But it seems evident that anyone habilitated to a substantial level of physical and psychological positive health will thereby have the capacity (in some circumstances) for a favorable balance of pleasant over unpleasant experience, the fulfillment of a satisfactory level of fully informed desires, a fully informed, autonomous and positive form of life-satisfaction, some basic level of the realization of ones potential, and threshold levels of at least some items on any plausible list of elements of a good life. Without the persistence of underlying healthy traits, the occurrent states themselves are unstable, unreliable, and often damaging. One is habilitative, by giving attention to the ways in which such injuries can either be prevented or made survivablefor example, by getting agreements between belligerents not to use chemical or biological warfare; by improving the speed with which traumatic injuries are fully treated; by the use of better body armor. The elimination of physical disease, deficit, disorder, or distress is not enough to stabilize and sustain physical health. This is used to develop a theoretical structure and classification scheme for work in positive psychology. Another is the identification of health with complete physical, mental, and social well-being. The model looks at the biological factors which affect health, such as age, illness, gender etc. Positive psychology does, however, include a complex, so far largely programmatic, stream of work from many investigators that is directly relevant to a eudaimonistic conception of complete health3in which the causal connections and correlations between mental and physical, positive and negative dimensions of health are systematically explored. To clinch the connection to eudaimonism, Haybron makes clear that there is one other important similarity. So the presence of positive mood propensities (and their preponderance over any such negative propensities? A stable, favorable social environment. Given the prominence of the definition, as well as the fact that some of the criticism of it has come from prominent philosophers working in bioethics (see the overview in Bok, 2008), it is probably wise to say a word here about its relation to the eudaimonistic conception of health I will propose. Rather, it is about whether the large body of literature on hedonic measures should now be revised to include both eudaimonistic and hedonic ones. This pretheoretical choice has unfortunate results. The soft-pedaling of the purely affective dimension of happiness comes in part from the pressure philosophers are under to respond to several important types of objections to incautious accounts of affective well-being: the objection that strong affective experience on either side of the ledger frequently distorts sound perception, deliberation, judgment, and decision making; the objection that decision making with a strong affective component can overwhelm virtuous intentions and virtuous traits of character, leading to behavior that is irrational, or inconsistent with justice; the objection that ordinary conceptions of happiness must be corrected to make clear that genuine well-being and happiness require that justice and the moral virtues generally take priority over pleasant affective states; and. Other work to which Keyes refers, and other chapters in the Oxford Handbook, are also of interest for present purposes. For present purposes, the general concept of basic justice is limited to practicable, enforceable requirements. That would lead one to believe that the books target is mental health rather than mental illness. But when such things become popularized as standard treatments, and when such standards bear a suspicious resemblance to independently motivated social norms that underlie racism, sexism, homophobia, or other forms of oppression, programs designed to pursue positive health can do widespread damage. Good medical habilitation and rehabilitation aims at achieving such positive health. The reasoning is simple: (1) It is wholly implausible to think that ill health is not part of the subject of basic justice. But what cannot be missed is that it also includes much more than health. And in both contemporary psychology and eudaimonism, there is a close connection between healthy human development and basic character traits associated with virtue. The book groups traits under six major headings, each corresponding to a constellation of items identified, cross-culturally, as a core virtue. If not, then the conception of eudaimonistic health will not be sufficient for present meta-theoretical purposes. All of this tends to reinforce the practice of marginalizing or excluding altogether from clinical medicine much of what eudaimonistic theorists think of as healthleaving it in the hands of people interested in soft things like flourishing, a good life, wellness, holistic health, happiness, joy, and quality-of-life issues rather than health, strictly defined. Perfect health and perfect virtue are quite evidently beyond those limits. It is proposed that eudaimonic well-beingif explored, understood, and implemented in a manner that holds true to the purity of the conceptoffers significant promise for shifts in health. And for purposes of basic justice, we are not yet much closer to an understanding of the point at which declines in health must become a matter of concern for normative theories of basic justice, and at which further improvements in health can reasonably be assigned to something other than basic justice. But in the eudaimonistic tradition, to be a healthy adult is by itself to be equipped with at least rudimentary forms of the traits we call virtues when they are more fully developed: