The COVID-19 pandemic is a global contagion of unprecedented proportions and health, economic, and social consequences. As with many health problems, its impact is uneven. This article argues the C...

Health and Social Justice (Ruger 2009a) developed the ?health capability paradigm,? a conception of justice and health in domestic societies. This idea undergirds an alternative framework of social cooperation called ?shared health governance? (SHG). SHG puts forth a set of moral responsibilities, motivational aspirations, and institutional arrangements, and apportions roles for implementation in striving for health justice. This article develops further the SHG framework and explains its importance and implications for governing health domestically.

What are the respective roles and responsibilities of global, national, and local communities as well as individuals themselves to address health deprivations and avert health threats? This article offers the beginnings of a theory of global health justice, arguing for universal ethical norms (general duty) with shared global and domestic responsibility (specific duties) for health. It offers a global minimalist view I call ‘ provincial globalism ’ as a mean between nationalism and cosmopolitanism, in which a provincial consensus must accompany (...) a global consensus on health morality. This minimalist account asserts global and national duties to promote human flourishing and, more specifically, individuals’ central health capabilities. In this view, justice requires prioritizing responsibilities through shared health governance to reduce shortfall inequalities in central health capabilities — a general duty to reduce premature mortality and escapable morbidity. It examines the difficulties presented by the philosophical principles of connectedness, causality, remediation, partiality, and capacity in the allocation of responsibility for global health. It offers a theory of responsibility allocation based on a functional, health agency centered and homeostatic balanced understanding of the analytical components required to solve global health problems and parcels out roles and responsibilities at the global, national, local, and individual levels accordingly. Allocations of responsibility rest on the effectiveness and special obligations of different actors, respecting self-determination by groups and individuals and seeking voluntary commitments . This view understands that the remedy for global health problems must be sustainable to take nations and the global health community to a new global health equilibrium that remedies current problems and prepares for new health threats to come. (shrink)

While there is a growing body of work on moral issues and global governance in the fields of global justice and international relations, little work has connected principles of global health justice with those of global health governance for a theory of global health. Such a theory would enable analysis and evaluation of the current global health system and would ethically and empirically ground proposals for reforming it to more closely align with moral values. Global health governance has been framed (...) as an issue of national security, human security, human rights, and global public goods. The global health governance literature is essentially untethered to a theorized framework to illuminate or evaluate governance. This article ties global health justice and ethics to principles for governing the global health realm, developing a theoretical framework for global and domestic institutions and actors. (shrink)

The proper object of global health governance should be the common good, ensuring that all people have the opportunity to flourish. A well-organized global society that promotes the common good is to everyone’s advantage. Enabling people to flourish includes enabling their ability to be healthy. Thus, we must assess health governance by its effectiveness in enhancing health capabilities. Current GHG fails to support human flourishing, diminishes health capabilities and thus does not serve the common good. The provincial globalism theory of (...) health governance proposes a Global Health Constitution and an accompanying Global Institute of Health and Medicine that together propose to transform health governance. Multiple lines of empirical research suggest that these institutions would be effective, offering the most promising path to a healthier, more just world. (shrink)

Against a backdrop of non-ideal political and legal conditions, this article examines the health capability paradigm and how its principles can help determine what aspects of health care might legitimately constitute positive health care rights—and if indeed human rights are even the best approach to equitable health care provision. This article addresses the long American preoccupation with negative rights rather than positive rights in health care. Positive health care rights are an exception to the overall moral range and general thrust (...) of U.S. legal doctrine. Some positive rights to health care have arisen from U.S. Constitutional Eighth Amendment cases and federal and state laws like Medicare, Medicaid, the State Children’s Health Insurance Program, the Emergency Medical Treatment and Active Labor Act, and the Patient Protection and Affordable Care Act. Finally, this article discusses some of the difficulties inherent in implementing a positive right to health care in the U.S. (shrink)

The American Journal of Bioethics, Volume 12, Issue 7, Page 65, July 2012.

