A pragmatist recovery of health: Rethinking the limits of biomedicine
This project applies insights primarily from classical American pragmatism to pressing contemporary debates regarding the biomedical model of health. More specifically, it focuses on the ethical implications of theoretical frameworks in philosophy of medicine and the technologies that enable their practical application in clinical practice, with a particular focus on the relationship between quantitative and existential-qualitative dimensions of health and our conceptions of them. Whereas mainstream biomedical ethical debate tends to be limited to applications of established ethical paradigms to biomedical problems, thereby effectively taking the biomedical conceptualization of health for granted, I argue that biomedicine, as articulated by the biostatistical theory of health (BST) and practiced by evidence-based medicine (EBM), in presupposing a reductive, strictly quantitative view of the human person, carries with it some ethically undesirable practical consequences. The dissertation addresses these problems, first, by reconstructing the concept of health in a manner that remains scientifically respectable while doing justice to the fullness of human selfhood, and, second, by developing a commensurate account of the human self that emphasizes, but does not reduce to physiological embodiment, and understands selves contextually, within both their somatic and social environments. In place of a static picture of health as statistical normality, it offers the dynamic ideal of living healthily, which incorporates and foregrounds individual's systems of lived meaningfulness. The dissertation concludes by surveying recent evidence-based research supporting the thesis.
0497: Medical Ethics