PHIL 226, Week 2

NEW: Instructions for exercise 1.

What are Health and Disease?

What are the goals of the health sciences?

These questions matter for issues concerning national health plans and allocation of resources.

What are concepts?

• Defined: necessary and sufficient conditions.
• Exemplars:  good examples and counterexamples.
• Prototypes:  typical conditions.
• Explanations: causal relations.
• PHIL/PSYCH 256 on concepts.

What is Health?

World Health Organization:

• "Health is a state of complete physical and social well-being and not merely the absence of disease or infirmity."
• "The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being."

Problems with these claims:

• Does health require complete well being?
• Is there a right to maximal health care? To minimal health care? Adequate health care?

My attempt: Health is the capacity to satisfy your vital needs, both biological and psychological.

What is Disease?

1. Biological definition (objective): disease is an impairment of normal biological function. The concept of disease is descriptive and scientific.

2. Social definition (normative): disease is a condition that constitutes a threat to well-being. The concept of disease is normative and value-laden, relative to social contexts.

3. Combined definition (Thagard): ?A disease is a breakdown in normal biological mechanisms that diminishes people’s ability to satisfy their vital needs. 

History of concepts of disease.

The Right to Health Care

Key issues

1. What kind of health care system should a country have?
2. What treatments should be provided by a health care system?

Options for delivering health care

1. Current Canadian system: publicly administered, comprehensive, universal, portable, accessible.
2. Modified Canadian system: make reforms to improve it, e.g. with a drug plan.
3. Free market: health is a commodity.
4. Modified free market (US): national coverage for old and very poor.
5. Two tier system (UK): national health plan, but people may also access private system.
6. Medical savings plan (Singapore). Everyone has a sum of money to spend on health care, and extreme expenses are covered.

Ranking of 16 health care programs by the Conference Board of Canada.

Life expectancies in countries.

Reasoning

1. What options are best supported by the consequences ERP?
2. What options are best supported by the rights/duties ERP?
3. What options are best supported by the principles ERP?
4. What options are best supported overall?

Core principles of the Tri-Council Policy Statement on Ethical Conduct of Research:

1. Respect for persons: autonomy, protect those with diminished autonomy
2. Concern for welfare: quality of life, avoidance of harm
3. Justice: fairness and equality

Review Questions for Week 2

1. What is the WHO definition of health and what might be wrong with it?
2. What are Callahan's modest conclusions about health?
3. What is the difference between objectivist and normative conceptions of disease?
4. According to the Canada Health Act, what are the criteria for funding provincial plans? How might these criteria be justified ethically?
5. How does the 2002 Royal Commision Report on Health propose to improve the Canadian health system? How might these changes be justified ethically?
6. What is the difference between purposive and functional approaches to what medical treatments should be funded?
7. Essay topic: Use the consequences, rights/duties, and principles reasoning patters to evaluate what you think are the most plausible options for delivering health care.

Phil 226

Paul Thagard

Computational Epistemology Laboratory.

This page updated Sept. 17, 2012