In the past three decades, levels of and contributors to global health aid have increased at an unprecedented pace. Development assistance for health—financial contributions from public and private institutions to low‐ and middle‐income countries to help improve health and health systems—nearly quintupled from 1990 to 2012 (from $5.7 billion to $28.1 billion). DAH is now provided by more than one hundred seventy major global health agencies and organizations, 15 percent of which are private entities (such as the Bill and Melinda (...) Gates Foundation), other not‐for‐profit organizations, and public‐private partnerships. Governments are still the largest source for DAH. While increased DAH is essential and welcome, these system developments raise numerous ethical questions. Are the resources sustainable, and do expenditures target correct priorities? Who should decide, and how should these decisions be made?. (shrink)

While there is a growing body of work on moral issues and global governance in the fields of global justice and international relations, little work has connected principles of global health justice with those of global health governance for a theory of global health. Such a theory would enable analysis and evaluation of the current global health system and would ethically and empirically ground proposals for reforming it to more closely align with moral values. Global health governance has been framed (...) as an issue of national security, human security, human rights, and global public goods. The global health governance literature is essentially untethered to a theorized framework to illuminate or evaluate governance. This article ties global health justice and ethics to principles for governing the global health realm, developing a theoretical framework for global and domestic institutions and actors. (shrink)

The American Journal of Bioethics, Volume 11, Issue 7, Page W1-W3, July 2011.

There is a special need for solidarity at the global level to address global health disparities. Ter Meulen argues that solidarity must complement justice, and is, in fact, more fundamental than justice to the arrangement of health care practices. We argue that PG/SHG, though a theory of justice, is fundamentally synergistic with solidarity. We relate PG/SHG to Jodi Dean’s conceptual work on reflective solidarity, contrasted with conventional solidarity, as an approach to transnational solidarity that dovetails with PG/SHG. We argue that (...) PG/SHG meets both the need for solidarity at the global level and the need for solidarity within theories of the arrangement of health care practices. (shrink)

This volume comprises a collection of ten essays by Allen Buchanan, and in some cases Buchanan and co-authors as well, on various topics under the general rubric of justice and health care. The essays were originally published over the span of some twenty-four years in various publication venues including edited books and journals in bioethics, public affairs, and law and policy. As Buchanan notes, the selected essays do not comprise an overall theory of justice and health care or justice and (...) health, and indeed a major motivation of this effort is to project a deep skepticism about the very task of attempting to put forth such a theory, which Buchanan eschews as too ambitious. He offers instead a more "modest" "thought-journey" to gain "a deeper appreciation of the complexities of thinking systematically, self-critically, and realistically about justice in health care". (shrink)

Jennifer Prah Ruger (2011) rightly points out that social cooperation is essential for achieving health justice. But she is unhappy with the approach to cooperation that social scientists and philosophers have taken. Her main objection is that their models are based on narrow self-interest. Her own proposal, which she calls "shared health governance", is based on public moral norms instead. If individuals and institutions internalized and followed such norms, justice in health could be achieved. -/- In this (...) commentary, I show that Ruger fundamentally misdiagnoses the problem of social cooperation and health justice. Because of the faulty diagnosis, her own proposal is at best unworkable, at worst utopian. (shrink)

Jennifer Prah Ruger's book Health and Social Justice is a substantial contribution to the emerging scholarship at the intersection of health issues and the philosophy of social justice. This area has been getting increasing attention which is partially evidenced by the growing number of monographs being published on the subject. Prah Ruger proposes a bold and expansive theory of justice and health care policy that is informed by health economics, public policy, political science, and legal (...) and political philosophy. The book should interest individuals seeking to bridge health care policy with social justice debates, public health ethicists, and political philosophers interested in population level health issues. (shrink)

Do we have a legal and moral right to health care against others? There are international conventions and institutions that say emphatically yes, and they summarize this in the expression of “the right to health,” which is an established part of the international human rights canon. The International Covenant on Social and Economic Rights outlines this as “the right of everyone to the enjoyment of the highest attainable standard of physical and mental health,” but declarations such as this remain tragically (...) unfulfilled. According to recent figures, roughly two billion people lack access to essential drugs or to primary health care. Millions are afflicted by infections and illnesses that are easily avoidable or treatable. In the developing world many children die or grow stunted and damaged for lack of available treatments. Tropical diseases receive little or no attention by the major pharmaceutical companies’ research departments. Is this a massive violation of the right to health? And if so, why does it attract so little attention? Is it because our supposed commitment to human rights and the rule of law is hypocritical and hollow? Or is it because the right to health is a special case of a right, so that these tragedies are no violation at all? Jennifer Prah Ruger summarized this puzzle when she wrote: “one would be hard pressed to find a more controversial or nebulous human right than the right to health.” In this essay I discuss three different theories of a right to health care. I conclude by offering my own reconstruction of one such theory. (shrink)

