The meaning of health is often disputed. Different people and cultures have different understanding of what it means to be healthy, whether health is simply a medical state, or a broader, more holistic state. I believe that health is much more than its medical definition, that is, being free of disease. Although this is certainly a component of health, the meaning of health goes beyond this to include a broader, open-ended approach centered around different aspects of health.
Throughout time, many have given their take on the definition of health. According to the Cambridge Dictionary, health is “the condition of the body and the degree to which it is free from illness, or the state of being well.”[Cambridge University Press, 2019] In 1948, the World Health Organization (WHO) adopted a definition of health which says health is “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”[World Health Organization, 2019, para. 1] Importantly, this acknowledges other factors important to overall health and is considerably broader. However, this definition seems to set the bar too high. The absoluteness of the word “complete” seems very unattainable, if not impossible. This would therefore imply that no one can be healthy, which obviously should not be the case. To be healthy, one does not need to perfect socially, mentally, and physically. In my opinion, one can be classified as and live a healthy life without being perfect in these three aspects of health. A third definition to consider can be seen in the Ottawa Charter for Health Promotion, an important Health Canada document. It states that to be healthy, “an individual or group must be able to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment.” [Government of Canada, 2019, para. 3] This is also considerably open-ended and may classify some as wrongfully unhealthy. Taken together, I believe we must stand somewhere in the middle of these two ends of the spectrum. That is, all three descriptions of health are relevant, but I do not believe they are true on their own.
Health is inevitably tied to many determinants. This includes social, mental, and physical, as stated by the WHO. But more specifically, we can also include economic, environmental, ecological, and personal factors as important. In the 21st century, these factors are constantly changing around us. Rapid changes occur throughout society every day. As human beings, we are constantly adapting to this change in numerous ways. We are responsible for our health to an extent, and the factors around us also play a role in shaping our health. Thus, a key component of the meaning of health must be one’s ability to adapt. At the same time, the WHO definition, as well as the Cambridge Dictionary definition and Ottawa Charter interpretation must be included to some extent.
Therefore, I believe that health means being able to adapt in order to live in an ideal state of physical, social, and mental well-being. In this situation, ideal can be defined by oneself, as well as a doctor and society at large. This definition allows for many essential determinants of health to be included, such as social, environmental, physical, and mental well-being. Due to the ever-changing society and individual differences, the ideal state can be combination of one’s own conception, as well as doctor’s, and the general public. In this way, health is more dynamic, allowing for the definition to be tailored to the individual. Yet, it is still rigid enough that one can decisively distinguish between healthy, and unhealthy.Each moral theory has major defining factors. There is no single correct or best theory; each may be favored in different situations. In order to make decisions about the applicability of each theory, it is important to understand the basic features of each.
Utilitarianism is a monistic, consequentialist theory. Its central idea is that the morality of an action should be determined based on the principle of utility. Whether or not an action is considered moral depends solely on the consequences of the action. Should the consequences promote utility (happiness) for those affected by the action, it would be considered moral. Anything which would produce a greater amount of happiness or decrease the amount of unhappiness would be considered moral. Other factors are not important to the decision and should be rejected. Furthermore, utilitarianism says that each person should only be valued as one person; that is, all people should be valued as equals. In addition, utilitarianism is further divided into act utilitarianism (AU) and rule utilitarianism (RU). The difference between AU and RU lies in the fact that AU focuses on individual actions, while RU focuses on the effects of types of actions. Specifically, in AU, individual actions are judged based on maximizing utility. Conversely, in RU, actions are judged based on the consequences if it were to become a general rule for all of society. According to RU, an act would be morally correct if it agrees with a universal general rule which tends to maximize happiness or minimize unhappiness.
Kant’s deontological ethics is a duty-based, monistic theory. It is a non-consequentialist theory due to the fact that it is deontological (duty-based). Actions are judged based on whether they are performed for the sake of moral duty. Thus, all actions are either required by moral duty, forbidden by moral duty, or simply permissible (amoral). Kant’s two leading formulations help one to understand what actions fall into each category. The first formulation describes that one should always act upon a principle which could be a universal law for all rational beings to follow. The second formulation details that one should act so that humanity is always treated as an end, but never as only a means. Taken together, the two formulations show that actions which treat beings solely as a means, and/or cannot be considered a universal law are forbidden. Actions which treat beings with respect and dignity are required by Kant’s formulations. Finally, actions which are neither moral, nor immoral, are simply permissible.
