Descriptions of helth bsed on physiologicl mesurements ignore the ide of helth s vlue. Wht they offer in precision, they lck in depth; for, surely, being helthy is much more thn hving n your orgns quietly functioning within plus or minus two stndrd devitions of norml. Vlue-free descriptivist definitions of helth cnnot be more thn component of comprehensive concept of helth, for helth is vlued. Helth is vlue beyond formlizble knowledge. However, vlue-bsed definitions of helth lck universlity; they depend on the individul's (or culture's) determintion of wht is to be vlued. Descriptivist definitions ignore the subjective dimension, wheres normtivist definitions exlt it.
The World Helth Orgniztion defined helth s " stte of complete physicl, mentl nd socil well-being nd not merely the bsence of disese or infirmity." (Genev: World Helth Orgniztion, 1958). This definition, if tken literlly, is meningless. However, we believe tht ll normtivist definitions of helth, including this hopelessly utopin WHO vision, derive from common ground, core mening or experience of helth tht requires interprettion. (Mordcci, 1995)
ny experienced clinicin cn recll terminlly ill ptient who objectively seemed the sme the dy he died s the dy before except for hving (often quite explicitly) lost his will to live. Implicit in this will to live, nd of specil importnce to the seculr individul, is sense of life being worth living despite ll the suffering one my encounter in life nd despite the wreness of the certinty of deth nd nothingness.
The helthy individul is well-functioning s whole, in hrmony physiclly nd mentlly with himself nd with his surroundings. lthough we tend to spek of helth s though it were commodity--something to be lost or regined--it is not detched from the person it belongs to. It is prt of the person's life story. Helth is dynmic; it hs pst, nd present, nd it is precondition for future. Desire, without which there is no story, belongs to the future--there lies the hoped for full blossoming of life. Thus there seems to be sort of inevitble metphysics embedded in the experience nd lnguge of helth nd illness, which clls for wreness nd for creful nlysis in the light of n dequte chrcteriztion of the concepts we use. It Is extremely importnt for medicine to be conscious of the depth of our desire for helth nd our fer of illness: they re not only physicl or biopsychologicl conditions tht cn be fced in reductionistic pproch. The existentil, morl, nd symbolic dimensions of the experience of illness must be ddressed s chllenges the ptient is required to fce with his culturl, personl, nd religious resources, nd in which the physicin is sked to help him not only s physicin but s person. No technicl nswer cn help the ptient to understnd nd fce the existentil dimensions of helth nd illness: in this respect, the eduction physicins now receive in mny countries round the world (nd especilly in the West) seriously limits their bility to cre for their ptients.
Helth s wholeness, hrmony, nd well-functioning, nd s slvtion from deth is desirble end in itself However, the crux of concept of helth, nd its greter mening or vlue, is helth s mens. Helth is viewed s the experience of life s Promise of good; the ultimte good tht is hoped for is the full life--this we refer to s plenitude. lthough this is similr to Seedhouse's concept of helth s foundtion for chievement, the ide of plenitude