Response To The Naturalist Approach

A central problem in the philosophy of medicine involves how we should define the terms 'health' and 'disease'. In this essay I will explain two prominent approaches namely naturalism & normativism. I will also state which approach I think is better and why I believe it is better.

The first approach that I will explain is Naturalism. The Naturalist approach attempts to highlight what is normal and biologically natural for humans. Naturalists focus on whether an organ or system is normal, or functions accordingly. Thus, they focus on the physiological and psychological states. There are four criteria's to the Naturalist approach. Firstly there must be a reference group of uniform design, for example the age limits of the group studied. This is important for what happens in one group, may not be the same in the other. Secondly, the normal functioning within the reference group is a typical contribution to its survival and reproduction. Here statistics (where the normal functioning is the average) are important. Thirdly, disease is a type of internal state that limits or stops normal functioning and is caused by the environment. Lastly, it is believed that health is the absence of disease.

The objection to the Naturalist approach is that it does not reflect personal values when defining health and
disease. It does not reflect how our personal values play a role in what seems to be healthy or diseased. For example, for some people homosexuality is normal, thus healthy and for other not thus diseased. The problem of the naturalist approach is that it entails that something we cannot control, is a disease.

The second approach is Normativism.
The Normative approach attempts to highlight that health and disease reflect our personal values. Normativists focus on whether a psychological or physiological state carries value or not. In Normtivism, the states that we desire are considered healthy and the states we want to avoid are considered as disease. Normativism tries to overcome the problems of Naturalism but does not use the terms 'health' and 'disease' better than in the Naturalist approach. Normativists confirm their view but disconfirm naturalism in cases where a state is classified as a disease at one time, but healthy at another time, as in the case of
homosexuality.

The problem of the Normative approach is that it entails that any undesirable state is a disease. For example, when we consider alcoholism, it is agreed that it is an undesirable state, but not that it is a disease. It does not define 'health' and 'disease' as it is used by lay people and medical practitioners. It is subjective and therefore fails.

I believe that neither approaches are better than the other. The reason for this is because both approaches fail to determine the terms 'health' and 'disease'. Both approaches determine disease as something that is not normal or undesirable and health as normal or desirable. Each one of these approaches only focus on one of the two factors that are important when discussing medical cases, that is either the physiological and psychological factors, or the values we attach to those factors.

In this essay I explained Naturalism and Normativism, two central approaches in defining 'health' and 'disease'. I also explained why I believe neither approaches succeed in defining these terms and thus why neither one is better than the other.