Aristotelian virtue ethics is a goal-oriented theory, which argues that we should be virtuous people. According to Aristotle, there is but one goal in life, which is happiness and well-being. A virtuous human can achieve this state by being able to make morally acceptable decisions. Virtues are qualities of character, which are learned through experience and considerable practice. Virtue is a kind of disposition which is centered around living in moderation, courageously, and generously; in harmony with thought and feeling. Aristotle argues that decisions cannot be made solely based on moral rules and obligations, but requires unity of virtuous qualities and character traits to make morally valid decisions. In this way, a virtuous human can choose the best option between two extremes. There may be other goals in life, however, these are merely intermediate ends to the final goal of happiness and well-being.
Feminist ethics is a theory which has been developed over time as a challenge to traditional theories which are considerably more individualistic and largely developed my males. It argues that traditional theories fail to consider the moral experience of females, and are inherently built into the foundations of society, fostering bias and discrimination. It aims to understand and correct this. An integral part of feminist ethics is context, which is not included to the same extent in traditional theories. That is, when making decision about moral issues, the context of the situation should be considered. This often includes the socio-political context. Therefore, whether actions, situations, and societies are just is also an important factor in making moral decisions. The modified-egalitarian and libertarian resource allocation models differ in many ways. This includes their basic characteristics and values, as well as how these characteristics affect society. Both models can be applied as health care systems. In this way, the advantages and disadvantages of both models can be seen. The libertarian health care system model focuses on individual freedoms. In this system, health care is a commodity, much like other consumer goods and services. It can be sold and purchased; the free market will determine the supply and demand. This can be contrasted with a modified-egalitarian system, which focuses on freedom as well as equality. In this model, typically a basic universal health care will be offered, with other non-basic services and goods offered at a price. The basic health care will be guaranteed to all, and financed as a public service. Therefore, there is an aspect of equality from the basic health care offered, but also freedom to purchase goods and services which are not considered basic. I believe that the advantages of the modified-egalitarian model outway its disadvantages.
Comparing the two models, there are clear advantages of the modified-egalitarian model over the libertarian model. The major advantage of the modified-egalitarian model is that everyone is guaranteed basic health care. That is, everyone has equal right to the basic health care. This is different that the libertarian model where there is no guaranteed health care. A second important advantage is the decreased bureaucracy in the modified-egalitarian model. In the libertarian model, health care is commodity, much like other consumer goods and services. In the modified-egalitarian model, it is viewed as more of a basic right. As a result, the libertarian model makes way for increased profits of sellers, and therefore typically has increased bureaucracy compared to the modified-egalitarian model. This is an important advantage of the modified-egalitarian system as it allows for less steps between physicians treating patients and payment for their services.
Conversely, the modified-egalitarian has multiple disadvantages when contrasted with the libertarian model. Firstly, due to the lack of a free market (and therefore competition and supply and demand), there is no market regulating prices. As a result of this, there is little to no incentive for cost containment. A second major disadvantage to the modified-egalitarian model is that it may have decreased efficiency, compared to the libertarian model. This includes extensive wait times and more inefficient resource allocation. As a result of the perceived free service, demand and spending increases both continually increase.
In my opinion, the advantages of the modified-egalitarian model outweigh its disadvantages. According to the World Health Organization (WHO), health is a fundamental human right, and they support countries in moving towards universal health care. This is something which I agree with, and the modified-egalitarian model supports having basic universal health care available to all. In this sense, health is a right, rather than a commodity. As well, the decreased bureaucracy and increased professional autonomy of the modified-egalitarian system allows for decreased steps between the patient and the physician. While efficiency and cost containment are no doubt integral components of a successful health care system, they can still be achieved within reason. A prime example of this is the Canadian health care system. The Canadian system has its downfalls, however, it still manages to provide universal health care to all at a smaller cost that the American system, which has libertarian roots. Overall, I believe that the advantages of the modified-egalitarian system outweigh its disadvantages.