The need for informed analyses of health policy is now greater than ever. The twelve essays in this volume show that public debates routinely bypass complex ethical, sociocultural, historical, and political questions about how we should address ideals of justice and equality in health care. Integrating perspectives from the humanities, social sciences, medicine, and public health, this volume illuminates the relationships between justice and health inequalities to enrich debates. Understanding Health Inequalities and Justice explores three questions: How do scholars approach (...) relations between health inequalities and ideals of justice? When do justice considerations inform solutions to health inequalities, and how do specific health inequalities affect perceptions of injustice? And how can diverse scholarly approaches contribute to better health policy? From addressing patient agency in an inequitable health care environment to examining how scholars of social justice and health care amass evidence, this volume promotes a richer understanding of health and justice and how to achieve both. -/- The contributors are Judith C. Barker, Paula Braveman, Paul Brodwin, Jami Suki Chang, Debra DeBruin, Leslie A. Dubbin, Sarah Horton, Carla C. Keirns, J. Paul Kelleher, Nicholas B. King, Eva Feder Kittay, Joan Liaschenko, Anne Drapkin Lyerly, Mary Faith Marshall, Carolyn Moxley Rouse, Jennifer Prah Ruger, and Janet K. Shim. (shrink)

The central role of Health Care Analysis is to advance discourses between philosophy, health, and policy. Within that very wide-ranging agenda, perhaps the most complex challenges are in global health. In countries across the world, many, many populations are unable to enjoy conditions in which they can be healthy. The barriers to change are political, economic, social, regulatory, legal, and philosophical. Lawrence Gostin’s recent book on Global Health Law therefore marks a contribution of the highest importance, marrying practical and philosophical (...) agendas, and aiming at achieving global health with justice. -/- To progress the important work of Gostin’s book, the current journal issue draws together leading scholars in moral and political philosophy, economics, and law, with a shared interest in questions of global justice. In the first paper, Eric Friedman and Lawrence Gostin provide a clear overview of the practical and theoretical global health challenges and their response to these. Their analysis is followed by stimulating contributions from Norman Daniels, Jennifer Prah Ruger, Shawn Harmon, Attiya Waris and Laila Abdul Latif, Heather Widdows, and A.M. Viens, each engaging with questions raised by Global Health Law. The different papers underscore the significance of this area of inquiry, and the imperative to bring insights from scholarly work into global health practice. (shrink)

In her target article “Shared health governance” (AJOB 11(7): 32-45, 2011) and in her book Health and Social Justice (2009), Jennifer Prah Ruger defends an original model of governance dubbed “Shared Health Governance” (SHG). This model borrows elements from many other models of governance, and one may wonder what is the secret sauce that holds together these diverse ingredients. In response, Ruger would perhaps ultimately turn to public moral norms. My comment raises some concerns about the (...) function and content of these norms in her model and their connection to her claims about shared sovereignty within SHG. (shrink)

