Abstract
I argue for a conception of health as a person's ability to achieve or exercise a cluster of basic human activities. These basic activities are in turn specified through free-standing ethical reasoning about what constitutes a minimal conception of a human life with equal human dignity in the modern world. I arrive at this conception of health by closely following and modifying Lennart Nordenfelt's theory of health which presents health as the ability to achieve vital goals. Despite its strengths I transform Nordenfelt's argument in order to overcome three significant drawbacks. Nordenfelt makes vital goals relative to each community or context and significantly reflective of personal preferences. By doing so, Nordenfelt's conception of health faces problems with both socially relative concepts of health and subjectively defined wellbeing. Moreover, Nordenfelt does not ever explicitly specify a set of vital goals. The theory of health advanced here replaces Nordenfelt's (seemingly) empty set of preferences and society-relative vital goals with a human species-wide conception of basic vital goals, or ‘central human capabilities and functionings’. These central human capabilities come out of the capabilities approach (CA) now familiar in political philosophy and economics, and particularly reflect the work of Martha Nussbaum. As a result, the health of an individual should be understood as the ability to achieve a basic cluster of beings and doings—or having the overarching capability, a meta-capability, to achieve a set of central or vital inter-related capabilities and functionings.
Highlights
Health and disease as well as related concepts such as illness, disability, impairment, and so forth have profound importance in modern societies
The main points to take away from this article is that health as a concept can be defensibly conceived as a meta-capability, the capability to achieve a cluster of basic capabilities to be and do things that reflect a life worthy of equal human dignity
Nordenfelt provides a line of reasoning to conceptualizing health as the ability to achieve a set of vital goals which, I have argued, is the same as saying having the capability to achieve a set of basic capabilities and functionings
Summary
Health and disease as well as related concepts such as illness, disability, impairment, and so forth have profound importance in modern societies. The theory of health advanced here replaces Nordenfelt’s (seemingly) empty set of preferences and society-relative vital goals with a human species-wide conception of basic vital goals, or ‘central human capabilities and functionings’ These central human capabilities come out of the capabilities approach (CA) familiar in political philosophy and economics, and reflect the work of Martha Nussbaum.[3] As a result, the health of an individual should be understood as the ability to achieve a basic cluster of beings and doings – or having the overarching capability, a meta-capability, to achieve a set of basic inter-related capabilities and functionings. The point at which I extinguish my own second order ability to do the first-order action, or some other biological event, another person, or an environmental factor destroys it, I become ill or unhealthy.[17] It is insightful of Nordenfelt to account for such a second order ability It recognizes that individuals move around different environments and/or require learning time to adapt, or some individuals may choose to not achieve their vital goals. I consider each in turn, and show how they can be overcome by integrating it with the social and political theory of human capabilities
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