Applying McMurtry’s Life-Value Framework to Disease and Health

McMurtry’s Life-Value Onto-Axiology: Prioritizing Life Over Profit

John McMurtry’s life-value onto-axiology is a philosophical framework that defines value in terms of what sustains and enriches life. He introduces concepts like the life-ground – “all the conditions required to take one’s next breath,” or essentially the total natural and social conditions that life depends on​. In this view, life value is “whatever enables life capacities,” and life capital is the means of life that can generate more life (for example, resources like food, water, clean air, knowledge that, when used, lead to more life without depletion)​. McMurtry contrasts the life sequence of value (Life → Means of Life → More Life) with the dominant money sequence of value that drives modern economies​. In a healthy life sequence, economic activity is judged by how it sustains or expands life – for instance, providing clean air, nutritious food, shelter, and other “means of life” that allow people to survive and develop​. By contrast, the money sequence often pursues profit regardless of damage to life or health, and it can even turn destructive – for example, Money → Means of Life Destruction → More Money (as seen when industries profit by harmful products or environmental damage)​. McMurtry argues that the ruling economic paradigm fails to register these “life-losses” in its value accounts​. In other words, market systems count money gains while ignoring the erosion of life-supporting conditions – a life-blindness that his onto-axiology seeks to correct​.

Under McMurtry’s life-value framework, institutions and policies should be evaluated by how well they serve the universal life necessities – those things without which life is reduced or destroyed​. This approach inherently challenges any system (economic, political, or medical) that puts monetary or institutional imperatives above the fundamental requirements of life. McMurtry even characterizes an unrestrained market as “inefficient and life-destructive” to the extent that it is not regulated by life needs​. His well-known critique of capitalism in The Cancer Stage of Capitalism uses a medical analogy: unchecked financial capitalism behaves like a cancer in the social body, multiplying profit for its own sake while “dismantling environmental and civil life-fabrics”​. In that book, he develops the idea of the civil commons – shared public resources and services that provide for life needs – and conceives of them as society’s “social immune system.” Just as an immune system protects a body, the civil commons (public health systems, environmental protections, education, etc.) protect and sustain the community’s life capacities​. A life-value onto-axiological perspective thus insists that preserving and expanding these life-support systems is the ultimate criterion for “value,” trumping narrow economic gains when the two are in conflict​.

Rethinking the “Natural History of Disease”

In epidemiology, the natural history of disease refers to the progression of an illness in an individual from onset to outcome without intervention​. It’s often presented as a straightforward biological timeline: for example, exposure to a pathogen leads to subclinical changes, then symptoms, diagnosis, and finally recovery or death​. Traditional medical perspectives tend to treat this progression as an inherent, almost automatic path dictated by biology. McMurtry’s life-value approach urges us to critique and reframe this concept by recognizing that what appears “natural” is profoundly shaped by social and environmental conditions. In reality, disease progression is not a simple biomedical destiny; it is socially conditioned at every step. As the World Health Organization’s landmark commission on social determinants put it, “Biology does not explain” why people a few miles apart have vastly different health outcomes – the differences “result from the social environment where people are born, live, grow, work and age”​. In other words, the course a disease takes (who is susceptible, how severe it becomes, who recovers) often has as much to do with nutrition, stress, living conditions, inequality, and access to care as it does with the microbe or pathology itself.

A life-value analysis challenges the implicit assumption that the “natural” progression of disease is inevitable or apolitical. Instead, it asks: What life-supporting conditions are missing such that this disease arose or worsened? For example, the “natural history” of tuberculosis or COVID-19 is drastically altered by crowded housing, poor ventilation, and malnutrition – conditions rooted in social organization. From McMurtry’s perspective, calling these outcomes “natural” obscures the fact that many are actually policy-driven or market-driven. If large numbers of people develop diabetes “naturally” over time, is that really a purely biological trend, or does it reflect an environment of inexpensive ultra-processed food and lacking preventive healthcare? A life-value approach redirects attention from just the pathogen or individual body to the life-ground factors: food security, clean water, sanitation, safe working conditions, and social equity (the things needed “to take your next breath” in the broad sense)​. It sees diseases less as isolated events in bodies and more as manifestations of a life-support system under stress or deprivation. This reframing resonates with long-standing views in social medicine. Over a century and a half ago, Rudolf Virchow famously stated that “Medicine is a social science and politics is nothing else but medicine on a large scale,” insisting that physicians must address societal problems underlying disease​. McMurtry’s framework amplifies this insight by providing a value theory: it’s not enough to note that social conditions influence illness; we must morally prioritize changing those conditions above protecting profits or bureaucratic inertia. In short, what epidemiologists call the natural history of disease would, under a life-value lens, be understood as the historical trajectory of an ill life-ground – a trajectory we can change by improving life conditions.