Testimony is an invaluable source of knowledge. We rely on the reports of those around us for everything from the ingredients in our food and medicine to the identity of our family members. Recent years have seen an explosion of interest in the epistemology of testimony. Despite the multitude of views offered, a single thesis is nearly universally accepted: testimonial knowledge is acquired through the process of transmission from speaker to hearer. In this book, Jennifer Lackey shows that this (...) thesis is false and, hence, that the literature on testimony has been shaped at its core by a view that is fundamentally misguided. She then defends a detailed alternative to this conception of testimony: whereas the views currently dominant focus on the epistemic status of what speakers believe, Lackey advances a theory that instead centers on what speakers say. The upshot is that, strictly speaking, we do not learn from one another's beliefs - we learn from one another's words. Once this shift in focus is in place, Lackey goes on to argue that, though positive reasons are necessary for testimonial knowledge, testimony itself is an irreducible epistemic source. This leads to the development of a theory that gives proper credence to testimony's epistemologically dual nature: both the speaker and the hearer must make a positive epistemic contribution to testimonial knowledge. The resulting view not only reveals that testimony has the capacity to generate knowledge, but it also gives appropriate weight to our nature as both socially indebted and individually rational creatures. The approach found in this book will, then, represent a radical departure from the views currently dominating the epistemology of testimony, and thus is intended to reshape our understanding of the deep and ubiquitous reliance we have on the testimony of those around us. (shrink)

A widely accepted view in recent work in epistemology is that knowledge is a cognitive achievement that is properly creditable to those subjects who possess it. More precisely, according to the Credit View of Knowledge, if S knows that p, then S deserves credit for truly believing that p. In spite of its intuitive appeal and explanatory power, I have elsewhere argued that the Credit View is false. Various responses have been offered to my argument and I here consider each (...) of these objections in turn. I show that none succeeds in undermining my argument and, thus, my original conclusion stands—the Credit View of Knowledge is false. (shrink)

The lottery paradox involves a set of judgments that are individually easy, when we think intuitively, but ultimately hard to reconcile with each other, when we think reflectively. Empirical work on the natural representation of probability shows that a range of interestingly different intuitive and reflective processes are deployed when we think about possible outcomes in different contexts. Understanding the shifts in our natural ways of thinking can reduce the sense that the lottery paradox reveals something problematic about our concept (...) of knowledge. However, examining these shifts also raises interesting questions about how we ought to be thinking about possible outcomes in the first place. (shrink)

In the philosophical literature on mental states, the paradigmatic examples of mental states are beliefs, desires, intentions, and phenomenal states such as being in pain. The corresponding list in the psychological literature on mental state attribution includes one further member: the state of knowledge. This article examines the reasons why developmental, comparative and social psychologists have classified knowledge as a mental state, while most recent philosophers--with the notable exception of Timothy Williamson-- have not. The disagreement is traced back to a (...) difference in how each side understands the relationship between the concepts of knowledge and belief, concepts which are understood in both disciplines to be closely linked. Psychologists and philosophers other than Williamson have generally have disagreed about which of the pair is prior and which is derivative. The rival claims of priority are examined both in the light of philosophical arguments by Williamson and others, and in the light of empirical work on mental state attribution. (shrink)

Do we apply higher epistemic standards to subjects with high stakes? This paper argues that we expect different outward behavior from high-stakes subjects—for example, we expect them to collect more evidence than their low-stakes counterparts—but not because of any change in epistemic standards. Rather, we naturally expect subjects in any condition to think in a roughly adaptive manner, balancing the expected costs of additional evidence collection against the expected value of gains in accuracy. The paper reviews a body of empirical (...) work on the automatic regulation of cognitive effort in response to stakes, and argues that we naturally see high- and low-stakes subjects as experiencing different levels of ‘epistemic anxiety’, and anticipate different levels of cognitive effort from them for this reason. If unresolved epistemic anxiety always bars an ascription of knowledge, then we can explain our responses to cases involving shifting stakes without positing any variation in the standards of intuitive knowledge ascription. (shrink)

Ex ante contractualism holds that in situations involving risk we ought to act in accordance with principles that license the action that satisfies the strongest individual claim, where those claims are a function of the expected value that a given policy gives each person ex ante. I here challenge ex ante contractualism on contractualist grounds. I argue that adopting ex ante contractualism would have far reaching implications that contractualists, or many nonconsequentialist in general, would find very hard to accept. I (...) conclude that to block these implications, contractualists should adopt an ex post approach to deal with decisions under risk. (shrink)

