The Value of Lives, Misc

This essay explores the moral reasoning underpinning the common view that it is worse to kill a human compared with killing an animal. After examining the serious deficiencies of traditional approaches, the author develops an alternative utilitarian-based framework that proportions the seriousness of killing to levels of sentience. He demonstrates how this new approach avoids the problems faced by the application of standard utilitarian formulae in weighing the seriousness of killing many low-sentience animals vis-á-vis killing a single human. The author (...) concludes with a discussion of how this new approach overcomes the difficulties faced by Peter Singer’s dualist form of utilitarianism. (shrink)

There are long-standing doubts about whether data from subjective scales—for instance, self-reports of happiness—are cardinally comparable. It is unclear how to assess whether these doubts are justified without first addressing two unresolved theoretical questions: how do people interpret subjective scales? Which assumptions are required for cardinal comparability? This paper offers answers to both. It proposes an explanation for scale interpretation derived from philosophy of language and game theory. In short: conversation is a cooperative endeavour governed by various maxims (Grice 1989); (...) because subjective scales are vague and individuals want to make themselves understood, scale interpretation is a search for a focal point (Schelling 1960). A specific focal point it hypothesised; if this hypothesis is correct, subjective data will be cardinally comparable. Four individually necessary and jointly sufficient conditions for cardinal comparability are specified. The paper then argues this hypothesis can be empirically be tested, makes an initial attempt to do so using subjective well-being data, and concludes it is supported. Numerous areas for further research are identified including, at the end of the paper, how certain tests could be used to ‘correct’ subjective data if they are not cardinal. (shrink)

Theories of well-being tell us what makes a life good for the one who lives it. But there is more to what makes a life worth living than just well-being. We care about the worth of our lives, and we are right to do so. I defend an objective list theory of the worth of a life: The most worthwhile lives are those high in various objective goods. These principally include welfare and meaning. By distinguishing between worth and welfare, we (...) can capture the intuitive pull of broad theories of welfare without their liabilities. (shrink)

In the recent literature across philosophy, medicine and public health policy, many influential arguments have been put forward to support the use of randomization procedures to allocate scarce life-saving resources. In this paper, I provide a systematic categorization and a critical evaluation of these arguments. I shall argue that those arguments justify using randomization procedures to allocate scarce life-saving resources in fewer cases than their proponents maintain and that the relevant decision makers should typically allocate scarce life-saving resources directly to (...) the individuals with the strongest claims to these resources rather than use randomization procedures to allocate such resources. (shrink)

_ Source: _Page Count 19 As things currently stand, our deaths are unavoidable and our lifespans short. It might be thought that these qualities leave room for improvement. According to a prominent line of argument in philosophy, however, this thought is mistaken. Against the idea that a longer life would be better, it is claimed that negative psychological states, such as boredom, would be unavoidable if our lives were significantly longer. Against the idea that a deathless life would be better, (...) it is claimed that such a life would be lacking in important sources of value, because death is a precondition for many of our valuing attitudes. I argue that these problems are avoided by very long lives that incorporate fading memory, limited ignorance of future events, and temporal scarcity. I conclude that very long lives are, in principle, desirable, and that death does not play an essential role in our valuing attitudes. (shrink)

Defining quality of life is a difficult task as it is a subjective and personal experience. However, for the elderly, this definition is necessary for making complicated healthcare-related decisions. Commonly these decisions compare independence against safety or longevity against comfort. These choices are often not made in isolation, but with the help of a healthcare team. When the patient’s concept of quality of life is miscommunicated, there is a risk of harm to the patient whose best interests are not well (...) understood. In order to bridge this gap in understanding and unite seniors with their caretakers as a cohesive team, we need to establish a definition of quality of life. In this paper, my personal experiences with the elderly will be analysed along with five essays on the topic of ageing. These sources provide clear evidence that quality of life for seniors is majorly determined by the ability to preserve one’s lifelong identity. When making difficult decisions in geriatric healthcare, this greater understanding of the determinants of life quality will allow treatments to best serve the elderly. Defining quality of life allows healthcare providers to shift the focus from minimising disability toward maximising ability. I believe this shift would provide seniors with better health outcomes and properly enhance the quality of their years. (shrink)

