Health Care and Hedonism
1980; Johns Hopkins University Press; Volume: 24; Issue: 1 Linguagem: Inglês
10.1353/pbm.1980.0080
ISSN1529-8795
Autores Tópico(s)Mental Health and Psychiatry
ResumoHEALTH CARE AND HEDONISM FRANCIS SCHILLER* "Health care"—the term as well as its "delivery"—has been with us only since the nineteen sixties, appearing in Index Medicus not before 1971. "Hedonism," or at least hedone—that is, pleasure as an ethical precept, a goal for living—goes back to the fourth century b.c., to Aristippus (died 399), the legendary founding philosopher of the Cyrenaic school which spread from North Africa to Greece in post-Socratic days [1, vol. 3, p. 432]. A philosophy of life, however, and the cure or prevention of what threatens it belong to different disciplines. It is a far cry from the image of the medical professional, grave if also friendly, bent on delivering us from pain, disability, disfigurement, death, to the image of a provider (sit venia verbo) notjust of such health care, but of positive pleasure even to the point of delight, not to say ecstasy. Yet in its development over the centuries medicine has here and there tried to contribute a fringe benefit of heightened life enjoyment. Otherwise, most of such endeavors were educational, political, or artistic. And how do we distinguish between "joy through strength [or health]" and "strength [or health] throughjoy"—the latter slogan a propaganda item unfortunately taken from the Nazi vocabulary? Cause and effect may become blurred or interchangeable. One assumption, ofcourse, is that "getting well" and "feeling good" amount to a real sense of euphoria, the other that a sense of euphoria relieves physical discomfort or prevents or even cures disease—assumptions that are perhaps in need of verification. To start with, does a definition of terms help? Hardly. The World Health Organization assures us that its middle name stands for a state which is "not merely the absence of disease." It is one of "complete physical, mental, and social well-being" [2, p. 230]. This is not the place to quibble about the vagueness of "social" in that context, or the upper and lower limits of "complete." It is bad enough that concepts are hard to define in any way other than against the background of their opposites . "Well" or "good" is meaningless unless we hold it against "bad," ?Clinical professor of neurology and senior lecturer, History of Health Sciences, University of California, San Francisco, California 94143.© 1980 by The University of Chicago. 003 1-5982/81/2304-0213$0 1.00 Perspectives in Biology and Medicine · Autumn 1980 \ 81 "healthy" meaningless unless we imply that there is no touch of sickness, no discomfort. True, Bichat's famous definition of "life" as the "sum of the forces that resist death" is rightly held up to ridicule. For it is in fact impossible to find any superior definition for this or any other basic concept without sounding a little ridiculous. We usually can only substitute a pedantic string of weaker words telling us less than the one we set out to define: one that is strong and commonly understood. Is not "well-being" just a weaker synonym of "health"? Such definitions or circumlocutions may only serve to strengthen one's position in a controversy . The World Health Organization simply wished to emphasize a noble sentiment, a comprehensive humanitarian effort to secure the right to health. "Bodily health," according to Charles Kingsley, the Victorian novelist, pamphleteer, and Christian socialist, "makes one unconscious of one's own body" (quoted in [3, p. 5])—a shrewd enough observation. But it will not be accepted by those to whom it suggests a turn of mind conditioned by real or imaginary ill health and possibly the fear of more to come. (Kingsley died at the age of 56, although he might qualify as a "health nut.") People eager to take care of their own health by engaging in exercise or careful eating will insist that they do get frequent messages from their skins, their muscles, and even from some of their deep-seated organs, having trained themselves for such positive awareness. It may be hard to say who is the more introspective, even to a touch of hypochondriasis : the presumably sedentary Victorian who tries to forget that he has a body, or the late twentieth-century runner after that very experience...
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