A Curious Reader asks: What’s the definition of health?



According to the World Health Organization, health is “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” The apparent fullness of this definition carries a powerful intuitive appeal: A comprehensive definition of health should cover all aspects of life, it would seem. However, the WHO definition has been the target of criticism in the medical literature since its first appearance in that organization’s constitution in 1948. The American bioethicist Daniel Callahan, for instance, writes for The Hastings Center Studies (Callahan’s own institution) that “one of the grandest games” in the field of medicine “is that version of king-of-the-hill where the aim of all players is to upset the World Health Organization definition of ‘health.’ ”

Citing the Austrian-British philosopher Ludwig Wittgenstein’s famous aphorism “meaning is use,” Callahan goes on to rehearse a handful of well-known problems with the WHO definition, including: (1) that it is hopelessly vague; (2) that it casts “the medical profession” and “the psychological profession in the role of high priests;” and (3) that it has the potential for misuse in the hands of Savonarola-style moralists, who will simply reframe their agendas in the language of “mental and social well-being.”

For Callahan, the possibility of tyranny by the medical profession is reason enough to be cantankerous about what might seem like mere semantics.

Writing in 1973, Callahan acknowledged that, in making these points, he was already “beating a dead horse.” Nevertheless, the same WHO definition endures, maintaining a place of prominence in the official documents governing a major international institution. And for Callahan, the possibility of tyranny by the medical profession is reason enough to be cantankerous about what might seem like mere semantics.

But it’s easy enough to criticize. What definition would Callahan have us use instead? Ultimately, he suggests that simpler is better: Health means physical health, full stop. “The image of a physically well body is a powerful one and, used carefully, it can be suggestive of the kind of wholeness and adequacy of function one might hope to see in other areas of life,” he concludes.