Is health philosophically distinctive?

ABSTRACT

This commentary critically examines Barnes’ ameliorative skepticism about health, which is a distinctive form of skepticism. While we agree with Barnes that health is indeed messy, involving biological, normative, societal, and phenomenological factors in a complex manner that defies simplistic explanation, we do not think that health is messy in a distinctive way. We argue that health is in fact remarkably similar to another messy phenomenon that is familiar to philosophers (i.e. truth), and that an existing philosophical account of another messy phenomenon (i.e. pluralism about truth) can be applied to health.

KEYWORDS:

• Health
• mental health
• pluralism
• functionalism
• truth

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1. Strictly speaking, it is not Barnes’ view that health is uniquely weird and messy. According to Barnes, not only health but also many other phenomena in the social world are messy: “This book is about health specifically, but you can also read it as a kind of illustrative example case of a more general strategy for how we might approach the philosophy of a messy, fragmented, amorphous social world” (Barnes, 2023, p. 8).

2. One of us appealed to Wakefield’s harmful dysfunction analysis of disorder as an account of delusions as malfunctioning beliefs before (Miyazono, 2015), and is not fully convinced by Barnes’ objection to Wakefield’s theory (Chapter 1). For the purpose of this paper, however, we grant for the sake of argument that Barnes’ objections to existing theories of health and disorder, including Wakefield’s theory, are convincing.

3. It is not clear what Barnes actually means by “real”, but she suggests that witches are not real in the sense that “witch” does not refer to anything. When, after a thorough investigation, we couldn’t find people who fit what we initially expected about witches, we should conclude that “witch” refers to nothing (rather than that “witch” refers to something that is very different from what we initially expected). Truth properties such as correspondence, coherence, pragmatic utility are real in this sense. There are different views about what coherence actually is, for example, but they all agree that “coherence” refers to something; in other words, the issue is about the nature of coherence, not about the existence of coherence.

4. But Barnes’ claim seems to be deeper than this. The issue here is not merely to make sense of how different things, like biological functions and subjective wellbeing, can all be constitutive of health; rather it is to make sense of how these things, which are not only different but also actively in tension with one another, can all be relevant to health. We will come back to this issue later.

5. But “pluralism” and “functionalism” that are discussed in Barnes’ book seem to be slightly different from what we have in mind here.

6. A possible difference between truth and health is that, on the one hand, we might ask comparative questions, e.g., whether Mika is overall healthier than Jess, while on the other hand we do not ask such comparative questions about truth, e.g., whether the conjunction P & Q & R is truer than the conjunction S & T & U. But, we might ask such a question in some special circumstances, e.g., when a teacher needs to rank students’ essays in terms of accuracy, where one essay claims that P & Q & R while another essay claims that S & T & U.

Additional information

Funding

The work was supported by the Japan Society for the Promotion of Science [21H00464].