PLEASING DESIRES OR PLEASING WISHES? A NEW APPROACH TO HEALTH DEFINITION by ProQuest

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									Vol. 25:1 Spring 2009




G U EST C O M M E N TA RY


Pleasing Desires or Pleasing Wishes? a
neW aPProach to health Definition
C A R LO V. B E L L I E N I , M D, A N D G I U S E P P E B U O N O C O R E , M D


Abstract
It is difficult for caregivers to have clear awareness of their aim, health, because the
present WHO definition of health has widely been criticised as utopian and misleading.
It might be helpful to consider health as the realisation of our desires, that is, the
possibility of restoring previous skills or to perform skills the average person can
perform. Desires differ according to age and possible underlying pathologies; even the
possibility of expressing them can be different. So we outline some consequences: 1)
health will be attained even in the presence of a disease, if the desire of the patient is not
the disappearance of the disease—he/she is aware of the ineluctability of the disease—
but is orientated to obtain other gratifications; 2) even nonverbal patients can express
desires, so health can be in their range; 3) considering health not as the realization of
desires but of wishes may contrast with the principles of justice and non-maleficence, as
will be highlighted in the text.
Key words: health, medicine, desire


Recently A. Stark highlighted the limit to medical activity as a hot topic1: should medical
professionals avoid commercial pressures and fashion-determined requests or impose
certain cures? And how can they recognize their true endeavours and goals? B. Brülde
recently wrote that medicine has at least seven plausible goals that are irreducible to
each other, namely, to promote functioning, to maintain or restore normal structure and
function, to promote quality of life, to save and prolong life, to help the patient to cope
well with her condition, to improve the external conditions under which people live, and
to promote the growth and development of children. This gives room for some concern,
he says: it does not seem reasonable, for instance, to improve physiological function or
functional ability unless this is expected to have positive effects on quality of life and/or
length of life or to improve the quality of life in any respect or by any means.2 Thus,
when we say that physicians should “cure,” should they please without limits?
     The current World Health Organization (WHO) definition of health is clearly
misleading. The sweeping definition of health contained in the Preamble to the
Constitution of the WHO, signed in July 19 and effective in 198 in accordance with
Article 80 of the Constitution, has generated
								
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