Pluralistic (or multi-factorial) if two or more of the above considerations are combined into a single definition. In my own tentative view, a person’s position in the health-illness dimension is a function of their respective positions in five different dimensions, their clinical status, or organ function, their ‘ability to perform’, to use the abilities they have, to what extent they have certain relevant basic abilities, what their health-related mood state is like and how pleasant-unpleasant their health-related bodily experiences and emotions are.


The first of these dimensions is ‘biomedical’, the following two are functional, and the last two concern the person’s well-being. Another way to accommodate all three definitions is to introduce a distinction between fundamental health and manifest health. A person’s manifest health can vary from day to day, it gets worse when we catch colds, and it can be temporarily improved by different forms of doping or recreational drugs. To have good manifest health is roughly to be in good shape.


A person’s fundamental health is of a more dispositional or resourcelike kind, and it remains intact when she is struck by the flu. Fundamental health is to a considerable extent a matter of how resistant and resilient one is, and it determines how disposed one is to fall ill or to die prematurely. Now, it seems that manifest health is mainly a matter of (health-related) functioning and well-being, whereas fundamental health is more of a biomedical matter. In this way, all three definitions can be accommodated.