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Conceptualising Health: Insights from the Capability Approach

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Abstract

This paper suggests the adoption of a ‘capability approach’ to key concepts in healthcare. Recent developments in theoretical approaches to concepts such as ‘health’ and ‘disease’ are discussed, and a trend identified of thinking of health as a matter of having the capability to cope with life’s demands. This approach is contrasted with the WHO definition of health and Boorse’s biostatistical account. We outline the ‘capability approach’, which has become standard in development ethics and economics, and show how existing work in those areas can profitably be adapted to healthcare. Cases are used to illustrate the value of adopting a capability approach.

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Notes

  1. Boorse, of course, sees health as a matter of being able to exercise key functionings. But he restricts these functionings to survival and reproduction [4, p. 57]. Anne Gammelgaard criticises this narrow range as unsupported by biology [10, pp. 110–113].

  2. For example, Nussbaum is critical of the indeterminacy of Sen’s version of the Capability Approach and argues that “Sen needs to be more radical...by introducing an objective normative account of human functionings and by describing a procedure of objective evaluation by which functionings can be assessed for their contribution to the good human life” [19, p. 176].

  3. From here on, when we refer to ‘capability’, we mean ‘health considered as capability’ and not capability more broadly construed. How exactly these two concepts relate to each other is a major question that we hope to address in future work.

  4. This potential is at the heart of the promise we see in taking a capability approach to health. However, detailed exploration of this claim is beyond the scope of this paper, and will be addressed in future research.

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Law, I., Widdows, H. Conceptualising Health: Insights from the Capability Approach. Health Care Anal 16, 303–314 (2008). https://doi.org/10.1007/s10728-007-0070-8

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