Utilitarianism is often criticized because of its reliance on the interpersonal aggregation of harms and benefits. However, since the rejection of all forms of interpersonal aggregation strikes most people as implausible, some critics of utilitarianism have proposed theories of Limited Aggregation. These occupy the middle ground between fully aggregative and non-aggregative views. Recently, Limited Aggregation has been criticized for having counterintuitive implications that seem even worse than the counterintuitive implications of fully aggregative and non-aggregative views it tried to escape. I (...) here propose a new view of Limited Aggregation that does better than existing accounts in this regard. It is more modest than existing accounts of Limited Aggregation, but it retains the view's core idea. This, I claim, is the thought that sometimes very strong individual claims stand in the way of realizing the best outcome. (shrink)

Testimony is a vital and ubiquitous source of knowledge. Were we to refrain from accepting the testimony of others, our lives would be impoverished in startling and debilitating ways. Despite the vital role that testimony occupies in our epistemic lives, traditional epistemological theories have focused primarily on other sources, such as sense perception, memory, and reason, with relatively little attention devoted specifically to testimony. In recent years, however, the epistemic significance of testimony has been more fully appreciated. I shall here (...) focus on two questions that have received the most attention in recent work in the epistemology of testimony. First, is testimonial knowledge acquired only by being transmitted from speaker to hearer? Second, must a hearer have positive reasons to justifiedly accept a speaker's testimony? (shrink)

In the Essay Concerning Human Understanding, Locke insists that all knowledge consists in perception of the agreement or disagreement of ideas. However, he also insists that knowledge extends to outer reality, claiming that perception yields ‘sensitive knowledge’ of the existence of outer objects. Some scholars have argued that Locke did not really mean to restrict knowledge to perceptions of relations within the realm of ideas; others have argued that sensitive knowledge is not strictly speaking a form of knowledge for Locke. (...) This chapter argues that Locke’s conception of sensitive knowledge is in fact compatible with his official definition of knowledge, and discusses his treatment of the problem of skepticism, both in the Essay and in the correspondence with Stillingfleet. (shrink)

Once symbolized by a burning armchair, experimental philosophy has in recent years shifted away from its original hostility to traditional methods. Starting with a brief historical review of the experimentalist challenge to traditional philosophical practice, this chapter looks at research undercutting that challenge, and at ways in which experimental work has evolved to complement and strengthen traditional approaches to philosophical questions.

This essay raises new objections to the two dominant approaches to understanding the justification of group beliefs—_inflationary_ views, where groups are treated as entities that can float freely from the epistemic status of their members’ beliefs, and _deflationary_ views, where justified group belief is understood as nothing more than the aggregation of the justified beliefs of the group's members. If this essay is right, we need to look in an altogether different place for an adequate account of justified group belief. (...) From these objections emerges the skeleton of the positive view that this essay goes on to develop and defend, called the _group epistemic agent account_: groups are epistemic agents in their own right, with justified beliefs that respond to both evidence and normative requirements that arise only at the group level but that are nonetheless importantly constrained by the epistemic status of the beliefs of their individual members. (shrink)

You and I have been colleagues for ten years, during which we have tirelessly discussed the reasons both for and against the existence of God. There is no argument or piece of evidence bearing directly on this question that one of us is aware of that the other is not—we are, then, evidential equals relative to the topic of God’s existence. There is also no cognitive virtue or capacity, or cognitive vice or incapacity, that one of us possesses that the (...) other does not—we are, then, also cognitive equals relative to the question at issue. Given this evidential and cognitive equality, combined with the fact that we have fully disclosed to one another all of our reasons and arguments relative to this topic, we are epistemic peers with respect to the question whether God exists. Yet despite the symmetry of our epistemic positions, we deeply disagree about the answer to this question. What response does rationality require in such a case, where epistemic peers disagree over a question despite there being no apparent asymmetries between them? (shrink)

Against recent work by Haslanger and Leslie, I argue that we do not yet have good reason to think that we should single out generics about social groups out as peculiarly destructive, or that we should strive to eradicate them from our usage. Indeed, I suggest they continue to serve a very valuable purpose and we should not rush to condemn them.

