Incisively written, this new edition of a popular guide first published in 1996 slices through the rhetoric of health promotion. Its penetrating analysis quickly reveals health promotion’s conceptual roots, providing an enlightening map of their web of theory and practice. David Seedhouse proves that health promotion, a discipline intended to improve the health of a population, is prejudiced—every plan and every project stems first from human values—and argues that only by acknowledging this will a mature discipline emerge. To help speed (...) progress the author proposes a positive, practical theory of health promotion destined to inspire anyone who wishes to create better health. This new edition includes three new chapters on conventional health promotion, radical and foundational health promotion and mental health promotion, providing examples of the use of foundational health promotion. This new edition also adds five new teaching exercises, incorporates and updates the guide for teachers and lecturers and includes a new topical case study. This book is laced with entertaining dialogues and readers are encouraged to explore ten carefully presented exercises. Educational, accessible and intelligent, Health Promotion: Philosophy, Prejudice and Practice, 2nd Edition is a seminal work which heralds the beginning of the end of health promotion’s long adolescence. It is nothing less than essential reading for all practitioners and students of health promotion. (shrink)

It appears that there are two distinct practices within public health, namely health promotion and disease prevention, leading to different goals. But does the distinction hold? Can we promote health without preventing disease, and vice versa? The aim of the paper is to answer these questions. First, the central concepts are defined and the logical relations between them are spelt out. A preliminary conclusion is that there is a logical difference between health and disease, which makes health promotion and disease (...) prevention two distinct endeavours. However, since disease is defined in relation to health, as those kinds of internal processes and states that typically lead to ill health, the difference is smaller than it might appear. Second, in order to answer the practical question whether it is possible to promote health without preventing disease, and vice versa, several kinds of public health interventions are discussed. The conclusion is that while health promotion and disease prevention can be distinguished conceptually, they can hardly be distinguished in practice. Most general measures do both at the same time. (shrink)

This paper argues that the medical conception of health as absence of disease is a value-free theoretical notion. Its main elements are biological function and statistical normality, in contrast to various other ideas prominent in the literature on health. Apart from universal environmental injuries, diseases are internal states that depress a functional ability below species-typical levels. Health as freedom from disease is then statistical normality of function, i.e., the ability to perform all typical physiological functions with at least typical efficiency. (...) This conception of health is as value-free as statements of biological function. The view that health is essentially value-laden, held by most writers on the topic, seems to have one of two sources: an assumption that health judgments must be practical judgments about the treatment of patients, or a commitment to "positive" health beyond the absence of disease. I suggest that the assumption is mistaken, the commitment possibly misdescribed. (shrink)

Health-related quality of life is the ultimate general goal for medicine, health care and public health, including health promotion and health education. The other important general goal is health-related welfare. The aim of the paper is to explain what this means and what the consequences of these assumptions are for health work. This involves defining the central terms “health”, “quality of life” and “welfare” and showing what their conceptual relations are. Health-related quality of life has two central meanings: health-related well-being, (...) which constitutes quality of life, and health as ability, which contributes causally to quality of life. Four meanings of health-related welfare are put forward: general well-being, health as ability, other inner properties of the individual, and external factors. States and processes covered by these categories contribute causally to health-related quality of life. Finally, using these distinctions, some more specific goals for medicine and health care, on the one hand, and for public health and health promotion, on the other, are outlined. In the former fields work is primarily directed towards changing the health-related quality of life of the individual through direct measures, “manipulating” the individual, whereas public health work and health promotion primarily use indirect measures and further health through various sorts of health-related welfare changes, e.g. through changing the environment. (shrink)

The concept of ‘empowerment’ is used frequently in a number of professional areas, from psychotherapy to social work. But even if the same term is used, it is not always clear if the concept denotes the same goals or the same practice in these various fields. The purpose of this paper is to clarify the discussion and to find a plausible and useful definition of the concept that is suitable for work in various professions. Several suggestions are discussed in the (...) paper, for example control over life or health, autonomy, ability, self-efficacy, self-esteem, and freedom, and it is concluded that there are two plausible complementary uses, one as a goal and one as a process or approach. Empowerment as a goal is to have control over the determinants of one’s quality of life, and empowerment as a process is to create a professional relation where the client or community takes control over the change process, determining both the goals of this process and the means to use. (shrink)

Empowerment is a concept that has been much used and discussed for a number of years. However, it is not always explicitly clarified what its central meaning is. The present paper intends to clarify what empowerment means, and relate it to the goals of health promotion. The paper starts with the claim that health-related quality of life is the ultimate general goal for health promotion, and continues by briefly presenting definitions of some central concepts: “welfare” “health” and “quality of life”. (...) Several suggestions as to what empowerment is are then discussed: autonomy, freedom, knowledge, self-esteem, self-confidence, and control over health or life. One conclusion of this discussion is that empowerment can be seen as a complex goal which includes aspects of the three central concepts welfare, health and quality of life. To the extent that the empowerment goals aimed at are health-related, it is concluded that empowerment is a legitimate goal for health promotion. But empowerment is not only a goal, it can also be described as a process or as an approach. This process, or approach, in a fundamental way involves the participants in problem formulation, decision making and action, which means that the experts have to relinquish some of their control and power. (shrink)

