Health and the Minimally Good Life—What Is Really Necessary to Avoid Ill-Being and (Otherwise) Fare Well Enough

The World Health Organization defines health as a complete state of mental and physical well-being. On this account, health is the absence of ill-being and not just diseases, or illnesses, which typically undermine aspects of wellbeing. Normativists generally appeal to value judgements in defining illness or disease—where certain states make people ill or diseased partly because people judge these states or functional limitations negatively, many suggesting they do so because they think these states negatively affect well-being. Naturalists, instead, suppose that health and disease are relatively unaffected by personal or societal judgement but depend on biological (or other) facts. This chapter proposes an objective normative account that bridges this divide—suggesting that we can best define health and disease partly by reference to well- and ill-being objectively defined. It argues that people need the biological (and perhaps mental) functions necessary to live at least minimally well to qualify as healthy, and that those lacking sufficient well-being (who have ill-being) are often ill. However, it also argues that people can have the biological (and mental) functions necessary to live minimally well without being healthy and that disease is only a subcategory of ill-being—people can fare poorly (have ill-being) without being ill. Although this chapter explains some conceptual connections between health and ill-being, it holds that what matters more than providing the necessary and sufficient conditions for what qualifies as a disease is deciding what conditions we should medicalize and discovering how to help people live well enough. This account is valuable because it helps us progress towards this end.