Disease Progression as a Socially Conditioned Process

McMurtry’s approach emphasizes that disease does not unfold in a vacuum. Health and illness are embedded in what he calls the “life-fabric” of society​. Factors like poverty, inequality, education, and community networks are not secondary to pathology; they are determinant conditions of who falls ill and how illness progresses. Modern research strongly supports this view: disparities in the progression and outcome of diseases often map to social and economic disparities. For instance, a child born in an impoverished area can have a dramatically shorter life expectancy than one born in a wealthier neighborhood, even within the same city – a difference not explained by genetics, but by social determinants like nutrition, exposure to violence, and healthcare access​. McMurtry would classify things like clean air, nutritious food, secure housing, and supportive relationships as “universal life goods” – goods required for human beings to survive and flourish​. When these life goods are denied or unequally distributed, we see entire populations experience higher rates of “naturally occurring” disease. In truth, their disease is socially produced by life-destructive conditions. Critical medical thinkers have echoed this: physician-anthropologist Paul Farmer describes epidemic disease in impoverished communities as stemming from “structural violence,” the social arrangements that put certain groups in harm’s way. Similarly, scholars in medical anthropology and sociology argue that illness is socially constructed and produced, not just biologically given​. In this sense, the natural history of diseases like diabetes, hypertension, or depression includes chapters written by social forces – stress, marginalization, overwork, environmental toxins, etc. A life-value analysis insists we read those chapters closely. It directs attention to how social pathologies (like extreme inequality or environmental pollution) express themselves as biomedical pathologies in human bodies. Rather than treating those social factors as external “context” or background, McMurtry’s framework puts them foreground as causal and remediable. If lack of nutritious food is helping drive an illness, then ensuring that life-need is met is as critical as any drug – in fact, more fundamentally so, because it aligns with the primary mission of sustaining life capacity. By viewing disease progression through this holistic, social lens, we move away from seeing disease as an isolated natural event and toward seeing it as feedback about how well or poorly our society’s life-support systems are functioning.

Life-Blind Priorities in the Medical System

The life-value onto-axiology not only critiques broad social determinants of health, but also the institutional priorities of the healthcare system itself. McMurtry uses the term “life-blind” to describe decision-making that ignores or undermines life requirements. Unfortunately, many traditional medical and public health approaches have been constrained by economic and institutional forces that can be strikingly life-blind. One glaring issue is the way profit-driven imperatives can overshadow the goal of sustaining life. The pharmaceutical industry is a prime example: therapies and research often follow the money rather than the greatest life-value. There is an old cynical saying, “a patient cured is a customer lost,” highlighting a conflict between health outcomes and business models. While drug companies certainly seek to improve health, they are also beholden to shareholders and profit goals, which skews priorities. Expensive medications for chronic management of disease (which ensure long-term revenue) may be favored over one-time cures or preventive measures that would eliminate the market. Indeed, a 2018 report by Goldman Sachs openly asked, “Is curing patients a sustainable business model?”​, implying that too much success in curing disease could undermine pharmaceutical profits. This dynamic exemplifies what McMurtry would call a money sequence that has decoupled from life needs​. Instead of Life → Means of Life → More Life, the industry can slide into Money → More Money, even if life outcomes stagnate or suffer. As McMurtry observes, such a pattern becomes “unproblematic to the dominant economic paradigm” because life losses (people who remain sick, or environmental health costs) do not show up on the balance sheet.

