INTRODUCTION

Health is important to us, but it remains difficult to get a conceptual grip on the term “health”. Health still often appears as Gadamer described it: a clandestine (and therefore not configurable) gift and “wonder of absentmindedness” (Gadamer [1993] 1996: 126, my translation). With the rise of “surveillance medicine” (Armstrong 1995), however, a great deal of effort focuses on health promotion and disease prevention, especially in public health. As a consequence, the “clandestine gift of health” is more often conceived as self-made, not given, and a risk diagnosis frequently replaces one of a manifest disease as a cause for medical attention, although risk reveals vulnerability, not disease. How can this situation be conceptualized?

In the following chapter, the situation of women with a genetic disposition to develop hereditary breast and ovarian cancer is introduced as a starting point for the examination of different health theories, followed by a proposal of a constructivist understanding of health.

BRCA-POSITIVE WOMEN: A CASE STUDY OF RISK AND DANGER

BRCA-positive women: life with chronic risk

BRCA represents the breast cancer genes (BRCA1 and BRCA2) associated with a familial cancer syndrome called hereditary breast and ovarian cancer (HBOC). HBOC includes the accumulated occurrence of different types of breast and ovarian cancers as well as a number of less common cancers (colon, prostate, skin and pancreas), linked to family-specific DNA variations at these two DNA sites.