건강 개념의 정립 -크리스토퍼 부어즈와 레나르트 노르덴펠트의 건강 논쟁을 중심으로- = Building a Concept of Health -Focusing on the Debate between Christopher Boorse and Lennart Nordenfelt over Health-

다국어 초록 (Multilingual Abstract)

‘Health’ has been mainly defined as ‘absence of disease’, even though it implies that one’s life is in a good state when one’s physical and mental status is sound. However, in order to view health in more comprehensive perspectives, including the issues of distribution of sources or quality of life, then there have been debates between the narrow definition of health as ‘absence of disease’ and a broader definition of it as ‘the base of quality of life’ in the Western world. These debates are significant in medicine for the scope of health and treatment as well as healthcare policies. Moreover, with the reality that better quality of life is highly expected and the importance of policies to realize it is being empathized, it is necessary to understand health more elaborately. Accordingly, this article aims to suggest an exquisite understanding of health through debates over the core concept of health. Therefore, after reviewing the naturalistic concept of health as ‘absence of disease’ by American bioethics theorist Christopher Boorse, and the normativist concept of health affecting human life significantly by Swedish philosopher Lennart Nordefelt, a layered concept of health that synthesizes both theories will be possible.

국문 초록 (Abstract)

‘건강’은 사람의 신체와 정신 상태가 온전할 때 그 사람의 삶이 평온할 수 있음을 내포하면서도 주로 ‘질병의 부 재’로 정의되어 왔다. 그러나 자원 분배나 삶의 질과 같은 보다 포괄적인 의미에서 건강을 조망해야 할 필요성에 서 최근 서구 학계에서는 ‘질병의 부재’로서의 협의의 건강 개념과 ‘삶의 질의 전제’로서의 광의의 건강 개념을 둘러싼 논쟁이 이어지고 있다. 이러한 논쟁은 건강과 치료의 범위를 어디까지로 한정할 것인가와 같은 의학 뿐 아니라 건강 관련 정책과도 관련하여 중요한 의미를 지닌다. 더욱이, 실제로 좋은 삶의 질에 대한 기대가 높아지 고, 그실현을위한정책의중요성에대한인식이점점더강조되고있는현실에서, 건강에대한보다정교한이 해가요구된다. 그에따라서이글은건강개념을둘러싸고제시된논의들을통해건강에대한그와같은정교한 이해를 제시하고자 한다. 그러므로 각각 ‘질병의 부재’로서 제시한 미국의 생명윤리학자인 크리스토퍼 부어즈 (Christopher Boorse)의 자연주의적 건강 개념과 건강을 인간 삶 전반에 중요한 영향을 끼치는 광의의 개념으로 파악해야 한다는 스웨덴 철학자, 레나르트 노르덴펠트(Lennart Nordenfelt)의 규범주의적(normativist) 건강 개념 을 살펴본 후에 두 개념을 종합하는 중층적인 개념으로 건강을 제시하고자 한다.

참고문헌 (Reference)

• 1 Nordenfelt, Lennart, "The concepts of health and illness revisited" 10 : 5-10, 2007
• 2 Kim, Young-mi, "The Cultural History of Infectious Diseases" Hyean Publishing 2010
• 3 Powers, Madison, "Social Justice: The Moral Foundations of Public Health and Health Policy" Oxford University Press 2006
• 4 Nordenfelt, Lennart, "On the notion of health as ability" 3 : 101-105, 1996
• 5 Nordenfelt, Lennart, "On Nature of Health: An Action-Theoric Approach" Kluwer Academic Publishers 1995
• 6 Pörn, Ingmar, "Health, Disease, and Causal Explanations in Medicine" D. Reidel Publishing Company 1984
• 7 Boorse, Christopher, "Health as a Theoretical Concept" 44 : 542-573, 1977
• 8 Venkatapuram, Sridhar, "Health Justice: An Argument from the Capabilities Approach" Polity 2011
• 9 Whitebeck, Caroline, "Concepts of Health and Disease:Interdisciplinary Perspectives" Addison-Wesley Publishing Company 1981
• 10 Boorse, Christopher, "Biomedical Ethics Reviews, What is Disease?" Humana Press 1997
• 11 Khushf, George, "An agenda for future debate on concepts of health and disease" 10 : 19-27, 2007
• 12 Nordenfelt, Lennart, "Action, Ability, and Health: Essays in the Philosophy of Action and Welfare" Kluwer Academic Publishers 2000
• 13 Schramme, Thomas, "A qualified defense of a naturalist theory of health" 10 : 11-17, 2007
• 14 Boorse, Christopher, "A Second Rebuttal on Health" 39 (39): 683-724, 2014