The enigma of health: cultural, health political, and philosophical aspects

Ethics, at its core, relates to our practices and their moral justification. The practice of medicine, by definition, takes place in a fundamentally ethical context. In ordinary circumstances the goals to which physicians direct their medical practices are held tacitly, but sometimes fresh examination of these is occasioned. This conceptual article considers a range of approaches that have been taken to the notion of health, ancient and modern, historical and contemporary, beginning with the socio-cultural, then the health political, and finally the medical philosophical. Although these are contrasting perspectives, each are bound up with questions of values and of the relation between the objective and subjective. The contrast is discussed between the idea of health as a positive and dynamic condition in terms of functional ability, and characterisations of health as purely the absence of disease. Finally, a typology of theories of health is proposed along ontological and epistemological lines