Some lives are more meaningful than others. Some lives are more important than others. What is the relationship between meaning in life and importance? Because both can be described as relating to significance, the two are often conflated. But these are rather different concepts and the meaningful and the important can easily come apart. They do, however, interact in important ways. When importance also meets the conditions for meaningfulness, it amplifies it, and importance on a large scale is a key, (...) and perhaps the only, source of superlative meaningfulness. When contrasted with the quest for meaning, the desire for importance can seem shallow and egocentric. But the desire to make an important contribution reflects a legitimate existential concern. And, in their best form, both the desire for importance, and that for meaningfulness, similarly combine outward-looking and self-regarding aspects. (shrink)

Some think that life is worth living not merely because of the goods and the bads within it, but also because life itself is good. I explain how this idea can be formalized by associating each version of the view with a function from length of life to the value generated by life itself. Then I argue that every version of the view that life itself is good faces some version of the following dilemma: either (1) good human lives are (...) worse than very long lives wholly devoid of pleasure, desire-satisfaction, knowledge, or any other goods, or (2) very short lives containing nothing but suffering are worth living. Since neither result is plausible, we ought to reject the view that life itself is good. On the view I favor, any given life may be worth living because of the goods that it contains, but life itself is neutral. (shrink)

For Aristotle, the happy life is the highest human good. But could even unhappy human lives have a grain of intrinsic goodness? Aristotle’s views about the value of the “mere living,” in contrast to the good living, have been neglected in the scholarship, in spite of his recurrent preoccupation with this question. Offering a close reading of a passage from Nicomachean Ethics IX.9, I argue that, for Aristotle, all human lives are intrinsically good by virtue of fully satisfying the definition, (...) and thus function, of their biological species. On the one hand, this rudimentary goodness is inde-pendent of whether the life is lived well or badly; on the other hand, it is ultimately outweighed by the badness inflicted on life by vice or extreme pain, so that the unhappy lives are, all things con-sidered, not worth choosing. (shrink)

According to lexical views in population axiology, there are good lives x and y such that some number of lives equally good as x is not worse than any number of lives equally good as y. Such views can avoid the Repugnant Conclusion without violating Transitivity or Separability, but they imply a dilemma: either some good life is better than any number of slightly worse lives, or else the ‘at least as good as’ relation on populations is radically incomplete, in (...) a sense to be explained. One might judge that the Repugnant Conclusion is preferable to each of these horns and hence embrace an Archimedean view. This is, roughly, the claim that quantity can always substitute for quality: each population is worse than a population of enough good lives. However, Archimedean views face an analogous dilemma: either some good life is better than any number of slightly worse lives, or else the ‘at least as good as’ relation on populations is radically and symmetrically incomplete, in a sense to be explained. Therefore, the lexical dilemma gives us little reason to prefer Archimedean views. Even if we give up on lexicality, problems of the same kind remain. (shrink)

Mill defines utilitarianism as the combination of a “theory of life” and a moral claim: only pleasure and freedom from pain are desirable as ends, and the promotion of happiness is the sole goal of moral action. So defined, utilitarianism is open to ad hominem pessimistic objection: a “theory of life” which entails the impossibility of happiness fits poorly with a morality centered on its promotion. The first two challenges Mill confronts in Utilitarianism share this pessimistic structure. Interestingly, however, these (...) challenges paint inverted pictures of the best utilitarian life: one suggests this life is satisfying but ignoble, the other that it is noble but unsatisfying. I explain Mill's treatment of both challenges as genuinely pessimistic interpretations of utilitarianism's “theory of life.” Read through the lens of Mill's engagement with pessimism, these challenges point to distinctive conceptions of dignity and satisfaction that play a significant role in Mill's ethics. (shrink)

In Almost Over: Aging, Dying, Dead, Frances Kamm seeks to make sense of people’s widely variant choices about which lives they would choose to continue living. She does this by defending the Prudential Prerogative, which, in analogy to the Moral Prerogative, holds that in a fairly wide range of conditions we are under no intrapersonal rational obligation to choose either to die or to live on. I argue against Kamm's case for the Prudential Prerogative in favor of Life Holism, the (...) view that you ought to live the life that would be best for you as an individual when each potential life is considered as a whole. I argue that the features of the Moral Prerogative that make it an attractive principle do not transfer to the Prudential Prerogative, and that Life Holism can better account for the perspectival and non-summative features of the normative phenomena Kamm wants to capture while retaining a tight connection between reasons and goodness. (shrink)

