Department for Health, Technology and Society, Gjøvik University College, Gjøvik, Norway,
Health Care Anal. 2013 Dec;21(4):283-97. doi: 10.1007/s10728-013-0255-2.
In his influential theory of health Nordenfelt bases the concepts of health and illness on the notions of ability and disability. A premise for this is that ability and disability provide a more promising, adequate, and useful basis than well-being and suffering. Nordenfelt uses coma and manic episodes as paradigm cases to show that this is so. Do these paradigm cases (and thus the premise) hold? What consequences does it have for the theory of health and illness if it they do not? These are the key questions in this article, which first presents the relationship between pain and disability in Nordenfelt's theory and the paradigm cases he uses to argue for the primacy of disability over pain. Then, Nordenfelt's concepts of illness are outlined, highlighting its presumptions and arguments. The main point is that if you do not have an action-theoretical perspective, it is not obvious that disability is the core concept for illness. The compelling effect of the paradigm cases presupposes that you see ability as the primary issue. To those who do not share this presumption, people in coma may not be ill. There are alternative well founded arguments for the primacy of first person experiences for the concept of illness. Hence, we need better arguments for the primacy of disability over first person experiences in illness, or first-person experience should be more primarily included in the concept of illness.
在他有影响力的健康理论中,Nordenfelt 将健康和疾病的概念建立在能力和残疾的概念之上。这一前提是,能力和残疾比幸福和痛苦提供了更有希望、更充分和更有用的基础。Nordenfelt 使用昏迷和躁狂发作作为范例来说明这一点。这些范例案例(以及因此的前提)是否成立?如果它们不成立,对健康和疾病理论会有什么影响?这些是本文的关键问题,本文首先介绍了 Nordenfelt 理论中疼痛和残疾之间的关系,以及他用来论证残疾比疼痛更重要的范例案例。然后,概述了 Nordenfelt 的疾病概念,突出了其假设和论点。要点是,如果没有行动理论的观点,残疾是否是疾病的核心概念并不明显。范例案例的强烈影响假设您将能力视为主要问题。对于那些不认同这一假设的人来说,昏迷中的人可能没有患病。对于疾病概念中第一人称体验的首要地位,还有其他有充分依据的替代论点。因此,我们需要更好的论点来证明残疾比第一人称体验在疾病中更具首要地位,或者第一人称体验应该更主要地包含在疾病概念中。