The first in a series of postings on the connection between health, beauty, and freedom in the human person and the implications on the practice of medicine.
What is health? I use the word regularly and had never doubted that I knew what it meant until my doctor asked me to define it. Then, I realized, that I was struggling to do so.
My first stab was to suggest that it was the absence of illness. But as my doctor pointed out, somewhat Socratically, the problem then is what is that we have to know what illness is…And, if we define illness as the absence of health we’re just going around in logical circles.
I have since asked several doctors this question and all have told me, that despite acknowledging that restoring health is their occupation, they were hazy on what it is, precisely, explaining that there was very little discussion of the topic at medical school.
This struck me as strange, not to mention slightly worrying. If doctors can’t say what health is how can we trust their intentions for us when they treat us? Alternatively, I might go in for a check-up and be given a clean bill of health, but still be uncertain that I am genuinely healthy.
Before I speculate on the meaning of health further, I want to ask if any of you out there can come up with a theologically grounded definition, please post in the comments section below!
For my part, in a search for some ideas, I went to the font of all knowledge, the internet, and found the following: first the World Health Organization definition (with a name like that they ought to know, surely?):
Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
And then I found three other definitions on Google:
Health is the absence of any disease or impairment.
Health is a state that allows the individual to adequately cope with all demands of daily life (implying also the absence of disease and impairment).
Health is a state of balance, an equilibrium that an individual has established within himself and between himself and his social and physical environment.
The problem with all of these definitions, even including that of the WHO, is that we can’t know what they mean unless we know first what the terms well-being or balance mean or to cope adequately mean for a human person. And we can’t say what these terms mean unless we know also what a human being is, and what is the purpose of our existence.
In short, a person is healthy, I suggest and drawing on these internet-supplied definitions, when he is fit for purpose and unless we know the purpose of human existence, we can’t know what health is.
We can see now why the discussions in medical school are reported by doctors as being so hazy and vague. Medical schools are typically aggressively secular institutions that reject Catholic teaching. As a consequence and unable to reach a consensus on the subject, they avoid the subject altogether.
So here is my first stab at a longer definition of health for the human person:
Health is the optimal condition of freedom of the human person directed to the fulfillment of their end for existence. It is attained through the optimal harmony of all aspects of the human person - body, soul, and spirit
The end of human existence is to be in union with God in eternal happiness.
We can address the meanings of well-being, balance, and coping adequately accordingly. ‘To be’ is a verb, so well-being is the state of undertaking essentially human activity well. He does this when it is ordered to his ultimate end. Similarly, at this point his life is balanced; and when it is balanced he does far better than coping adequately with everyday life.
Health care, therefore, is always concerned with the treatment of the whole person. This doesn’t mean that there should be no medical specialists, but it does mean that a cardiologist, for example, ought to be aware of the impact on the whole person of any treatment he prescribes. A cardiologist considers first what is necessary for a healthy heart, next how it impacts the whole body, and finally how it impacts his capacity for spiritual well-being in light of the fact that a person is a profound unity of body and soul..
Further, under this definition of health, someone who is permanently blind can be considered still to be healthy. This doesn’t mean that we shouldn’t aim give him sight if we can but rather, given that we can’t, we are saying that he is as healthy as he could be. Similarly, an old person, who cannot do what he could when younger, might still be referred to as healthy when we consider him to be healthy for his age.
Sometimes consideration of the optimal harmony of the whole person can lead us to decide to sacrifice some bodily health for the greater health of that person: we might offer dignified hospice care for the last days of a cancer patient so that they can die in comfort and dignity, rather than relentlessly prolonging life without regard to other costs.
This definition, incidentally, has a number of implications for the nature of human beauty, and the training of doctors which will come in a future posting.
To close today I want to consider what freedom is, as this is another phrase that has diminished power in a secular materialist world.
When I speak of freedom I am thinking of a classical understanding by which we are not truly free unless we are able to exercise our freedom well. This means having both the power to act and the knowledge of or insight into how to act well. Here is a working definition of freedom:
Freedom is the capacity to choose the practicable best. There are three components to freedom:
The knowledge of the best choice we can make in any situation. We cannot know what the best choice is if we do not know the standard by which we make such a judgment, which is that it must be leading us optimally to our ultimate end, that is our telos.
The power to achieve it
Lack of external constraint or compulsion directing the choices we make.
Here is a tangentially connected addendum for your amusement!
It is an old joke about bad doctors:
Doctor to patient: Which leg did you say was hurting?
Patient: Left
Doctor: Oh, I see [long pause]… So, anyway, I have some bad news and some good news. The bad news is that I’m sorry, I amputated the wrong leg.
Patient: Oh no! What is the good news? The good news is that the other one is getting better.