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Editorial: Dogmas, Stigmas, and Questionable Arguments for Better Health

Everyone wants to be healthy, and everyone wants to get well when they are ill. Being healthy contributes to our ability to exercise our autonomy, and to live the lives we wish to live. According to the UNESCO Declaration of Human Rights, there are rights to health and healthcare. It would be hard to argue against the wish to be healthy—be it on an individual, social, or global level. Additionally, most theories of social justice consider health to be a primary good that should be guaranteed for every citizen.1,2 Problems start the moment we try to define “health” more precisely. Is “health” an ideal and optimal state that people should strive for but can never fully achieve? Or is “health” a state of normal functioning—an absence of disease? Broadly speaking, there are two main ways of defining health. The biomedical and reductionist view is interested in physiological anomalies, brain chemistry, viruses, bacteria and the like, and seeks to intervene with medical solutions. In this model, sickness and health are understood objectively through measurable facts. In contrast, the holistic, or social, account looks at capabilities and well-being in a wider sense, and at health more as a subjective experience. A pluralistic account of health would take both of these aspects into account. Problems arise if one side is given excessive attention over the other. Health is also a moral concept. Being “unwell” is sometimes seen as an excuse for restricting a person’s self-determination, and a reason for questioning her rationality and moral character. Throughout history, self-standing women, sexual minorities, the poor, political dissidents, and other “misfits” have experienced this, as their rights have been curtailed by appeals to sickness and related irrationality. Protecting health, and the right to self-determination, frequently come into conflict when health is discussed. According to a widely-accepted view, society has a duty to protect individuals against health hazards. This is why most countries have safety controls on food production and food products, construction materials, cars, and pharmaceuticals, to mention but a few. However, there are limits to this. While many countries require motorcyclists to wear helmets, only some extend this to cyclists, and none do to pedestrians, although, arguably, cyclists and pedestrians would benefit from helmets as well. This is because, generally, people are assumed to have an extensive right to self-determination over their own lives and bodies. We are allowed to harm our bodies, if we want to, for example, by drinking too much, engaging in dangerous sports, overworking, and staying in abusive relationships. However, when the harm to self is seen to threaten to harm others, or when the autonomy of the person herself is brought into question, there