Abstract
Can one be ill and happy? I use a phenomenological approach to provide an answer to this question, using Merleau-Ponty’s distinction between the biological and the lived body. I begin by discussing the rift between the biological body and the ill person’s lived experience, which occurs in illness. The transparent and taken for granted biological body is problematised by illness, which exposes it as different from the lived experience of this body. I argue that because of this rift, the experience of illness cannot be captured within a naturalistic view and propose to supplant this view with a phenomenological approach. The latter approach accounts for changes in the ill person’s relationship to her social and physical world. These changes, I argue, cannot be captured by a naturalistic perspective. I then propose the notion of health within illness as a useful concept for capturing the experience of well-being reported by some ill people. I present empirical evidence for this phenomenon and assess its philosophical significance. Finally, I suggest that adaptability and creativity are two common positive responses to illness, demonstrating that health within illness is possible. The three elements combined – the transformed body, health within illness and adaptability and creativity – serve as the basis for a positive answer to the question posed above.
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Notes
I would like to thank Eran Dorfman and Samir Okasha for helpful discussions of the relationship between naturalism and phenomenology.
Fulford (1993) shows how Boorse himself slips into value-laden language.
This has been proposed by Boorse (1997), who suggests a distinction between disease, the biological dysfunction, and illness, the normative and social effect of disease. The problem with this approach is that it, again, splits a unified phenomenon into two. It treats different aspects of illness as belonging to two domains, the physical and the social. Seeing the various areas of impact as separate serves to further objectify disease. The phenomenological approach rejects the mind/ body dichotomy and therefore rejects the split between disease and illness, and instead offers a unified account.
For a detailed phenomenological account of daily life with multiple sclerosis see Toombs (1995).
This is, of course, a very different use of the term than in its more usual milieu, in evolutionary biology. I am using the term here in the general colloquial sense. Interesting questions about function that may overlap with the biological debate can arise in some cases. For example, the use of hands to propel a wheelchair may be seen as an exaptation, where hands and tool combined replace the function of walking.
An interesting exception is a study of East-End Londoners’ attitude to illness, which notes their cheerful stoicism and pragmatism towards illness (Cornwell 1984). The author provides a social explanation. These people view illness as a normal part of life, and use terms such as ‘normal illness’ and ‘health problems which are not illness’. In this sense, biographical disruption carries particular class- and age- related connotations (Williams 2003, p.103).
A friend told me her 4 years old son once said to her: “Mummy, I’ve got a headache in my tummy”.
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Carel, H. Can I Be Ill and Happy?. Philosophia 35, 95–110 (2007). https://doi.org/10.1007/s11406-007-9085-5
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DOI: https://doi.org/10.1007/s11406-007-9085-5