This profit-driven bias can lead to perverse outcomes in practice. For instance, life-saving medications or preventive interventions might be neglected if they’re not profitable. Many tropical diseases that kill thousands (so-called neglected diseases) saw little R&D investment for decades because the affected populations had low purchasing power – their lives were implicitly valued less in the market calculus. Even within wealthy countries, we find the health system responding more vigorously to diseases of the affluent (which promise high returns on expensive treatments) than to diseases of the poor. Healthcare access inequities reflect a similar life-blind prioritization. In a life-coherent system, everyone would have access to the means of life (including healthcare) by virtue of being alive; but in reality, ability to pay often dictates who gets timely care or preventive services. This means that economic status – a market outcome – can determine life and death, a clear violation of life-value ethics. McMurtry’s critique aligns with public health scholars who note that “health systems will not naturally gravitate towards equity” without deliberate action​.

Moreover, the culture of modern medicine itself can become entranced by what McMurtry would call life-blind onto-axiology – a fixation on technical and market solutions that ignores lived human needs. A striking analysis in the AMA Journal of Ethics points out that pharmaceuticals tend to make the biological aspects of illness highly visible (lab values, molecular targets) while rendering the social suffering of patients invisible​. By focusing doctors’ attention on “intracellular” processes, a pill might divert attention from the fact that a patient’s illness is rooted in job insecurity or trauma or pollution​. In effect, the medical system often “medicalizes” problems that are fundamentally social – prescribing an antidepressant for a person in intolerable living conditions, for example – because it is more financially and institutionally expedient to treat symptoms with commodities (drugs, procedures) than to address upstream causes. This phenomenon has been termed “disease mongering” when drug companies actually expand the boundaries of illness to sell more products: “Pharmaceutical companies sponsor diseases and promote them to prescribers and consumers” in order to expand markets, as Ray Moynihan and colleagues famously observed​. They warned that the social construction of illness (how societies perceive and deal with illness) is being usurped by a “corporate construction of disease,” wherein normal life processes or mild problems are redefined as serious diseases in need of medication​. All of these trends – aggressive marketing, focus on lucrative treatments, neglect of prevention, and unequal care – illustrate a failure to prioritize life-value in practice. The onto-axiological diagnosis is that our health system often serves two masters: life and profit. And when forced to choose, it too frequently serves the latter. McMurtry’s framework demands we recognize this as a pathological value system, akin to a body attacking its own tissues. In The Cancer Stage of Capitalism, he argues that a society which allows financial imperatives to systematically undermine its public health and “life-defense” systems is essentially cannibalizing its own life-capacities​. Just as a cancer diverts resources for uncontrolled growth at the expense of the organism, a for-profit healthcare model can drain resources from preventive and public health measures to fuel high-cost interventions that generate revenue. The result is paradoxical scarcity amid plenty – cutting funding for clean water or clinics because budgets are tight, even as billions are spent on high-tech treatments for late-stage illness. McMurtry calls out this contradiction and challenges us to realign the system’s priorities with the true end of medicine: sustaining and improving life.

A Holistic and Just Life-Value Approach to Health

Reframing disease through a life-value lens leads to a holistic understanding of health and a more just approach to preventing and treating illness. Instead of compartmentalizing health into biomedical silos, a life-value approach starts from the premise that health is integration in a life-supportive environment. Every policy area becomes health policy: food security, housing, education, labor conditions, environmental protection – all are seen as health interventions, since they enrich or impoverish the life-ground on which all health outcomes depend. In practical terms, a life-value approach would emphasize prevention and the provisioning of life necessities over the downstream, market-driven model of “find disease, then sell a cure.” It aligns with the vision of public health pioneers and the World Health Organization’s definition of health as a state of complete physical, mental, and social well-being. For example, rather than viewing an epidemic of obesity and diabetes as a series of individual failures to be managed with drugs, a life-value reframe would mobilize society to ensure nutritious food is affordable and junk food marketing is curbed – treating the food system as part of our collective life fabric that must be healed. McMurtry’s notion of a “life-coherent economy” (sometimes called a life economy​) is one where resources are directed to public goods that enhance life for all. In the healthcare context, that means robust investment in civil commons like universal healthcare access, public sanitation infrastructure, vaccination programs, and health education – all the shared supports that allow people to live healthy lives. It also means valuing caregivers, nurses, and community health workers as much as surgeons and biotech CEOs, because the former are often the ones maintaining day-to-day life capacities in communities.

