How should we define 'health' and 'disease'? There are three main positions in the literature. Naturalists desire value-free definitions based on scientific theories. Normativists believe that our uses of 'health' and 'disease' reflect value judgments. Hybrid theorists offer definitions containing both normativist and naturalist elements. This paper discusses the problems with these views and offers an alternative approach to the debate over 'health' and 'disease'. Instead of trying to find the correct definitions of 'health' and 'disease' we should explicitly talk about the considerations that are central in medical discussions, namely state descriptions (descriptions of physiological or psychological states) and normative claims (claims about what states we value or disvalue). This distinction avoids the problems facing the major approaches to defining 'health' and 'disease', and it more clearly captures what matters in medical discussions. © 2009 Elsevier Ltd. All rights reserved.
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