This paper seeks to develop a theory of health that aligns with the shift in contemporary medical practice and research toward a temporally extended epidemiological view of health. The paper describes how such a theory is at the core of life course based approaches to health, and finds theoretical grounding in recent work in the philosophy of biology promulgating a process theory of life.

In the philosophical debate on aging, it is common to raise the question of the theoretical definition of aging in terms of its possible characterization as a disease. Understanding aging as a disease seems to imply its medicalization, which has important practical consequences. In this paper, we analyze the question of whether aging is a disease by appealing to the concept of disease in the philosophy of medicine. As a result of this analysis, we argue that a pragmatist approach to (...) the conception of disease is the best alternative to highlight the relevance of the medicalization of aging. From this pragmatist perspective, it can be seen that the notion of aging is going through a conceptual change, and aging can today be understood as a not radically different process from any other condition that is usually considered a disease. (shrink)

New technologies facilitate the enhancement of a wide range of human dispositions, capacities, or abilities. While it is argued that we need to set limits to human enhancement, it is unclear where we should find resources to set such limits. Traditional routes for setting limits, such as referring to nature, the therapy-enhancement distinction, and the health-disease distinction, turn out to have some shortcomings. However, upon closer scrutiny the concept of enhancement is based on vague conceptions of what is to be (...) enhanced. Explaining why it is better to become older, stronger, and more intelligent presupposes a clear conception of goodness, which is seldom provided. In particular, the qualitative better is frequently confused with the quantitative more. We may therefore not need “external” measures for setting its limits – they are available in the concept of enhancement itself. While there may be shortcomings in traditional sources of limit setting to human enhancement, such as nature, therapy, and disease, such approaches may not be necessary. The specification-of-betterment problem inherent in the conception of human enhancement itself provides means to restrict its unwarranted proliferation. We only need to demand clear, sustainable, obtainable goals for enhancement that are based on evidence, and not on lofty speculations, hypes, analogies, or weak associations. Human enhancements that specify what will become better, and provide adequate evidence, are good and should be pursued. Others should not be accepted. (shrink)

Human enhancement is ontologically, epistemologically, and ethically challenging and has stirred a wide range of scholarly and public debates. This article focuses on some conceptual issues with HE that have important ethical implications. In particular it scrutinizes how the concept of human enhancement relates to and challenges the concept of health. In order to do so, it addresses three specific questions: Q1. What do conceptions of HE say about health? Q2. Does HE challenge traditional conceptions of health? Q3. Do concepts (...) of health set limits to or direct HE? Addressing Q1 reveals that HE tends to frame and form our conception of health. Thereby it challenges traditional conceptions of health. Accordingly, health does not provide strong sources for setting limits to HE. On the contrary HE seems to define and expand the concept of health. Common to the concepts of HE and health is that both depend on vague value concepts, such as happiness, well-being, or goodness. There seems to be a tendency in the HE literature to define the goal of human life in terms of what is bigger, stronger, faster, more intelligent, and more resilient. However, this is confusing “goodness” with “more” and quality with quantity. Until HE more appropriately defines happiness, HE will fail to provide a relevant compass for improving the life of human beings. On the contrary, if we let simplified conceptions of “enhancement” come to define goodness or health, we may do more harm than good. Until doing so, we may well learn from Tithonus, listen to Douglas Adams’ Wowbagger, and pay attention to Virginia Woolf’s Orlando. Enhanced life may not be better. The same goes for health. (shrink)

Brain age prediction is a relatively new tool in neuro-medicine and the neurosciences. In research and clinical practice, it finds multiple use as a marker for biological age, for general health status of the brain and as an indicator for several brain-based disorders. Its utility in all these tasks depends on detecting outliers and thus failing to correctly predict chronological age. The indicative value of brain age prediction is generated by the gap between a brain’s chronological age and the predicted (...) age, the brain age gap (BAG). This article shows how the clinical and research use of brain age prediction tacitly pathologizes the states that it is sensitive to. It will be argued that the tacit character of this transformation conceals the need for its explicit justification. (shrink)

In everyday medical settings in Japan, physicians occasionally tell an elderly patient that their symptoms are “due to old age,” and there is some concern that patient care might be negatively impacted as a result. That said, as this phrase can have multiple connotations and meanings, there are certain instances in which the use of this phrase may not necessarily be indicative of ageism, or prejudice against the elderly. One of the goals in medical care is to address pain and (...) suffering that develops with age in elderly individuals, and whether or not aging is a disease is inconsequential. However, assuming that an individualized and thorough examination has been performed, there are some conditions that can be attributed only to age. Accordingly, physicians must acknowledge the merits and drawbacks of using the phrase “due to old age,” and exercise caution when using it. Both physicians and their elderly patients must share a common awareness of the incomplete and limited nature of modern medicine and its scope, and physicians must help their elderly patients accept and live with the aging phenomenon. (shrink)