Approaching the problem of defining 'health' and 'disease' from the perspectives of evolutionary psychology and Darwinian medicine
AuthorsLewis, Stephen J.
AffiliationChester College of Higher Education
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AbstractConcepts of 'health' and 'disease' are of fundamental importance to ethical considerations regarding medical provision. Yet the terms have no clearly agreed definitions. In fact, the difficulty of defining health has led to most attention being given to defining disease instead. Here, two schools of thought have arisen: the 'naturalist' which argues that disease is an objective entity in itself and the 'normativist' which gives emphasis to the subjective nature of disease experience differing between cultures and through history. Respectively, these two schools characterize quantitative (or functional) and qualitative (or evaluative) views of disease. Although both schools offer important insights, they are essentially at odds. This poster outlines an approach that seeks to find a basis for a meeting (if not a unification) of these schools by adopting ideas and approaches from evolutionary psychology and Darwinian medicine. From the perspective of reproductive fitness, the question of whether health and disease can be said to exist as biological entities is addressed and the idea that all that matters is reproductivity is considered. It is suggested that attitudes regarding certain biological entities, such as physical or physiological states, serve adaptive functions. The suggestion is then made that, although open to social and cultural influence, attitudes towards and qualitative definitions of health and disease also have biological bases. Thus, it may be argued that evaluative definitions of disease have functional (evolutionary) bases, thereby linking the naturalist and normativist schools of thought. Important in this linkage, however, is acceptance of ideas from evolutionary psychology. The only discipline that currently unites the study of health and disease with that of evolutionary biology (including evolutionary psychology) is Darwinian medicine. It is within this discipline that new theoretical and evidence-based understanding of 'health' and 'disease' is likely to prove fruitful – in particular, in giving 'health' appropriately weighted attention.
CitationUnpublished symposium presentation given at the The Changing Face of Disease: Implications for Society joint symposium of the Society for the Study of Human Biology and the Human Biological Association at the University of Cambridge, 17-18 September 2001
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