反思“健康”:以免疫学为视角

Reflections on “Health” from the Perspective of Immunology

基于免疫学中的三种情况:免疫系统在癌症、母婴遗传和异种移植中的作用,审视关于“健康”的哲学争论。自然主义、传承了自然主义的倾向主义,以及建构主义所刻画的“健康”概念都难以在上述三种情况中良好运用。考察有机体在生理的、自然的层面上是否出现问题,以及出现的问题是否能够带来“好”的结果,并基于此给予价值判断是一种更好的刻画“健康”的进路。进行价值判断意味着会引起想象和期待:通过医疗干预能够“恢复健康”,这种期待和医学知识不可避免的不确定性之间存在张力,一旦期待落空,会破坏患者福祉。因而,免疫疗法等前沿方法的实际运用与临床研究中,仍然要求审慎对待“恢复健康”之类可能会对患者带来过高期待的表述。

The philosophical debate on “health” was examined based on three situations in immunology:the role of the immune system in cancer,maternal infant inheritance,and xenotransplantation.The concepts of “health” depicted by naturalism,dispositionalism inherited from naturalism,and constructivism are difficult to be well applied in the above three situations.Examining whether there is something “go wrong” in the organism on physiological and natural levels,and whether the occurrence of “wrong-goings” can bring “good” results,and then giving value judgments based on them,is a better approach to characterize “health”.Conducting value judgments means arousing the imagination and expectation:there is a tension between the expectation that “health can be restored” through medical intervention and the inevitable uncertainty of actual medical knowledge.If expectation failed,patients' well-being would be undermined.Therefore,in the clinical application and research of cutting-edge methods such as immunotherapy,it is still required to be cautious about statements such as “restoring health” that may bring excessive expectations to patients.