Health and Well-Being

by Luke Muehlhauser on April 22, 2010 in Ethics,Guest Post

harris on morality

The ethical theory I currently defend is desirism. But I mostly write about moraltheory, so I rarely discuss the implications of desirism for everyday moral questions about global warming, free speech, politics, and so on. Today’s guest post applies desirism to one such everyday moral question. It is written by desirism’s first defender, Alonzo Fyfe of Atheist Ethicist. (Keep in mind that questions of applied ethics are complicated and I do not necessarily agree with Fyfe’s moral calculations.)

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On my own blog I have been discussing Sam Harris’ claim that morality is concerned with “the well-being of conscious creatures.”

Harris himself admitted that “well-being” is an ill-defined term. In this posting, I use desirism to give a more precise meaning to the term “well-being”. However, in doing so, I put it in the context of a theory that denies that morality is about (or exclusively about) the well-being of conscious creatures. It is a theory that states that well-being is one concern, but it may legitimately be sacrificed at times in order to realize other values.

I do this by arguing that well-being has a great deal in common with health.

The Concept of Health

Health is good.

However, health is good in the same way that circles are round and bachelors are unmarried. It is built into the very definition of the word “health” that it is not to be used to refer to something that people have no reason to realize, and particularly not to things that people only have reason to avoid.

If a particular physical or mental state does not qualify as a state that people generally have reason to obtain, then we are simply not going to say that a person in such a state is healthy. And if it is a state that people generally have more and strong reasons to avoid, then we are going to use a term that means a physical (body) or mental state that people generally have reason to avoid – namely, ‘illness’ or ‘injury’.

Now I will add some desirism to the mix to see what desirism tells us about physical and mental health – and physical and mental illness.

Recall, beliefs and desires are propositional attitudes. A “belief that P” is the attitude that P is true – that P accurately describes the world. A “desire that P” is a motivating state – a ‘reason for action that exists’ – pushing the agent towards intentional actions that create or preserve states in which P is true.

Now, let us combine the propositions that (1) health is a state of physical or mental functioning that is necessarily good, and (2) value is a relationship between states of affairs and desires.

In this case, being ‘healthy’ means that one’s body or one’s mind is functioning in a state where it functions so as to fulfill the agent’s desires. Whereas having an ‘illness’ or having an ‘injury’ means having a state of physical or mental functioning that tends to thwart one’s desires. The fact that health tends to fulfill desires gives people a reason to act so as to realize states in which they are healthy. The fact that illness and injury tend to thwart desires means that people generally have reasons to act so as to avoid being in a state in which they are sick or injured.

There are two ways in which a state can tend to fulfill or thwart desires. It can do so directly or indirectly.

A state of physical or mental functioning can be a state that a person can have a direct desire to be in (such as being in a state of having an orgasm) or avoid (such as being in a state of pain). Or it can be a state that gives a person the capacity to realize states that fulfill other desires, or deprives the individual of the capacity to fulfill other desires. The latter includes states such as paralysis, muscle weakness, blindness, deafness, forgetfulness, an inability to think or reason clearly, or delusions.

So, desirism has allowed us to give a more precise meaning of what health, illness, and injury are. It has given us an understanding consistent with the fact that people have reasons to pursue health and to avoid illness and injury.

However, it has not given us any reason to hold health up as being the sole legitimate end of human intentional actions. It has not given us reason to suggest that people cannot or ought not ever sacrifice health in order to obtain some other end.

Imagine somebody trying to argue that, when deciding whether to kiss somebody, or to have sex, or to go sky diving, or to visit exotic lands, or to go to the laboratory and conduct experiments with radiation, or in deciding what to eat at a restaurant, that the sole legitimate concern one can have is the effect of the action on their health.

Well-being

Everything I have said above about health also applies to well-being.

Well-being is necessarily good. It is a part of the very definition of the term that we will only apply it to states that people have reason to pursue. In fact, we can see this is true for well-being even more than with health, since the value-term ‘well’ is a part of the term.

When we apply desirism to this fact, then we get the conclusion that a state of well-being is a state that tends to fulfill desires, either directly or indirectly. At the same time, well-being is absent when a state is one that tends to thwart desires – either because it is a state to which most people have an aversion, or it tends to create situations that thwart desires.

The reason that health defines only a subset of that which has value is because propositions regarding the functioning of a person’s body or brain/mind are merely a subset of the propositions that can be the objects of human desire. This means that, even though health refers to states of physical or mental functioning that tends to fulfill desires, it does not capture all of the possible desires that can be fulfilled.

In other words, just as we can have beliefs that are not beliefs about how one’s body or brain are functioning, we can have desires that are not about how one’s body or brain are functioning. These are desires that may well motivate an agent to act in ways other than to promote good health.

Similarly, just as we can have beliefs that are not beliefs about being in a particular state, we can have desires that are not about being in a particular state. In the same way that people can have legitimate concerns for things other than their physical and mental health, they can have interests in things other than the well-being of conscious creatures, and those interests can well distract us from acting to realize states other than the well-being of conscious creatures.

Propositions and Value

The method I described above can also explain why health is a component of well-being. Health propositions are propositions about the functioning of a person’s brain or body and their relationship to certain desires. Well-being propositions are propositions about the state a person is in and the relation of that state to certain desires. Propositions about the state of functioning of one’s body or mind are a subset of propositions about the state that a person can be in, so health is a component of well-being. However, health is not all there is to well-being.

In the same way, propositions about the state one is in are a subset of the proposition of states that can hold value (that can be objects of desires). As a result, well-being stands in the same relationship to total value that health stands in with respect to well-being. Well-being is a component of total value, just as health is a component of well-being. However, it would be as much of a mistake to focus exclusively on well-being as it would be to focus exclusively on health.

Conclusion

The analysis above gives us a clearer understanding of both health and well-being. However, the understanding is not consistent with the claim that morality is concerned exclusively with the well-being of conscious creatures. Morality is broader than that. Morality is concerned with all states that tend to fulfill desires, either directly or indirectly. States that conscious creatures are in are just a subset of states that can have value.

- Alonzo Fyfe

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{ 4 comments… read them below or add one }

Godless Randall April 22, 2010 at 10:15 am

Morality is concerned with all states that tend to fulfill desires, either directly or indirectly.

would this mean that all intentional acts are subject to moral consideration?

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bdforbes April 23, 2010 at 4:46 pm

Could somebody please give me an example of a well-being proposition that is not a health proposition?

EDIT: Or perhaps just clarify Alonzo’s statement “However, health is not all there is to well-being.”

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rvkevin April 23, 2010 at 5:33 pm

Could somebody please give me an example of a well-being proposition that is not a health proposition?EDIT: Or perhaps just clarify Alonzo’s statement “However, health is not all there is to well-being.”  

Depends on how you define health. If you are only talking about physical health, then there are many things included in well-being that don’t contribute to physical health, but do contribute to mental health: relationships, fulfilling goals, etc.

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bdforbes April 23, 2010 at 5:39 pm

Depends on how you define health.If you are only talking about physical health, then there are many things included in well-being that don’t contribute to physical health, but do contribute to mental health: relationships, fulfilling goals, etc.  

Thanks, that makes sense.

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