Questions regarding the nature of moral judgment loom large in moral philosophy. Perhaps the most basic of these questions asks how, exactly, moral judgments and moral rules are to be defined; what features distinguish them from other sorts of rules and judgments? A related question concerns the extent to which emotion and reason guide moral judgment. Are moral judgments made mainly on the basis of reason, or are they primarily the products of emotion? As an example of the former view, (...) Kant held all moral requirements to be derived from a principle of rationality (the categorical imperative). As an example of the latter, Hume famously claimed that reason is “the slave of the passions” and that moral judgments stem from the moral emotions. When addressing these issues, philosophers have largely relied on the traditional tools of philosophical analysis, along with introspection, anecdotal evidence and armchair speculation. In recent years, however, a rich body experimental psychology has emerged which, in the view of a growing number of philosophers, casts important new light on these venerable questions. Our aim, in this chapter, is to illustrate how empirical methods can help move traditional philosophical debates forward in interesting and important ways. Since space does not permit an exhaustive survey of the relevant experimental work, we will focus on a few of the most compelling examples. (shrink)

This paper hypothesises that museums are fundamentally haunted, and hauntological, institutions, and argues that understanding the spectre is necessary to understanding the true position and potential of the museum as a cultural form. In doing so, the paper will address what precisely spectres are, and what hauntology is, before discussing how museums are haunted and hauntological through their relation to memory, anxiety, and the unheimliche. Ultimately, the key argument and conclusion of this paper is that understanding and accepting the museum’s (...) inherently haunted status can enable us to change how museums behave in the twenty-first century, and how we understand their role in public life. (shrink)

This volume argues that educational problems have their basis in an ideology of binary opposites often referred to as dualism, and that it is partly because mainstream schooling incorporates dualism that it is unable to facilitate the thinking skills, dispositions and understandings necessary for autonomy, democratic citizenship and leading a meaningful life. Bleazby proposes an approach to schooling termed social reconstruction learning, in which students engage in philosophical inquiries with members of their community in order to reconstruct real social problems, (...) arguing that this pedagogy can better facilitate independent thinking, imaginativeness, emotional intelligence, autonomy, and active citizenship. (shrink)

The key concept in Kant’s aesthetics is “aesthetic reflective judgment,” a critique of which is found in Part 1 of the Critique of the Power of Judgment (1790). It is a critique inasmuch as Kant unravels previous assumptions regarding aesthetic perception. For Kant, the comparative edge of a “judgment” implicates communicability, which in turn gives it a public face; yet “reflection” points to autonomy, and the “aesthetic” shifts the emphasis away from objective properties to the subjective response evoked by the (...) object. Contrary to the view he had inherited, Kant did not treat aesthetic judgments as confused perceptions or inferior cognitions, but rather put them in a category of their own. For Kant, aesthetic reflective judgments implicated not only the processes involved in understanding the empirical world but also the processes involved in ascribing ideas or meaning to experience (which go beyond what is given in perception/cognition). This “going beyond cognition” may have been referred to by Kant as non-cognitive, but it is conditioned on a way of cognizing the object. Kant describes the features of such judgments in the Analytic of the Beautiful before addressing their possibility in subtle ways throughout the Deduction of Pure Aesthetic Judgments. Kant’s critique gives rise to three apparent dichotomies: immediate intuition and prior learning; autonomy and communicability; and non-cognitive response and aesthetic ideas. An interpretation of Kant’s theory can be deemed correct to the degree that it succeeds in showing that the contradictions are only apparent. I will argue that the resulting positive account of Kant’s aesthetic theory offers an understanding of aesthetic reflective judgment that is quite different from the standard formalism that the critics of formalism usually target and by which they misrepresent Kant’s aesthetic theory. When I refer to Kant’s formalism, then, I mean something quite different by this than what is meant by “standard formalism.” The latter is the representation given Kant’s formalism by its contemporary critics and is the typical account of formalism found in the art theory and philosophy of art literature, as will be demonstrated. (shrink)

Popular science in Nuremberg at the end of the 18th century exemplifies a little known German scientific culture: as in English und French towns, public lectures in natural philosophy and experimental demonstrations were offered to an interested bourgeois audience; the production of scientific toys flourished. The career of Johann Konrad Gütle, private teacher, itinerant lecturer and instrument maker, illustrates the popular scientific scene in Enlightenment Nuremberg.