The starting point for the contemporary debate about theories of health should be the holistic theory of Lennart Nordenfelt, claims George Khushf, not the refuted theory of Christopher Boorse. The present paper is an attempt to challenge Nordenfelt and to present an alternative theory to his and other theories, including Boorse’s. The main problems with Nordenfelt’s theory are that it is relativistic, that it leads to counter-intuitive results as to what goals can count as healthy, that it focuses on the (...) wrong kind of abilities, that it makes measuring health extra difficult, and that it does not give us a sufficient account of health, at most a necessary one. The alternative theory proposed is two-dimensional. First, health is to have developed the abilities and dispositions that members of one’s culture typically develop, and be able to use them, in acceptable circumstances; and second, health is to experience positive moods and sensations, the kinds that have internal causes. The theory solves the problems attached to Nordenfelt’s theory by not being individual relativistic, by eliminating the goals in the definition, by giving an alternative interpretation of “ability,” by making health easier to measure, and by adding the dimension of well-being that, together with health as ability, not only gives us a necessary, but also a sufficient, account of health. (shrink)

This paper contains an attempt at constructing a semantic framework for the field of health enhancement. The latter is here conceived as an extremely general category covering the whole area of health care and health promotion. With this framework as a basis I attempt to define the place of medicine within the enterprise of health enhancement. I finally indicate some normative issues for the future, in particular problems and possible developments for medicine as a species of health enhancement.

This paper contains an attempt at constructing a semantic framework for the field of health enhancement. The latter is here conceived as an extremely general category covering the whole area of health care and health promotion. With this framework as a basis I attempt to define the place of medicine within the enterprise of health enhancement. I finally indicate some normative issues for the future, in particular problems and possible developments for medicine as a species of health enhancement.

How far should we go in protecting and promoting public health? Can we force people to give up unhealthy habits and make healthier choices, or does everyone have the right to decide their own lifestyle? Should we stop treating smokers who refuse to give up smoking? Should we put a tax on fatty foods and ban vending machines in schools to address the obesity epidemic? Should parents be required to have their children vaccinated? Are some of our screening programmes unethical (...) Downs syndrome screening, for example or should we be screening people for more conditions, such as Huntington disease? Such questions are at the heart of public health ethics. Holland shows that to understand and debate these issues requires philosophy: moral philosophies, such as utilitarianism and deontology, as well as political philosophies such as liberalism and communitarianism. And philosophy informs other aspects of public health, such as epidemiology and health promotion. The aim of this book is to provide a lively, accessible and philosophically informed introduction to such issues. It is an ideal textbook for students taking courses in public health ethics. And since this book develops systematic discussions of issues in public health ethics, there is also much here to engage and challenge the more advanced reader. (shrink)

This inspirational book provides the philosophical backbone tocountless courses for health professionals. It poses twofundamental questions - "What is health?" and "How can more healthbe achieved?" - and answers them at a depth unmatched by any othertext in this field. David Seedhouse shows that these questions lieat the heart of health practice, and explains why all healthworkers should ponder them deeply. This second edition retains the freshness and enthusiasm of thefirst, while making the foundations theory and its practicalapplications clearer and (...) more accessible than ever. The bookincludes additional material and discussion, new case studies andrevised illustrations. * Describes and explores competing theories of health * Establishes a practical and ethical foundation for healthpromotion and education * Explains the foundations theory - a novel and comprehensive wayto understand health * Shows how the foundations theory might be used to create morehumane health services. (shrink)

Battle Hall Davies' brother Nick ran away from home when she was in high school. Now he has found her and she is going to stay with him for the summer before starting college. Battle discovers that neither she nor her brother is the person she thought they were.

A consideration of current debates in the philosophy of medicine and health care regarding the nature of health and health promotion, concepts and measurements of mental health problems, phenomenological conceptions of health and illness, allocation of health care resources and medical ethics.

One INTRODUCTION 1. Background The theory of the nature of health and disease, or of the concepts of health and disease, has been central in modem ...

The purpose of this paper is to give an explication of the concept of health which does not rely on the concept of disease. The explication is informed by a view of the human individual as an acting subject and it therefore places the abilities of agents in the centre. Abilities may be qualified in different ways. The qualification essential for understanding the dimension of health and illness relates abilities to environmental circumstances and high-ranking projects in the life plan. For (...) this purpose generalized adaptedness is introduced as the overarching construction. The dimension of health and illness is characterized in terms of the adequacy of the repertoire for generalized adaptedness. Some immediate consequences concerning the notion of care are noted. (shrink)

This paper is a critical analysis of the concept of mental disorder recently advanced by Jerome Wakefield. Wakefield suggests that mental disorders are most aptly conceived as "harmful dysfunctions" involving two distinct and separable components: the failure of the mechanism in the person to perform a natural function for which the mechanism was designed by natural selection, and a value judgment that the dysfunction is undesirable.

Wakefield's (2000) responses to our paper herein (Murphy and Woolfolk 2000) are not only unsuccessful, they force him into a position that leaves him unable to preserve any distinction between disorders and other problems. They also conflate distinct scientific concepts of function. Further, Wakefield fails to show that ascriptions of human dysfunction do not ineliminably involve values. -/- We suggest Wakefield is analyzing a concept that plays a role in commonsense thought and arguing that the task of science is to (...) identify the natural processes that accord with that commonsense concept. We argue that this represents an attempt to use conceptual analysis to legislate what should be acceptable science. We conclude that this constraint on science is unacceptable and that therefore Wakefield's overall position should be rejected. (shrink)