A Tyranny of Health?

By Theodore Dalrymple


The dream of a society so perfect that no one will have to be good (as T.S. Eliot put it) is a beguiling one for intellectuals, perhaps because they think that they will be in charge of it, as a recent article in the Journal of the American Medical Association titled “The Moral Determinants of Health” well illustrates.

In this article, which has the merit of being clear and logical, no single instance of individual conduct is mentioned as being necessary for, or conducive, to health. In the healthy society envisaged by the author, who is a public health doctor in Massachusetts, no one will have to try to behave well—not drink or eat too much, refrain from smoking or taking drugs, not indulge in hazardous pastimes, take recommended but safe exercise and so forth—because everything will come as a matter of course to him. Living in a perfect society, he will behave perfectly. The author’s means of achieving these ends are entirely political, and wildly impractical examples of progressivism without practical wisdom—and as such, unremarkable.

More troublingly, in the author’s view, at least implicitly, health is the goal of goals to which all other considerations ought to be subordinate. It is perhaps natural for a doctor to think this, concerned as he is, day in, day out, with the health of others, but nevertheless this is a very reductive view of life.

It goes almost without saying that health is desirable; no one would actually prefer to be unhealthy than healthy, though a considerable number do prefer to claim to be unhealthy, or unhealthier than they are. But we should remember that a life is not well- or badly-lived according only to its length. Mozart died at thirty-six, but would anyone say that his life would have been better-lived had he survived to seventy-two but without having composed any of his music? People, moreover, sacrifice their lives for any number of reasons, from the noblest to the most ignoble. Would anyone say that Martin Luther King lived badly because he exposed himself to assassination, which a nice quiet life would not have done? As is known, assassination is bad for the health; we do not say, therefore, that people who tell the truth despite threats are bad because they betray the cause of health and thereby lower (albeit infinitesimally) life expectancy in their society.

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