Introduction -- Elucidating complexity theories -- Complexity in the natural sciences -- Complexity in social theory -- Towards transdisciplinarity -- Complexity in philosophy: complexification and the limits to knowledge -- Complexity in ethics -- Earth in the anthropocene -- Complexity and climate change -- American dreams, ecological nightmares and new visions -- Complexity and sustainability: wicked problems, gordian knots and synergistic solutions -- Conclusion.

The apparent underdetermination of the formalism of quantum field theory (QFT) as between a particle and a field interpretation is studied in this paper through a detour over the problem of unifying QFT with general relativity. All we have at present is a partial or approximate unification, QFT in non-Minkowskian spaces. The nature of this hybrid and the problem of its internal consistency are discussed. One of its most striking implications is that particles do not have an observer-independent existence. We (...) trace the ways in which physicists reacted to this at first highly implausible ontological consequence. We conclude that quantum fields rather than particles are after all the basic entities in QFT. (shrink)

Data indicate the ubiquity and rapid increase of depression wherever war, want and social upheaval are found. The goal of this paper is to clarify such claims and draw conceptual distinctions separating the depressive states that are pathological from those that are normal and normative responses to misfortune. I do so by appeal to early modern writing on melancholy by Robert Burton, where the inchoate and boundless nature of melancholy symptoms are emphasized; universal suffering is separated from the disease states (...) known as melancholy or melancholia, and normal temperamental variation is placed in contrast to such disease states. In Burton's time these distinctions and characterizations could be secured by the anchoring tenets of humoral theory. Without such anchoring, and in light of the findings and assumptions of today's biological diagnostic psychiatry, we must re-visit each of them. My goals here are to show the need for analytic foundations when claims are made about depression such as those cited above, and to draw attention to some contemporary attempts that may help provide those foundations, particularly, attempts to define disorder or disease. With adjustments, one of these (Cooper 2002) is shown to take us some way toward that goal. (shrink)

One of the most important aspects of Grice’s theory of conversation is the drawing of a borderline between what is said and what is implic- ated. Grice’s views concerning this borderline have been strongly and influentially criticised by relevance theorists. In particular, it has become increasingly widely accepted that Grice’s notion of what is said is too lim- ited, and that pragmatics has a far larger role to play in determining what is said than Grice would have allowed. (See for (...) example Bezuidenhuit 1996; Blakemore 1987; Carston 1991; Recanati 1991, 1993, 2001; Sperber and Wilson 1986; Wilson and Sperber 1981.) In this paper, I argue that the rejection of Grice has moved too swiftly, as a key line of objection which has led to this rejection is flawed. The flaw, we will see, is that relevance theorists rely on a misunderstanding of Grice’s project in his theory of conversation. I am not arguing that Grice’s versions of saying and implicating are right in all details, but simply that certain widespread reasons for rejecting his theory are based on misconceptions. (shrink)

Despite the conceptual problems in identifying the placebo effect, an increasing number of multidisciplinary inquiries rest on the assumption that there is a distinct class of effects, placebo effects. In this chapter, I argue against this assumption. I present cases and characterizations of the placebo effect as offered in the literature, and argue that the latter are subject to insurmountable problems. Moreover, I argue that identification of placebo effects as such is not useful for the three main purposes offered in (...) the literature. I then offer suggestions for why it may remain intuitive that some effects are placebo effects and close by noting the potential benefits of ultimately explaining away these intuitions. (shrink)

What is the best way to account for the badness of pain and what sort of theory of welfare is best suited to accommodate this view? I argue that unpleasant sensory experiences are prudentially bad in the absence of contrary attitudes, but good when the object of positive attitudes. Pain is bad unless it is liked, enjoyed, valued etc. Interestingly, this view is incompatible with either pure objectivist or pure subjectivist understandings of welfare. However, there is a kind of welfare (...) theory that can incorporate this view of the badness of pain and which is very, very close to being a form of subjectivism. Moreover, this hybrid account of welfare is entirely compatible with the deep motivations of subjectivism. I therefore argue that those who lean towards welfare subjectivism should adopt this account of pain, and that we should revise our understanding of subjectivism to count such theories as subjective. (shrink)