Health: A Comprehensive Concept

Abstract

is one of those everyday words that only seems self-evident in its meaning. Physiological measurements alone fail to capture the subjective dimension of health. Health is an end and means--it is foundation for achievement, first achievement itself, and precondition for further achievement. If we devote ourselves to finding holes exactly shaped to house such great words as Freedom, Honour, Bliss we shall spend lifetime slipping, and sliding and searching and all in vain. They are words without home, wanderers like the planets, and that is the end of it.[1] One might assume that just as grocers know what they mean by groceries, so health care providers surely must have dear concept of health in mind when they use this great word. is one of those everyday slippery-as-mercury words, the meaning of which seems so obvious and self-evident that we seldom take few moments to define the term consciously for ourselves. This is unfortunate because we cannot: (1) recognize which of our patients' expectations are authentically medical, (2) identify the appropriate role of physicians in an increasingly technological profession, and (3) understand the interrelationships of health, medicine, and the good life. Along with our patients, we share an amorphous idea of what it is to be healthy beyond simply being well-functioning[2]: clear concept of health could add some form and substance to this vague awareness. Descriptions of health based on physiological measurements ignore the idea of health as value. What they offer in precision, they lack in depth; for, surely, being healthy is much more than having an your organs quietly functioning within plus or minus two standard deviations of normal. Value-free descriptivist definitions of health cannot be more than component of comprehensive concept of health, for health is valued. is value beyond formalizable knowledge. However, value-based definitions of health lack universality; they depend on the individual's (or culture's) determination of what is to be valued. Descriptivist definitions ignore the subjective dimension, whereas normativist definitions exalt it. The World Organization defined health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.[3] This definition, if taken literally, is meaningless. However, we believe that all normativist definitions of health, including this hopelessly utopian WHO vision, derive from common ground, core meaning or experience of health that requires interpretation.[4] Any experienced clinician can recall terminally ill patient who objectively seemed the same the day he died as the day before except for having (often quite explicitly) lost his will to live. Implicit in this will to live, and of special importance to the secular individual, is sense of life being worth living despite all the suffering one may encounter in life and despite the awareness of the certainty of death and nothingness. How admirable! to see lightning and not think life is fleeting (Basho)[5] The healthy individual is well-functioning as whole, in harmony physically and mentally with himself and with his surroundings. A clue to this wholeness characteristic of health can be found in words related to health. The question, ma shlomcha--how are you?--in Hebrew literally asks if you are whole, intact, complete, at peace. The Old English hal, the Old High German heil, and the Greek hygeia and euexia connect health and hygiene to fullness and to the good life. Other words, the Italian salute, the French sante, the Spanish salud, introduce another characteristic of health--salvation. To be healthy is to be `saved' from death. The Hebrew word for health uses the same root, bet, resh, aleph, as the word for create, the opposite of death. …