Some people willingly risk or give up their lives for something they deeply believe in, for instance standing up to a dictator. A good example of this are members of the White Rose student resistance group, who rebelled against the Nazi regime and paid for it with their lives. I argue that when the cause is good, such risky activities (and even deaths themselves) can contribute to meaning in life in its different forms – meaning-as-mattering, meaning-as-purpose, and meaning-as-intelligibility. Such cases (...) highlight the importance of integrity, or living up to one’s commitments, in meaningful living, or dying, as it may be, as well as the risk involved in commitment, since if you die for a bad cause, you have only harmed yourself. However, if leading a more rather than less meaningful life benefits rather than harms you, there are possible scenarios in which you yourself are better off dying for a good cause than living a longer moderately happy life. This presents a version of a well-known puzzle: what, then, makes dying for a cause a self-sacrifice, as it usually seems to be? I sketch some possible answers, and try to make sense of relevant work in empirical psychology. (shrink)

This is a book review of Cheshire Calhoun's 2018 book, Doing Valuable Time.

This paper develops transfinite extensions of transitivity and acyclicity in the context of population ethics. They are used to argue that it is better to add good lives, worse to add bad lives, and equally good to add neutral lives, where a life's value is understood as personal value. These conclusions rule out a number of theories of population ethics, feed into an argument for the repugnant conclusion, and allow us to reduce different-number comparisons to same-number ones. Challenges to these (...) arguments are addressed, including the issue of comparing existence and non-existence in terms of personal value, the possibility of minimal quanta of time and life, and the meaningfulness of measuring closeness between outcomes with different population sizes. An asymmetry is uncovered between transfinite cycles of worseness and betterness, supporting a version of the weak procreative asymmetry. Transfinite transitivity principles are also favourably compared to the better-known principles of continuity. (shrink)

This paper presents a critique of David Benatar’s arguments on the badness of all human lives. I argue that even if Benatar is right that there is an asymmetry between the good and the bad in life so that each “unit” of bad is indeed more effective than each “unit” of good, lives in which there is a lot of good and only little bad are still overall good. Even if there are more unfulfilled than fulfilled desires in life, a (...) distinction should be drawn between desires to fulfill important goals and desires to fulfill trivial ones, and Benatar’s claim is untrue of the former. Benatar’s claim that we cannot really know that the quality of our own lives is good is problematic, but even if it were true, it would not show that we cannot estimate correctly the quality of other people’s lives, which is the point at issue. (shrink)

In this paper, I am dealing with the phenomena of “life” and “death.” The questions that I attempt to answer are “What is life, and what is death?” “Is it bad to die?” and “Is there life after death?” The method that I am using in this paper is that of phenomenology. The latter I understand as an inquiry into meaning, that is, what makes this or that phenomenon as such. Thus, I am approaching the phenomena in question from the (...) point of view of their meaning in the first place. I claim that ordinarily we constitute phenomena of “life” and “death” in a twofold way. When it comes to “life,” one can specify “life-as-biological,” and “life-as-a-possibility” senses. The former I understand as a cluster of biological processes that unfold in physical time. By “life-as-a-possibility,” I understand a cluster of projects, potentials that depend on our subjectivity. I claim that we essentially perceive life-as-biological through life-as-possibility. When it comes to “death,” I argue that we essentially constitute this phenomenon in a similar manner. On the one hand, we perceive “death” in the “death-as-biological/physical” sense which signifies the end of the organism’s biological processes. On the other hand, we constitute “death” as the “existential/practical death”/“death-of-possibility.” By that I mean an annihilation of all possibilities, and projects. In short, it is a situation when one’s life suddenly loses all its meaning and value: death of meaning. I argue that what constitutes the significance of “death-as-biological” for us is what I call the “existential/practical death” or “death-of-possibility.” I use the phenomena of mourning and suicide to illustrate my point better. -/- Reflecting on whether it is bad to die, I claim that if we accept the hypotheses I am defending in the paper, it appears that death is bad because it entails the loss of all possibilities. I also want to show that people’s desire for immortality is in fact reasonable, because the more one lives, the more possibilities one is able to realize. In other words, people’s desire for immortality is grounded in the essential understanding of the phenomenon of “life” as a possibility. -/- Reflecting on whether there is life after death, my answer is twofold. Since there is no scientific evidence of life after physical/biological death, I think there is no reason to believe in such as well. But when it comes to the question whether there is life after the existential/practical death, my answer is positive: “Yes, there is!” I try to show that it is always possible to find the meaning of life even in the light of the most terrible events. In this sense, there is always a light in the end of the tunnel. (shrink)

