Chapter

Health as the Capacity for Action

Mark D. Sullivan

in The Patient as Agent of Health and Health Care

Published on behalf of Oxford University Press

Published in print December 2016 | ISBN: 9780195386585
Published online December 2016 | e-ISBN: 9780190651336 | DOI: https://dx.doi.org/10.1093/med/9780195386585.003.0006
Health as the Capacity for Action

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Objective definitions of health and disease are favored because they promise a value-free measure of health problems and health care needs. But objective health does not simply cause the subjective experience of health. Self-rated health predicts mortality, disability, and hospitalizations for up to a decade after controlling for objective measures of health. Objective tissue abnormalities cannot be discovered to be pathological without reference to the experiences of patients acting in their natural environment. Patients adapt to chronic illness and its functional deficits over time with real improvements in their quality of life. Problems like pain and depression do not distort quality of life assessments, but are at their core. Since neither objective nor subjective models of health are valid, we must derive a different model: health as capacity for action. Any adequate approach to health must foster the patient’s sense of agency, her capacity to achieve her vital goals.

Chapter.  11131 words. 

Subjects: Medical Ethics

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