courage, persistence, endurance, self-command, practical wisdom, and so forth. Rehabilitation medicine also gets attention in the context of epidemicsand sometimes just in the context of celebrated cases. Ancient Greek eudaimonists do not make a sharp distinction between psychological health and well-being, or between health defined negatively (as the absence of disease, deficit, or injury) and health defined positively (as the presence of stable, strong, and self-regulating traits that contribute to something more than mere survival). Thepsychological factors: individual beliefs & perceptions. Emotion. They seem to run all the way through us, in some sense, feeling like states of us rather than impingements from without. That fits well enough with eudaimonism, and also seems uncontroversialunless one reads it as an attempt to construct the definition of health in ethical terms rather than in terms of physiological and psychological science.2 But it is not necessary to read the notion of complete health in this way, as the subsequent discussion in this chapter and the next two chapters will show. n organized into four models-clinical, role performance, adaptation, and eudaimonistic. These core virtues are defined in terms of various kinds of strengthfor example, wisdom, courage, temperance, justice, and so forth (Peterson and Seligman, 2004, 2930). With respect to fully functioning adults, it then seems unremarkable to treat health as one thing in a list of instrumental goods. The habilitation framework requires the adoption of a notion of complete healththat is, a unified conception of good and bad health, along both physical and psychological dimensions, in a given physical and social environment. (5) And if the same thing is true about purely psychological happiness (psychic affirmation or psychic flourishing), it too will be part of the subject matter of basic justice. This chapter develops the notion of eudaimonistic healtha conception of physiological and psychological good as well as bad health. Health includes both role performance and adaptive levels of health. An example is the National Health Information Survey conducted annually in the United States by the National Center for Health Statistics, part of the Centers for Disease Control.). The existing philosophical literature on the nature of happiness or a good life is replete with discussions that mention health in passing. Consider, for example, the massive Character Strengths and Virtues: A Handbook and Classification (Peterson and Seligman, 2004). Conceptions of the good life vary a good deal more than conceptions of basic moral development. Eudaimonia has a rich and ancient history pertaining to human development and health, but only recently has it begun to move out of its understudy role to happiness, which has held the starring . Unless this point is understood, however, a eudaimonistic conception of health can be troublesome in a contemporary context. These mood propensities do not immunize us from negative affective experience, but rather tend to bring us back to the positive kind. Furthermore, research and clinical work on even this limited form of positive health seem fragileoften considered along with other enhancements that are only indirectly related to genuine health matters. Adults who meet neither the criteria for flourishing or languishing are scored as moderately mentally healthy (90). Theories of basic justice still have to construct accounts of basic goods, and basic health.). Intheadaptivemodelofhealth,theoppositeendofthecontinuumfromhealthisillness. Finally, Rogers' model considers the community as a field in itself. Nonetheless, by the time this is pointed out we may be so attached to the theory we have worked out that it is hard to see the need for fundamental change. Christopher Boorse is a leading advocate of the attempt to give a purely descriptive definition, free of ethical content. But it is not so clear where, if at all, we should draw the line and say that progress toward better and better health will cease to track moral development in this way. This chapter develops the notion of eudaimonistic healtha conception of physiological and psychological good as well as bad health. Obvious objections to be met, again, include cases in which the desires might be inauthentic, self-defeating, not fully informed, not equivalent to rational need-satisfaction, or not congruent with basic justice. The same is true of clinical medicine. The argument for including functional well-being is obvious: mental health is mostly about positive functioning and appropriate or functional affect, just as mental illness is mostly about dysfunctional behavior and inappropriate or dysfunctional affect. And it is standardly recognized that such levels of positive health need to be high enough to be maintained in a reasonable range of challenging environments. It appears that this dispute is not about the importance of both of these dimensions of well-being itself. There are two main theories that fit nicely under the umbrella of eudaimonic well-being: The model of psychological well-being and self-determination theory. It seems a natural step to go from this to giving more emphasis to the health-oriented agenda of positive psychology and connecting it explicitly to a conception of complete healththat is, an integrated conception of physiological and psychological factors, along negative and positive dimensions with respect to health, together with the environmental factors that make it possible. The range of things that health insurance schemes will pay for is a reflection of thisand of the fear that extending the definition of health into the positive side of things will be completely unmanageable.