Hegel developed a philosophy of action in which the spirit is always active in the search of some aim, in realizing one’s potential or self-actualization. Hegel believed history is a progressive realization of freedom. Feuerbach’s critique of Hegel’s philosophy is that (any) idealism is an impediment to human freedom and self-understanding. Feuerbach believed that religion must be exposed as a purely human creation in order that humans may become self-conscious and free. For Marx history is the progressive development toward the socialization of the means of life. Money is impediment to human freedom and self-understanding. Marx avoided the idea of humanness or individualism in order to focus his theory on capital, the proletariat and surplus value to strengthen his theory, as he led the revolt of labor against capitalism.
In the 19th century two philosophers, Søren Kierkegaard and Friedrich Nietzsche, stood out with their reaction against the ‘impersonal’ rationalism of the Enlightenment, and stressed the importance of the individual. Kierkegaard (1813-1855), the ‘father of existentialism,’ believed that one must choose one’s own way without the aid of universal objective standards. Against the traditional view that moral choices involved an objective judgment of right and wrong, existentialists argued that moral choice involved objective judgments of right or wrong. It was necessary to create one’s own values in a world in which traditional values no longer governed. For Kierkegaard, the real problem of life was to discover one’s true talent, secret gift, authentic vocation.
For Nietzsche, the values (culture and traditions) of the dominant society (with an ideology consistent with its interests) were oppressing the emergence of a new generation of stronger individuals and a more vigorous society and culture. Darwin effectively showed that searching for a true definition of species was not only futile but unnecessary since the definition of a species is something temporary, something which will change over time, without any permanent, lasting and stable reality. Nietzsche strived through his philosophical work to do the same for cultural values. He substituted Darwin’s adaptive fitness with creative power – for Nietzsche, everything is in flux. Ideas should change as soon as information and input changes. The goal of the good life was self-fulfillment achieved by overcoming the conflicts in both natural and cultural environments through free personal choices.
After the Second World War, Friedrich Hayek (1899-1992), one of the most important economists of the 20th century, developed a definition of freedom by blending the ideas of John Locke and Adam Smith to create a social contract that supported laissez-faire capitalism. His writings had a major influence on market liberalization strategies, which included discrediting government economic planning. Hayek observed: “Equality of the general rules of law and conduct, however, is the only kind of equality conducive to liberty and the only equality which we can secure without destroying liberty. Not only does liberty have nothing to do with any other sort of equality, but it is even bound to produce inequality in many respects. This is the necessary result and part of the justification of individual liberty: if the result of individual liberty did not demonstrate that some manners of living were more successful than others, much of the case for it would vanish.”[i]
In his book, Road to Serfdom, published in England in 1944, Hayek developed ideas defending capitalism while attacking socialism. The problem with Soviet Russia and Nazi Germany, Hayek claimed, was not (only) the non-democratic nature of the political systems, but the (centralized) economic planning being pursued. He warned “most of those who want to restrict private initiative in economic life do so in the hope of creating more freedom in spheres which they value higher [but it]… is not possible without a thorough curtailment of individual liberty.” Hayek claimed, small government, free markets, low taxes, would provide prosperity in the long run.[ii] With the election of Ronald Reagan in 1980, these economic ideas went mainstream in the West.
The World Health Organization (WHO), defined health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” Wellness was not just absence of negative elements (illness and disease) but the presence of positive elements (physical health and happiness). Wellness is about reaching one’s full potential as a person. Wellness is a decision we make, and we take personal responsibility for achieving it. The WHO defines wellness as the optimal state of health of individuals and groups. There is a growing body of evidence about what makes people healthy.
Inequities reduce the freedom and opportunities for an individual to achieve wellness or good health and, in particular, to reach his full potential. The facts are, as income inequality increases, social mobility decreases. Reduced income translates to reduced wellness – the process by which a person is always seeking and moving towards his or her own highest potential – being the best you can possibly be. A big part of wellness is having meaning in one’s life and the sense that one is contributing to the world whether it be making a difference in the lives of friends and family, ecology or vocation. This has a great deal to do with attitude. Not surprisingly, much stress in in society can be attributed to economic inequality. In fact, economic inequality may have more of effect on our overall health than any other single factor. Research has shown economic inequality to be a primary cause of illness.[iii]
The completion of the human genome project in 2003, also saw the demise of the genetic paradigm and the revival of the epigenetic approach. From believing that our biological fates were written in our genes, it was now recognized that the environment, and more specifically, our perception of the environment, directly controls our behavior and genetic activity. Epigenetics is the new science that studies the complex mechanisms of genes being turned on and off according to environmental ques. The genome is very stable; mutations are seldom. On the other hand, the environment is very volatile. In order for the species to survive the genome has mechanisms that respond to the volatile environment by turning on and off genes. As the environment can influence genes, lifestyle can impact the expression of our genes. Early studies show an association between epigenetic marks (in the human genome) and socio-economic status. This has implications for population health and chronic diseases like cardiovascular disease.