Background: The brief generic Multicultural Quality of Life Index is a culturally informed self-report 10-item questionnaire used to measure health-related quality of life. QoL is an important outcome measure in guiding healthcare and is held as a substantial parameter to evaluate the effectiveness of healthcare. Attention Deficit Hyperactivity Disorder in children might negatively influence the parents’ QoL. Having a validated questionnaire to measure QoL for this population will therefore be a vital first step in guiding healthcare for parents of children (...) with ADHD. We aimed to examine the reliability and validity of the Norwegian version of the MQLI in a sample of parents of children with ADHD.Methods: In a cross-sectional study, 128 parents of children with ADHD were recruited from four outpatient clinics within the Child and Adolescents Mental Health Services in Norway. They completed the MQLI along with an alternative well-being scale, the Five-item World Health Organization Well-being Index, and a form including demographic variables. Reliability and validity of the MQLI were examined. We conducted a factor analysis and calculated internal consistency and the correlation between the MQLI and the WHO-5.Results: Factor analysis of the parents reported MQLI yielded a one-factor solution. For the MQLI, Cronbach’s alpha was 0.73. The correlation between the two measures of MQLI and WHO-5 was high, reflecting convergent validity since the association between the two measures was strong.Conclusion: Results from this study support the reliability and validity of the Norwegian version of the MQLI for assessment of quality of life in parents of children with ADHD with good psychometric properties. Study findings support the use of the questionnaire in CAMHS. (shrink)

The aim of the article is to examine differences in the quality of life as well as gratitude, meaning in life and positive orientation to life between diocesan and religious seminarians and secular students. The influence of religiosity on quality of life and subjective well-being is the subject of numerous studies, but seminarians have rarely been included in them. The present research was carried out for the first time with a group of diocesan and religious seminarians in Poland and secular (...) students. The study involved 296 participants—98 diocesan seminarians, 96 religious seminarians and 102 secular students in the control group. Results showed significant differences in the quality of life. Religious and diocesan seminarians scored higher than the control group members in the psychophysical, personal, psychosocial and metaphysical spheres. In addition, in terms of gratitude, and the presence of meaning in life, religious and diocesan seminarians achieved higher scores than the control group but lower scores in searching for the meaning in life. There were no significant differences between diocesan and religious seminarians except that only diocesan seminarians obtained significantly higher scores on positive orientation to life than the control group. Overall, results support the idea that seminarians have higher quality of life and subjective well-being than secular students. Research implications are discussed. (shrink)

Pessimism is, roughly, the view that life is not worth living. In chapter 46 of the second volume of The World as Will and Representation, Arthur Schopenhauer provides an oft-neglected argument for this view. The argument is that a life is worth living only if it does not contain any uncompensated evils; but since all our lives happen to contain such evils, none of them are worth living. The now standard interpretation of this argument (endorsed by Kuno Fischer and Christopher (...) Janaway) proceeds from the claim that the value—or rather valuelessness—of life’s goods makes compensation impossible. But this interpretation is neither philosophically attractive nor faithful to the text. In this paper, I develop and defend an alternative interpretation (suggested by Wilhelm Windelband and Mark Migotti) according to which it is instead the actual temporal arrangement of life’s goods and evils that makes compensation impossible. (shrink)

The purpose of this article is to unearth the dimensions of quality of work life and work–life balance and to find the impact of the quality of work life on work–life balance. Data have been gather...

