REDEFINING HEALTH - LIVING WITH CANCER

The patients presented in this paper were being treated for cancer. No ne denied the diagnosis, and all were adhering to the medical regimen. Yet these patients also said that they were healthy in the face of th e implications of their disease and the physical toll imposed by the t reatments. The definition of health currently used by the American hea lth care system is too restrictive to encompass the perception voiced by these individuals. This paper proposes to broaden the concept of he alth to help provide a legitimate place in society for individuals wit h chronic, life-threatening illnesses. A theoretical framework is prop osed which might explain how these patients could still see themselves as healthy despite their disease. The core concept of health in this model is a sense of self-integrity, and the construct of health has tw o dimensions, Physical Status and Social Function. Individuals with ch ronic, life-threatening diseases like cancer use both of these dimensi ons simultaneously in order to negotiate and reestablish a sense of se lf-integrity based on their continued social functioning even in light of their acknowledged physical condition. Implications for restructur ing our thinking about health, disease, and the mechanisms used to cop e with cancer are outlined in order to develop a more realistic defini tion of health which is contextually based in the lives of the individ uals with the disease. The criteria for assessment would not be biolog ic integrity alone, but a complex compromise between personal needs, s ocial obligations, and physical abilities.