The precise nature and role in medical practice of disease, health, illness, wellbeing, and associated notions such as sickness and wholeness, are fervently debated in the current medical literature (Boyd, 2000). For example, Germund Hesslow (1993) claims that the distinction between health and disease is “irrelevant” for medical practice, since a disease is not required for soliciting medical ... [Show full abstract] attention.1 The purpose of the following chapter is not to provide a definitive answer or solution to the debate but rather to explore the possibilities of an answer or a solution in order to clarify further the debate. As Lawrie Reznek contends, philosophy is germane to the discussion concerning the nature of disease: “Philosophy cannot cure disease, but it certainly can cure inappropriate disease attribution” (1987, p. 11). It is in this spirit that I undertake a discussion of the notions of illness and wellbeing.
The participants in the debate can be divided into two camps: the naturalists and the normativists. According to naturalists, disease and health are descriptive concepts that can be used to define the objective and real state or condition of a person. These concepts are strictly neutral to any personal or social values. According to the normativists, however, these concepts depend upon personal and social values. Reflecting these values, normativists often utilize terms like “illness” and “ wellbeing” to define a person’s subjective or constructed state or condition. In general, biomedical practitioners champion naturalistic notions of disease and health, while humanistic or humane practitioners advocate normativist notions of illness and wellbeing.