Ph.d. prøveforsvar ved Thor Hennelund Nielsen

Ph.d.-prøveforsvar 

Ved Ph.d.-studerende:Thor Hennelund Nielsen 

Opponent: Anna Paldam Folker

The dynamics of health and disease – can health be measured?

Contemporary trends push health care towards gaining evidence-based knowledge on the efficacy of health interventions along with the severity of states of health. To this end, patient-reported outcome measures (“PROMs”) are developed and applied. The measures are essentially questionnaires designed for (self)evaluation of health on broader dimensions like physical, psychological, and social health along with preference elicitation. The aggregated scores that the instruments yield represent a quantified assessment of the global or generic level of health and well-being of a person in certain health conditions.

However, when conceptualizing and operationalizing health into quantified and measurable items on a questionnaire, the tools implicitly rely on substantial philosophical assumptions about the nature of health and disease. In my project, I attempt to explicate the philosophical workings and assumptions of the instruments, both through a qualitative study of health professionals’ attitudes towards and uses of the instrument along with philosophical theorizing. I juxtapose these with philosophical theories of health and disease and strive to let the empirical investigations inform the theoretical and vice versa.

Throughout the four articles of the dissertation, I investigate the nature of health and disease from a naturalistic and normative as well as biological and phenomenological perspective, and whether they lend themselves to measurement and operationalization. I argue throughout that the conceptualization of health and disease in the instruments rely on fundamental simplifications of the phenomena themselves in order to make measurements, but that philosophical theories have fundamental shortcomings as well. In the dissertation, I therefore work towards providing the groundwork for a more integrative and processual conception of health and disease.