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)

A societal goal to which more and more people in the United States appear to be committed--at least officially--is the assurance of comprehensive health services for every person irrespective of income or geographic location. This paper offers one possible moral justification of the goal. It does so by attempting to apply various standard conceptions of social justice to considerations about health care and to reflect about the reasons why some of the conceptions seem more relevant than others. Several institutional implications (...) are also identified. (shrink)