The chapter, informed by the Systematicity and Understanding Theses, discusses how understanding in medicine bolsters human agency. Rejecting the initial pathocentric proposal of medicine’s aim (Pellegrino 2001; McAndrew 2019; Hershenov 2020), it advocates the Autonomy Thesis that argues medicine’s goal is not merely treating disease, but promoting health to enhance autonomy (Christman 2009). It adopts a "positive" notion of health that is more than disease absence (Venkatapuram 2013; Nordenfelt 2017) and establishes its relation with well-being and autonomy. The chapter introduces a pluralistic view of health concept difficulties through the lens of "conceptual engineering" and refutes criticisms suggesting the Autonomy Thesis’s permissiveness. The investigation is confined to "mainstream medicine" (Broadbent 2019, ch. 1) and considers the internal morality of medicine (Brody and Miller 1998; Pellegrino 2001). It strives to define a broad yet rigorous aim of medicine that applies to various branches.

The chapter is dedicated to critically engaging contemporary accounts. It explores views from Pellegrino (2001), Broadbent (2019), and four "list approaches" (Callahan et al. 1996; Brody and Miller 1998; Brülde 2001; Boorse 2016). This is a rather considerable amount of material to delve into in a single chapter, but the aim of the reconstruction is not to do justice to all the details of these accounts; rather it is to focus on examining to what extent they are able to overcome or bypass the challenges faced in Chapter 6 when working towards the final iteration of the Autonomy Thesis. Subjecting these competing views to critical scrutiny is not merely an essentially adversarial procedure, but also a means to assist in framing the proposal presented in the chapter. By inspecting the most relevant aspects of these accounts in light of the challenges considered in Chapter 6, the chapter also provides further reinforcement for the Autonomy Thesis by considering paths that our inquiry chose not to take.