A key element of a life-value approach is equity. If something is a fundamental condition for life, then from an ethical standpoint everyone should have access to it by right, not by privilege. This principle yields a framework for justice in health. Health inequities (such as stark differences in life expectancy or disease rates between rich and poor, or between racial groups) are seen as intolerable violations of life-value. They indicate that society is systematically valuing some lives over others – precisely what McMurtry’s axiological lens is designed to expose and oppose. By prioritizing those conditions that sustain and enrich life, we naturally focus on uplifting the most marginalized populations, because it is there that life-capacities are most undermined by deprivation. For instance, the life-value approach would strongly support measures like universal health coverage, because healthcare becomes a public good rather than a commodity – a means to protect life that should be available to all. It would also favor what social medicine calls “upstream” interventions: improving housing, creating living-wage jobs, reducing pollution, and ensuring education and social connection. These interventions might lie outside the traditional remit of medicine, but they have the greatest impact on preventing disease and enhancing wellbeing. In fact, McMurtry’s framework could be seen as a philosophical endorsement of the “health in all policies” approach championed by many public health experts: the idea that all sectors must ask how their policies affect people’s ability to live a flourishing life​. Because life-value onto-axiology is grounded in the interconnectedness of life-support systems, it encourages breaking down professional silos. A life-value oriented health system would work closely with sectors of food, housing, transportation, and education, treating them as partners in cultivating the public’s health. This is a biopsychosocial model expanded to a biopsychosocial-ecological model – truly holistic. Such a framework is not only more just (since it aims to distribute life goods universally), but also more effective in the long run, because it addresses root causes rather than endlessly patching symptoms. For example, rather than indefinitely managing asthma in children with inhalers (important as that is for relief), a life-value approach pushes us to also ask: are these children breathing polluted air? If so, justice and effectiveness demand we clean up the air. In summary, a life-value approach offers a paradigm shift: from a disease-care system to a genuine health care system, one that cares for the conditions of life. It reframes our metrics of success – not how many drugs prescribed or surgeries done, but how many years of healthy life added, how many communities have clean water and healthy food, how robust our “social immune system” is in preventing illness at its sources.

Challenging Orthodoxy: Alignments with Social Medicine and Public Health

McMurtry’s life-value framework does not arise in isolation – it builds on and extends a rich tradition of critique in social medicine, medical anthropology, and public health ethics. These fields have long questioned reductionist, purely biomedical understandings of disease, and they find a powerful ally in life-value onto-axiology. Social medicine, since the 19th century, has asserted that society shapes disease. Rudolf Virchow’s investigation of a typhus outbreak in 1848 led him to conclude that epidemics were rooted in poverty and injustice; he famously wrote that “politics is nothing else but medicine on a large scale,” highlighting that political action is necessary to tackle the causes of disease​. McMurtry’s perspective resonates strongly with Virchow’s: both insist that curing society (through social reform) is a prerequisite to curing patients. Life-value onto-axiology gives this an explicit value-theoretic backbone by stating that the good is what sustains life – thus, political-economic systems must be evaluated by whether they support or destroy the health of populations​. It essentially moralizes what social medicine observed empirically: if a policy causes ill-health (for example, austerity measures that reduce people’s access to food or healthcare), then that policy is not just unfortunate, but onto-axiologically bad – it negates life-value. Conversely, investments in public sanitation or universal healthcare are not just technical public health measures, but affirmations of what McMurtry calls the civil commons, our shared life defense network​.

Medical anthropology and sociology have contributed the idea that illness and health are socially constructed and imbued with cultural meaning. They point out, for instance, that what counts as a “disease” and how it’s experienced can vary by society, and that power relations often determine whose illnesses get attention. McMurtry’s framework complements these insights by exposing the value-biases at play: in a market-driven culture, conditions afflicting the poor or “unprofitable” ailments may be overlooked or not even labeled as problems worth solving. Anthropologists like Nancy Scheper-Hughes and Margaret Lock have used terms like “social suffering” to describe how illness is tied to social violence, inequality, and historical trauma. McMurtry adds that our economic system’s life-blind drives can perpetuate this suffering unless checked by life-value ethics. We saw earlier how the “corporate construction of disease” can medicalize social problems​; the life-value approach would turn that around, essentially demedicalizing to the extent possible and social-izing our conception of illness – bringing social context back into the frame of diagnosis and treatment. This aligns with approaches in critical public health that call for addressing the “causes of the causes.” For example, Britain’s epidemiologist Geoffrey Rose argued that the determinants of population health are largely communal and economic, not individual. Likewise, public health visionaries like Sir Michael Marmot emphasize creating societal conditions for people “to have the freedom to lead flourishing lives,” echoing what McMurtry identifies as enabling life-capacities​.