BackgroundDecisions about withdrawal of life support for infants have given rise to legal battles between physicians and parents creating intense media attention. It is unclear how we should evaluate when life is no longer worth living for an infant. Public attitudes towards treatment withdrawal and the role of parents in situations of disagreement have not previously been assessed.MethodsAn online survey was conducted with a sample of the UK public to assess public views about the benefit of life in hypothetical cases (...) similar to real cases heard by the UK courts. We then evaluated these public views in comparison with existing ethical frameworks for decision-making.ResultsOne hundred and thirty participants completed the survey. The majority agreed that an infant’s life may have no benefit when well-being falls below a critical level. Decisions to withdraw treatment were positively associated with the importance of use of medical resources, the infant’s ability to have emotional relationships, and mental abilities. Up to 50% of participants in each case believed it was permissible to either continue or withdraw treatment.ConclusionDespite the controversy, our findings indicate that in the most severe cases, most people agree that life is not worth living for a profoundly disabled infant. Our survey found wide acceptance of at least the permissibility of withdrawal of treatment across a range of cases, though also a reluctance to overrule parents’ decisions. These findings may be useful when constructing guidelines for clinical practice. (shrink)

Critical-Range Utilitarianism is a variant of Total Utilitarianism which can avoid both the Repugnant Conclusion and the Sadistic Conclusion in population ethics. Yet Standard Critical-Range Utilitarianism entails the Weak Sadistic Conclusion, that is, it entails that each population consisting of lives at a bad well-being level is not worse than some population consisting of lives at a good well-being level. In this paper, I defend a version of Critical-Range Utilitarianism which does not entail the Weak Sadistic Conclusion. This is made (...) possible by a fourth category of absolute value in addition to goodness, badness, and neutrality. (shrink)

Proposals for health care cost containment emphasize high-value care as a way to control spending without compromising quality. When used in this context, ‘value’ refers to outcomes in relation to cost. To determine where health spending yields the most value, it is necessary to compare the benefits provided by different treatments. While many studies focus narrowly on health gains in assessing value, the notion of benefit is sometimes broadened to include overall quality of life. This paper explores the implications of (...) using subjective quality of life measures for value assessment. This approach is claimed to be more respectful of patients and better capture the perspectival nature of quality of life. Even if this is correct, though, subjective measurement also raises challenging issues of interpersonal comparability when used to study health outcomes. Because such measures do not readily distinguish benefits due to medical interventions from benefits due to personal or other factors, they are not easily applied to the assessment of treatment value. I argue that when the outcome of interest in value assessment is broadened to include quality of life, the cost side of these measures should also be broadened. I show how one philosophical theory of well-being, Jason Raibley’s “agential flourishing” theory, can be adapted for use in quality of life research to better fit the needs and aims of value assessment in health care. Finally, I briefly note some implications of this argument for debates about fairness in health care allocations. (shrink)

The Quality of Life: Aristotle Revised, by KrautRichard. Oxford: Oxford University Press, 2018. Pp. x + 249.

Many find it reasonable to take our past actions into account when making choices for the future. In this paper, I address two important issues regarding taking past investments into account in prudential deliberation. The first is the charge that doing so commits the fallacy of honoring sunk costs. I argue that while it is indeed irrational to care about sunk costs, past investments are not sunk costs when we can change their teleological significance, roughly their contribution to our excellence (...) as temporally extended, reasons-responsive, and goal-directed agents. I suggest some general principles for evaluating such significance. Second, it’s a live issue whether we should care about the fate of our past projects, even if we can now affect it. I reject Dale Dorsey’s recent answer, and argue that the puzzle he addresses turns out to be merely apparent, if we take seriously the fact that we are temporally extended. (shrink)

As a neonatal neurologist, I serve families facing tragic decisions in which they must balance trade-offs between death and life with profound disability. I often find myself in complex discussions about future outcome, in which families sort through in real-time what information they value most in making such a choice. Will he laugh? Will he be in pain? Will he know how much he’s loved? In this month’s feature article, Brick et al share the results of an online survey aimed (...) at assessing public views on when a life is not worth living, in an effort to inform ongoing legal and clinical debates about withdrawal of life-sustaining treatment for children. These findings raise important questions about how we define and measure outcomes that matter to parents as they make these tragic decisions. It is challenging to interpret these findings in the absence of context of how decision-making for infants occurs in real-time. The nature of this study and its objective required that cases be substantially simplified. As the authors acknowledge, the prognoses and function of the children involved in these cases were often deeply contested. Prognostic uncertainty is common for children with significant …. (shrink)

Contemporary versions of natural rights libertarianism trace their locus classicus to Robert Nozick’s Anarchy, State, and Utopia. But although there have been many criticisms of the version of political libertarianism put forward by Nozick, many of these fail objections to meet basic methodological desiderata. Thus, Nozick’s libertarianism deserves to be re-examined. In this paper I develop a new argument which meets these desiderata. Specifically, I argue that the libertarian conception of self-ownership, the view’s foundation, implies what I call the Asymmetrical (...) Value Claim: a dubious claim about the importance of choice relative to other valuable capacities. I argue that this misunderstands what is really valuable in life, and show how it causes libertarianism to generate counterintuitive public policy recommendations. (shrink)

