Venkatapuram's Capability theory of Health: A Critical Discussion

Abstract

The discussion about theories of health has recently had an important new input through the work of Sridhar Venkatapuram. He proposes a combination of Lennart Nordenfelt's holistic theory of health and Martha Nussbaum's version of the capability approach. The aim of the present article is to discuss and evaluate this proposal. The article starts with a discussion of Nordenfelt's theory and evaluates Venkatapuram’ critique of it, that is, of its relativism, both regarding goals and environment, and of the subjectivist theory of happiness used. Then the article explains why Nordenfelt's idea of a reasonable environment is not a problem for the theory, and it critiques Venkatapuram's own incorporation of the environment into the concept of health, suggesting that this makes the concept too wide. It contends, moreover, that Venkatapuram's alternative theory retains a problem inherent in Nordenfelt's theory, namely, that health is conceived of as a second‐order ability. It is argued that health should, instead, be defined as first‐order abilities. This means that health cannot be seen as a capability, and also that health cannot be seen as a meta‐capability of the kind envisioned by Venkatapuram. It is, furthermore, argued that the theory lacks one crucial aspect of health, namely, subjective wellbeing. Finally, the article tries to illustrate how health, in the suggested alternative sense, as first‐order abilities, fits into Nussbaum's capability theory, since health as an ‘actuality’ is part of all the ‘combined capabilities’ suggested by Nussbaum.

Nursing home staff experiences of implementing mentorship programmes: A systematic review and qualitative meta‐synthesis

“…On the basis of Sen's capability theory, Nordenfelt pointed out that internal capabilities (e.g. occupational skill) are crucial and dynamic, requiring training in order to develop (Tengland, ). Many nurses with a high educational background, such as APNs, have acquired relevant knowledge and skills, but lower‐level employees, such as nursing assistants, may need additional training to improve their capabilities to guide mentees.…”

Health and capabilities: a conceptual clarification

“…22 Some degree of health, especially mental health, is required for all functionings (and is, thus, part of all capabilities), such as to freely move around (which requires the abilities to stand, walk, and hold one's balance), to play (which often requires the basic abilities to move and imagine), establish affiliations (which requires the disposition to experience emotions), make reproductive choices (which requires the ability to think and deliberate), live with other species (which requires basic perceptual abilities), control the environment (which requires critical reflexivity), seek employment (which requires basic psychological motivation), and make political choices (which requires basic reasoning capacity). Thus, (some degree of) health, as an 21 And it is probably not the view intended by Nussbaum, even though my discussion of it (Tengland 2016) in relation to Sridhar Venkatapuram's theory (2011) made it appear a second-order one. Note, however, that for some kinds of capabilities the second-order ability might suffice.…”

“…Sridhar Venkatapuram has, however, developed a theory of health, in relation to the capabilities theory. For a discussion of his theory, seeTengland 2016, where I initially introduced some of the ideas developed here. 6 I will, however, stick to writing "capability", since all capabilities have to be combined ones, that is, every being and doing (and feeling) requires both (internal) ability and (external) opportunity (seeNussbaum 2011, p. 20).…”

“…Note that the individual should not only have acquired the abilities (etc.) in question, but also be able to use them here and now (given that the environment is acceptable), in order to be considered healthy.15 Briefly, health-related, subjective well-being (and suffering) is those kinds of sensations and moods that have their immediate cause within the person(Tengland 2007(Tengland , 2016, for example, feeling fit, or experiencing pain. Much more will not be said about subjective wellbeing, since this aspect of health is less important for the capabilities than abilities.16 This claim might have to be qualified.…”

Philosophical investigations of socioeconomic health inequalities

“…This criterion generally says that judgments about p's health have to take into account the circumstances in which p finds her/himself. See for discussions on this Venkatapuram (2013), Nordenfelt (2013), andTengland (2016).…”