Where McMurtry’s perspective extends these critiques is in its systemic focus on value-system pathology. Social medicine might document that the poor have more disease; public health might call for better housing; medical anthropologists might reveal how a culture handles illness. But McMurtry asks us to dig deeper: why do we allow known life-requirements to be unmet in the first place? His answer often points to the reigning economic and institutional axiology – the way we have defined what is “worthwhile” or “efficient.” He argues that an economy that lets people go hungry or untreated while resources flow to things that don’t meet life needs is operating on a misaligned axiology, one that idolizes money or growth over life. In this sense, his critique is radical: it suggests that to truly improve health, we may need to overhaul our concept of development and success at the civilizational level. This brings a normative clarity to arguments for health equity. For instance, the WHO Commission on Social Determinants didn’t just catalog disparities; it declared that “social injustice is killing people on a grand scale”​. McMurtry’s framework reinforces this by explaining it as a form of collective irrationality – a consequence of valuing the wrong things. When the market says a life-saving vaccine is “too expensive” to give to poor children, a life-value lens calls that what it is: an injustice and a failure of rational priority (since money is valued over life).

Finally, the life-value approach aligns with movements in healthcare that call for human-centered and community-oriented care. The field of health promotion, for example, emphasizes enabling people to increase control over their health and demands intersectoral action (as seen in the Ottawa Charter for Health Promotion, 1986). McMurtry would likely applaud such efforts as steps toward a life-coherent health system. His life-value principles provide a unifying logic for why we need things like healthy public policy, community empowerment, and a focus on well-being rather than just disease metrics: because these are the ways to maximize life-capacity for all. It’s a philosophy that validates what practitioners in social medicine and public health have been doing, while also sharpening the critique of why it is often so hard to implement these humane approaches (pointing the finger at entrenched economic interests and value systems that resist change). In conclusion, applying McMurtry’s life-value onto-axiology to the concept of disease transforms our understanding of sickness from an isolated biological event to a symptom of how we organize our world. It demands we ask at every turn, “Are we valuing life, or something else?” If the answer is “something else,” his framework urges a reframing of our policies, institutions, and mindsets until life-value truly comes first – which, in the realm of health, means placing the flourishing of people and communities above all other imperatives. This life-grounded orientation offers a profoundly holistic and just way to understand and address disease, one that resonates with voices of conscience in medicine across generations and invites us to build a society where the natural history of disease is no longer a fated story of loss, but a malleable narrative of life upheld.

Sources

• McMurtry, John. Unequal Freedoms: The Global Market as an Ethical System. Garamond, 1998. (Develops the life-ground of value and critiques market value system.)
• McMurtry, John. The Cancer Stage of Capitalism. Pluto Press, 1999. (Introduces the “money-sequence” vs “life-sequence” of value and conceives the civil commons as society’s “social immune system”​.)

• McMurtry, John. “What is Good? What is Bad? The Value of All Values across Time, Place and Theories.” Philosophy and World Problems, Vol I-III, UNESCO: EOLSS, 2004-2011. (Foundational exposition of life-value onto-axiology​.)

• Moynihan, Ray, Iona Heath, and David Henry. “Selling Sickness: The Pharmaceutical Industry and Disease Mongering.” BMJ 324.7342 (2002): 886-891. (Discusses how corporate interests expand illness categories for profit​.)

• Castillo, Enrico G., and Joel T. Braslow. “How Pharmaceuticals Mask Health and Social Inequity.” AMA Journal of Ethics 23.7 (2021): 542-549. (Explores how biomedical focus can obscure social roots of disease.)

• World Health Organization (Commission on Social Determinants of Health). Closing the Gap in a Generation, 2008. (Demonstrates that health disparities are caused by social injustice and inequity​, aligning with the view that disease is socially conditioned.)

• Virchow, Rudolf. “Report on the Typhus Epidemic in Upper Silesia.” (1848). In Rather, L.J. (translator), Collected Essays on Public Health and Epidemiology (1985). (Classic statement that medicine must address social conditions​.)