Naturalism Vs Normativism

The manner in which the field of medicine defines ‘health’ and ‘disease’, is a central problem in the philosophy of medicine. Due to a greater focus on a more humanistic approach to medicine, two prominent approaches were founded, namely Naturalism and Normativism. In this essay I will attempt to explain which approach is more effective in defining these concepts, by comparing and explaining their negative and positive attributes in this process.

Naturalisms approach to defining health and disease uses Christopher Boorse’s definitions and is similar to that of the biomedical model in which it describes disease to be an internal state that is a departure from statistically normal functioning in some reference class. Boorse describes a ‘reference

The introduction of a reference class was to limit the application of normal functioning to smaller classes of people instead of one entire specie. Boorse’s describes the ‘normal function’ of a part or process within members of a reference class to be “a statistically typical contribution by it to their individual survival and reproduction”. Yet, ‘statistically normal functioning’ in a reference class is not in correspondence to the factor that is present statically the most, but rather the level of contribution is compared. Although Naturalism is the prominent philosophical approach to defining health and disease, Naturalism and Boorse’s definitions have been criticised. Naturalism biggest negative attribute is that it does not incorporate the concept of human values, when defining health and disease. This is problematic in today’s society, with changing values and conceptions of what is normal. Two main examples are homosexuality and pregnancy, which according to naturalism,

Therefore the psychological or physiological states that are considered to be ‘desirable’ to most would be considered as ‘health’, whilst the psychological or physiological states that are considered ’undesirable’ are considered to be a ‘disease’. Although, Normativism paves the way in becoming a more well-rounded approach including values of the changing society, Normativism does not consider the biological functioning when defining health and disease and this contributes to the negative attributes of this approach. Similar to Naturalism, whereas normal processes such as pregnancy are incorrectly defined as being a disease, Normativisms negative attribute of not considering the biological functioning when defining health and disease will lead to the same problem. Thus, Normativisms approach would define menstruation as a disease, as the values of society would deem menstruation as undesirable. Normativism also encounters a greater problem when considering which states society values or disvalues as being healthy or diseased. According to Normativism, if a state is considered undesirable it would logically entail that the state is considered a disease, yet this is not always the case. An example such as alcoholism encounters this problem, whereas the state is seen to be undesirable yet Normativisms approach cannot distinguish it as a disease, as it