Equality and Health

Health status is the most individual of all private possessions: always attaching to a single patient, never the property of a collectivity or a group, it can never be as important as the spirit or the soul but it is for all that a not insignificant part of that unique self that each one-off human has in mind when he tentatively ventures the philosopher’s auto-definition that ‘I am I’. A case of dysentery brought on by a superannuated hamburger is, far more than a mouldy statistic in a dusty office, a young girl’s grief at having to miss her elder sister’s first wedding. An earthquake in Lisbon, a minor nuisance to the holiday maker forced to relocate from the Estoril to the Algarve, is a major calamity to a manual labourer rendered paraplegic by a collapsing bridge. A famine in Africa, front page news throughout the journalised world, is a current affair with a personal meaning not captured by the media to a peasant farmer who starves to death in the drought. Health status is a quintessentially individual thing, and of this at least there can be no doubt: whatever the bystander may feel when learning of the child laid low by dysentery, the worker crippled in the earthquake, the agriculturalist wiped out by the famine, that reaction is likely to be as nothing when compared with the sensations that the afflicted parties themselves experience. A man would be more upset by the loss of a finger, Adam Smith predicted, than if ‘the great empire of China, with all its myriads of inhabitants, was suddenly swallowed up’1.