Health, health care and the problem of intrinsic value

Philosophical conceptual attempts to clarify the nature of health frequently alight on the idea that its value is intrinsic. It is asserted that health is a value in itself and as such can be abstracted from thoughts of preference or utility (subjective or instrumental value). In contrast, I argue here that it is highly problematic to conceive of the value of health in terms other than the instrumental. We value health for what it leads us to. The mistaken idea that health has essential intrinsic value is very often associated with attempts to justify the production of 'more health' through health promotion and public health interventions, possibly by authoritarian means. I argue that seeing health as properly instrumental in value supports liberal interpretations of the purpose and methods of health care (including public health and health promotion) and weakens justifications for authoritarian policy and practice. However, such liberal interpretations may pose real difficulties for occupational or professional direction in the field, and for the disadvantaged within health care systems.