Despite several decades of debate, the concept of disease remains hotly contested. The debate is typically cast as one between naturalism and normativism, with a hybrid view that combines elements of each staked out in between. In light of a number of widely discussed problems with existing accounts, some theorists argue that the concept of disease is beyond repair and thus recommend eliminating it in a wide range of practical medical contexts. Any attempt to reframe the ‘disease’ discussion should answer (...) the more basic sceptical challenge, and should include a meta-methodological critique guided by our pragmatic expectations of what the disease concept ought to do given that medical diagnosis is woven into a complex network of healthcare institutions. In this paper, we attempt such a reframing, arguing that while prevailing accounts do not suffer from the particular defects that prominent critics have identified, they do suffer from other deficits—and this leads us to propose an amended hybrid view that places objectivist approaches to disease on stronger theoretical footing, and satisfies the institutional-ethicaldesiderataof a concept of disease in human medicine. Nevertheless, we do not advocate a procrustean approach to ‘disease’. Instead, we recommend disease concept pluralism between medical and biological sciences to allow the concept to serve the different epistemic and institutional goals of these respective disciplines. (shrink)

Once limited to issues in maritime and trade law, today the most recognizable examples of international law govern issues such as human rights, intellectual property, crimes against humanity and international armed conflicts. In many ways, this proliferation has been a welcomed development. However, when coupled with international law’s decentralized structure, this rapid proliferation has also posed problems for how we (and in particular judges) identify if, when, and where international law exists. This article puts forward a novel, dignity-based account for (...) how we answer this question: arguing that an international law exists if and only if it is consistent with respecting dignity. The upshot of this account is two-fold. First, it explains many features of international law that other theories leave unaccounted for or under-explained. And second, my dignity-based account provides for a mechanism through which the system can continue to be developed and improved. (shrink)

The concept of disease remains hotly contested. In light of problems with existing accounts, some theorists argue that the disease concept ought to be eliminated. We answer this skeptical challenge by reframing the discussion in terms of the role that the disease concept plays in the complex network of health-care institutions in which it is deployed. We argue that while prevailing accounts do not suffer from the particular defects that critics have identified, they do suffer from other deficits, and this (...) leads us to propose a new account that satisfies the desiderata for a concept of disease in human medicine. (shrink)

In Planned Parenthood v. Casey the Court argued that the Fourteenth Amendment protected “choices central to personal dignity and autonomy”. In...

Rising temperatures, increased frequency and intensity of storms, and other extreme climate events clearly indicate that we are living in an era of dramatic climate change. The impacts of pollution...

We are grateful for the thoughtful attention the commentators and editors have given our paper. They raise many substantive points that warrant a response, but for reasons of journal space our reply must be brief. In our paper, we argue for an amended hybrid account of ‘disease’ in human medicine that takes normative ethics seriously, guards against pernicious classifications of disease and reconnects the concept with the goals of healthcare institutions in which disease diagnosis is embedded. Carel and Tekin, in (...) their respective pieces, raise issues about the objectivity and effective operationalisation of our account, Agar makes an ‘evolutionary’ case for disease concept eliminativism in mental health, and Wakefield and Conrad contend that our proposed modification to the harmful dysfunction account is unnecessary and undesirable. We will respond to each in turn. The rational moral justification component of our account raises difficult moral epistemological questions regarding which reasons are the weightiest ones and who should be allowed to participate in the rational justification process. Carel suggests that inevitable disagreement on this point undermines the alleged objectivity of our proposal. We agree with Tekin, however, that this is a feature of our account rather than a bug. What constitutes a good reason in moral deliberation is a question that goes to the very philosophical foundation of ethics ; but disagreement over which reasons are the weightiest ones does not prevent ethicists and policy makers from objectively assessing the strength of moral arguments by evaluating their empirical adequacy and logical structure, and this can take us a long way toward adjudication. The fact that rational justification has been used to support immoral practices and institutions does not warrant abandoning a reason-based approach to ethics any more than …. (shrink)

During his career, Ronald Dworkin wrote extensively on an impressive range of issues in moral, political, and legal philosophy, but, like many of his contemporaries, international law remained a topic of relative neglect. His most sustained work on international law is a posthumously published article, “A New Philosophy for International Law” (2013), which displays some familiar aspects of his views in general jurisprudence, in addition to some novel (though perhaps surprising) arguments as well. This paper argues that the moralized account (...) of international law we might have expected is conspicuously missing from this posthumous article; with Dworkin advancing an argument based on a form of political realism instead. (shrink)

Although this article uses Obergefell v Hodges (2015) as its frame, it aims to bring out some distinctive features of Justice Kennedy’s jurisprudence of dignity more broadly. There are two reasons why such an investigation is important. The first is important to those interested in the legal case. Indeed, in Dobbs v Jackson Women’s Health (2022), the Court now argues that the relevant ‘test’ for determining whether a right is protected under the Due Process Clause is whether the right is (...) found to be ‘deeply rooted’ in the nation’s history and tradition. This article aims to critique this decision, as well as originalist approaches to constitutional interpretation more broadly, and seeks to resurrect and reconstruct Kennedy’s jurisprudence of dignity that has undergirded (sometimes quietly) the expansion of civil rights protections to the LGBTQ+ community. The second reason this investigation is important is of interest to philosophers and legal historians. Dignity is a notoriously elusive concept, and much ink has been spilt trying to sort out the precise nature of its content and its boundaries. This article brings together the many (seemingly disparate) uses of dignity found across cases involving gay rights, abortion, and foreign sovereign immunity, and argues Kennedy effectively weaves these uses together in ways that may sharpen our understanding of dignity in both the philosophical and legal literatures. (shrink)