Epigenetics brings another dimension to self-care. Behaviour and environment can affect how genes are expressed. Epigenetics empowers people to take control of their health by making choices that may override their genetic code, such as diet, exercise, and personal attitude. An individual needs to access this epigenetic information, thus, he requires access to health care for prevention, appropriate monitoring and treatment. Much of health care is about prevention; as well as it maintains, or restores functioning (capacity) that is normal for an individual.
Through public policy and health protection, epigenetics provides a mechanism (for all) to assess their environment and adjust their genetic response accordingly. Various factors – diet, life styles and environmental exposures, can affect the epigenetic status of humans (and other organisms), helping to create their environment. Environmental events play a role in evolution by altering the way our genes are or are not expressed. Such alterations are temporary and reversible, but they can still be passed on, meaning that conditions affecting a parent may also affect the offspring of that parent. A wide range of environmental social and nutritional exposures can dramatically control how genes are expressed without changing the underlying DNA. How we develop mentally and physically has a impact upon our inherent capabilities and our set of life options. Wellness is control over how our genes are expressed or used – about turning off adverse genes and expressing healthy ones.
In the 21st century, the epigenetics revolution is rewriting our understanding of genetics, disease, and inheritance. Individuals are much more sensitive to exposures from their environment, diet and lifestyles than previously thought. Epigenetics identifies that certain exposures to toxins, especially during periods of developmental vulnerability, can cause long-term harm to exposed individuals, and sometimes their progeny. Environment and food play key roles in epigenetic changes and in the development of chronic diseases. Epigenetic control of our genes represents a fundamental shift in the way we understand our world. Because of the role epigenetics plays in human development and in disease causation, there is an important role in regulating epigenetic harms.
Epigenetic harms impact on an individual’s capabilities or freedom of life choices. Preserving human potential as a freedom and protecting human capabilities in an equitable manner from epigenetic harms become an important aspect of public health goals. In the capabilities approach people are in a position to avail themselves of the freedom and have choices and opportunity – not affected by access to education and healthcare. Such a system protects the individual’s opportunity to pursue functions (by choosing meaningful ends) within their developing capabilities set. Regulation of epigenetic risks is challenging; risks cannot be calculated with any certainty. The capabilities approach addresses (1) what impacts do particular epigenetic risks have on our ability to exercise free choices? (2) are these risks avoidable? (3) and how are these risks distributed across society? The June 1992 Declaration of the Rio Conference on Environment and Development, Principle 15 reads: “In order to protect the environment, the precautionary approach shall be widely applied by States according to their capabilities. Where there are threats of serious or irreversible damage, lack of full scientific certainty shall not be used as a reason for post-postponing cost-effective measures to prevent environmental degradation.”[iv]
For the protection of all members of the community, a new regulatory framework is required to address epigenetic risk from specific substances (food and environmental chemicals), even if conclusive proof of disease causation cannot be established. It is necessary to introduce the requirement of generating epigenetic risk data to producers of suspected harmful substances. When evidence gives us good reason to believe that an activity, technology, or substance may be harmful, we should act to prevent harm – to protect public health, environment and the future of our children. If we always wait for scientific certainty, people will suffer and die and the natural world may suffer irreversible damage. The goal is to protect human capability in an equable manner.
Why is this important now? Harmful toxins have accumulated over the years, and many have been identified as epigenetic harms associated with chronic disease. Epigenetics explains how environmental factors can switch genes on and off, based on choices we make. Epigenetic studies will predict what environments need to be created womb to tomb in order to protect us, and minimize the risk of chronic diseases.
Wellness is not about the absence of disease. Wellness is control over how our genes are expressed or used – about turning off adverse genes and expressing healthy ones. It is movement towards the highest genetic potential, in which a person is always seeking and moving towards his or her own highest potential – being the best you can possibly be. Living life to the fullest possible extent is made possible by life style changes, which enhance physical, mental and spiritual health.
Wellness is about reaching one’s full potential. Controlling epigenetic harms, or environmental harms, is about treating an individual’s potential as a freedom. The environment, heredity, chance, friends, luck, (things over which one has little control), plays a greater role in wellness than personal life style choices. Governments have a role in preserving human potential as a freedom.[v] The amount of good health or wellness an individual enjoys is a more important measure of freedom than the amount (size) of government or taxes enjoyed.
[i] Hayek, Friedrich A. “Equality, Value and Merit.” < http://www.woldww.net/classes/General_Philosophy/Hayek-equality.htm>.
[ii] Hayek, Friedrich. (07 Jan 2010) “What Price a Planned Economy.” http://mises.org/daily/4004
[iii] Rabin, Mitchell. “The Stress of Inequality and its Powerful Effect on Health.” (12 March 2011) <http://www.naturalnews.com/031674_inequality_health.html>.
[iv] “Rio Declaration on Environment and Development.” <http://www.unep.org/ Documents.Multilingual/Default.asp?documentid=78&articleid=1163>.
[v] Khan, F. “Preserving human potential as freedom: a framework for regulating epigenetic harms.” <http://www.ncbi.nlm.nih.gov/pubmed/21243846>.