Aristotle's doctrine on causation identifies four distinct types of cause: formal, efficient, material, and final. Science is said to have differentiated itself from philosophy by concentrating solely on efficient causes. Nonetheless, when applied to narratives of causation, Aristotle's doctrine provides a useful heuristic to explore the issues such as Aboriginal and biomedical perceptions of causal factors for non-insulin dependent diabetes mellitus (NIDDM) on Manitoulin Island, Ontario. This paper also outlines two divergent causal stories for NIDDM and the associated moral positions regarding the 'righteous' pursuit of health. Biomedical narratives emphasize the role of lifestyle factors, particularly the impact of obesity, in causation. In the case of diabetes, the moral course of action is pursued through lifestyle choices. In contrast, Aboriginal narratives emphasize the role of genetics in causation. These narratives describe diabetes as collectively affecting Aboriginal people - thus identifying Aboriginal people as different. Aboriginal frameworks for health venture beyond the 'efficient' cause of biomedicine and thus the moral pursuit of health within this framework involves returning to an initial state of health and purity through traditional knowledge.