Health and human nature: A naturalist's account of health and normality

The argument between naturalists and normativists about the notions of health, normality and disease has largely revolved around the fact-value distinction and the problem of the place of values in biomedical science. In this essay it is argued that the proper place for a naturalist to begin an investigation of these notions is in biology, and that the fact-value controversy is an inappropriate focus for a naturalist investigating the semantics of health notions. A rigorous naturalist analysis of standards of organismic assessment should begin with the kinds of organismic assessment made in the biological sciences. Perhaps the most fruitful area of discussion regarding organismic assessment is the discussion among ecologists of the classification of symbioses.; Three models offer themselves as frameworks for the classification of symbioses. First there is the model presented in most introductory texts in biology which classifies symbiotic relationships according to harm or benefit to the organisms in the association. Second, there is the model which more sophisticated biologists employ which classifies symbiotic relationships according to fitness effects on the organisms in the association. This second model is often taken as a refinement of the first. Finally, it is suggested that an alternative functional assessment model escapes shortcoming of each of the earlier two models.; Generalization of this functional assessment of the organism in the face of varying conditions and environments rather than merely varying associations provides the groundwork for a plausible reconstruction of health and normality, with the assessment of health being simply functional assessment, and normality being the more complicated of the two notions. It is suggested that a condition of an organism is normal if it is to be predicted from among a group of alternatives from a functional analysis of the rest of the organism. What emerges from this analysis is a notion of normality which we contrast with disease and pathology and a notion of health as more than the mere absence of disease.