commonly defined as the statistical normality of biological function, distinguishing it from other conceptions that emphasize value‑laden or practical judgments, and treating disease as an internal state that reduces functional ability below species‑typical levels. The paper argues that the medical notion of health as absence of disease is a value‑free theoretical construct and challenges the assumption that health judgments must be practical or that health is inherently value‑laden.

Abstract

This paper argues that the medical conception of health as absence of disease is a value-free theoretical notion. Its main elements are biological function and statistical normality, in contrast to various other ideas prominent in the literature on health. Apart from universal environmental injuries, diseases are internal states that depress a functional ability below species-typical levels. Health as freedom from disease is then statistical normality of function, i.e., the ability to perform all typical physiological functions with at least typical efficiency. This conception of health is as value-free as statements of biological function. The view that health is essentially value-laden, held by most writers on the topic, seems to have one of two sources: an assumption that health judgments must be practical judgments about the treatment of patients, or a commitment to “positive” health beyond the absence of disease. I suggest that the assumption is mistaken, the commitment possibly misdescribed.