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Human enhancement (HE) is ontologically, epistemologically, and ethically challenging and has stirred a wide range of scholarly and public debates. This article focuses on some conceptual issues with HE that have important ethical implications. In particular it scrutinizes how the concept of human enhancement relates to and challenges the concept of health. In order to do so, it addresses three specific questions: Q1. What do conceptions of HE say about health? Q2. Does HE challenge traditional conceptions of health? Q3. Do concepts of health set limits to or direct HE? Addressing Q1 reveals that HE tends to frame and form our conception of health. Thereby it challenges traditional conceptions of health (Q2). Accordingly, health does not provide strong sources for setting limits to HE (Q3). On the contrary HE seems to define and expand the concept of health. Common to the concepts of HE and health is that both depend on vague value concepts, such as happiness, well-being, or goodness. There seems to be a tendency in the HE literature to define the goal of human life in terms of what is bigger, stronger, faster, more intelligent, and more resilient. However, this is confusing "goodness" with "more" and quality with quantity. Until HE more appropriately defines happiness, HE will fail to provide a relevant compass for improving the life of human beings. On the contrary, if we let simplified conceptions of "enhancement" come to define goodness or health, we may do more harm than good. Until doing so, we may well learn from Tithonus, listen to Douglas Adams' Wowbagger, and pay attention to Virginia Woolf's Orlando. Enhanced life may not be better. The same goes for health.

The emerging concept of systems medicine (or 'P4 medicine'-predictive, preventive, personalized and participatory) is at the vanguard of the post-genomic movement towards 'precision medicine'. It is the medical application of systems biology, the biological study of wholes. Of particular interest, P4 systems medicine is currently promised as a revolutionary new biomedical approach that is holistic rather than reductionist. This article analyzes its concept of holism, both with regard to methods and conceptualization of health and disease. Rather than representing a medical holism associated with basic humanistic ideas, we find a technoscientific holism resulting from altered technological and theoretical circumstances in biology. We argue that this holism, which is aimed at disease prevention and health optimization, points towards an expanded form of medicalization, which we call 'holistic medicalization': Each person's whole life process is defined in biomedical, technoscientific terms as quantifiable and controllable and underlain a regime of medical control that is holistic in that it is all-encompassing. It is directed at all levels of functioning, from the molecular to the social, continual throughout life and aimed at managing the whole continuum from cure of disease to optimization of health. We argue that this medicalization is a very concrete materialization of a broader trend in medicine and society, which we call 'the medicalization of health and life itself'. We explicate this holistic medicalization, discuss potential harms and conclude by calling for preventive measures aimed at avoiding eventual harmful effects of overmedicalization in systems medicine (quaternary prevention).

Unlabelled: This first-in-human study investigated the safety, tolerability, metabolism, pharmacokinetics, biodistribution, and radiation dosimetry of (68)Ga-bombesin antagonist (68)Ga-DOTA-4-amino-1-carboxymethylpiperidine-d-Phe-Gln-Trp-Ala-Val-Gly-His-Sta-Leu-NH2 (BAY 86-7548)., Methods: Five healthy men underwent dynamic whole-body PET/CT after an intravenous injection of BAY 86-7548 (138 ± 5 MBq). Besides total radioactivity, plasma samples were analyzed by radio-high-performance liquid chromatography for metabolism of the tracer. Dosimetry was calculated using the OLINDA/EXM software., Results: Three radioactive plasma metabolites were detected. The proportion of unchanged BAY 86-7548 decreased from 92% ± 9% at 1 min after injection to 19% ± 2% at 65 min. The organs with the highest absorbed doses were the urinary bladder wall (0.62 mSv/MBq) and the pancreas (0.51 mSv/MBq). The mean effective dose was 0.051 mSv/MBq. BAY 86-7548 was well tolerated by all subjects., Conclusion: Intravenously injected BAY 86-7548 is safe, and rapid metabolism is demonstrated. A 150-MBq injection of BAY 86-7548 results in an effective dose of 7.7 mSv, which could be reduced to 5.7 mSv with frequent bladder voids.

This article analyses the different connotations of "normality" and "being natural," bringing together the theoretical discussion from both human medicine and veterinary medicine. We show how the interpretations of the concepts in the different areas could be mutually fruitful. It appears that the conceptions of "natural" are more elaborate in veterinary medicine, and can be of value to human medicine. In particular they can nuance and correct conceptions of nature in human medicine that may be too idealistic. Correspondingly, the wide ranging conceptions of "normal" in human medicine may enrich conceptions in veterinary medicine, where the discussions seem to be sparse. We do not argue that conceptions from veterinary medicine should be used in human medicine and vice versa, but only that it could be done and that it may well be fruitful. Moreover, there are overlaps between some notions of normal and natural, and further conceptual analysis on this overlap is needed.

The concepts of health and disease are crucial in defining the aim and the limits of modern medicine. Accordingly it is important to understand them and their relationship. However, there appears to be a discrepancy between scholars in philosophy of medicine and health care professionals with regard to these concepts. This article investigates health care professionals' concepts of health and disease and the relationship between them. In order to do so, four different models are described and analyzed: the ideal model, the holistic model, the medical model and the disjunctive model. The analysis reveals that each model has its pros and cons, and that health care professionals appear to apply more than one models. Furthermore, the models and the way health care professionals' use them may be helpful for scholars in philosophy of medicine with regard to developing theories and communicating them to health care professionals.

The main problem of modern health care is to express its goals and its limits. To do this it is necessary to answer the fundamental question: what is normal and what is pathological? The French physician and philosopher Georges Canguilhem has tried to answer this question. He claims that for medicine, the difference between these fundamentals is determined by normativity and not by science. In doing this he wishes to save the autonomy of the individual patient and to delimit medicine from science.