The M → W thesis that a meaningful life must be a worthwhile life follows from an appealing approach to the axiology of life. Yet one of the most prominent voices in the recent philosophy of life literature, Thaddeus Metz, has raised multiple objections to that thesis. With a view to preserving the appeal of the axiological approach from which it follows, I here defend the M → W thesis from Metz’s objections. My defense yields some interesting insights about both (...) a meaningful life and a worthwhile life: a meaningful life should be firmly distinguished from a life with meaning, the value of a meaningful life must outweigh whatever disvalue the life has, a worthwhile life at a given time needn’t be a life worth continuing at that time, and the M → W thesis doesn’t preclude the possibility of something being part of what constitutes the meaningfulness of a life without also being part of what constitutes the worthwhileness of the life. (shrink)

Dying is (sometimes) bad for the dier because it prevents her from being the subject of wellbeing she otherwise would (the deprivation account). I argue for this from a (plausible) principle about which futures are bad for a prudential subject (the future-comparison principle). A strengthening of this principle yields that death is not always bad, and that the badness of death does not consist in that it destroys the dier.

This book is at once incisive and exploratory, interpretive and historic scholarship. It appeals to both general and specialized readers. It uniquely takes a common philosophical theme, the meaning of life, and traces it through many philosophers’ and novelists' works. Sometimes the theme is buried and implicit, and offers a plausible distillation of each author's view. The result is a title that may sound like a self-help book’s—except the contents expand in manifold directions rather than narrow to easy advice. The (...) reader, not spoon fed, is provided only one advice: Read these, and decide for onerself, especially if none of them answers sufficiently for each reader. Philosophers represnted include Schopenhauer, Kierkegaard. Nietzche, James, Wittgenstein, Novelists include Melville, Tolstoy, Proust, and Camus. (shrink)

Work done within the realm of what is sometimes called ‘descriptive ethics’ brings two questions readily to mind: How can empirical findings, in general, inform normative debates? and How can these empirical findings, in particular, inform the normative debate at hand? Brick et al 1 confront these questions in their novel investigation of public views about lives worth living and the permissibility of withdrawing life-sustaining treatment from critically ill infants. Mindful of the is-ought gap, the authors suggest modestly that their (...) data ‘may be useful when constructing guidelines for clinical practice’. In this commentary, I consider some potential limitations on the generalisability of these data in the context of policy and clinical practice, limitations which may in turn serve as directions for future empirical research. The authors’ study presented participants six case scenarios, five of which involved the possibility of withdrawing life-sustaining treatment from critically ill infants. The results revealed that “[a]lmost all respondents agreed that at some level of quality of life, life may be of no benefit or worse than death for an infant” and that “participants significantly favoured withdrawal of treatment for the most severe cases.” One salient detail in these scenarios …. (shrink)

Consider the utterances ‘our friendship is valuable’ and ‘I value our friendship’. On the face of it, these aren’t semantic equivalents: the former ascribes a property to our friendship, whereas the latter reports something about how I relate to our friendship. In this short paper, I first outline Samuel Scheffler’s account of valuing and of the difference between valuing and considering valuable. I then propose an amendment to his account of valuing, one which concerns how we interact with our value-related (...) emotions. Subsequently, I argue against Scheffler’s view of the distribution of valuing and considering valuable in the world. While I don’t deny that considering valuable without valuing is conceptually possible and indeed instantiated, I disagree that it’s typical within our evaluative lives. Next, I consider an obvious response to my empirical claim and sketch a dilemma which accompanies that response. Finally, I highlight two limits of my empirical claim. (shrink)

This article proposes a novel strategy, one that draws on insights from antidiscrimination law, for addressing a persistent challenge in medical ethics and the philosophy of disability: whether health systems can consider quality of life without unjustly discriminating against individuals with disabilities. It argues that rather than uniformly considering or ignoring quality of life, health systems should take a more nuanced approach. Under the article's proposal, health systems should treat cases where quality of life suffers because of disability-focused exclusion or (...) injustice differently from cases where lower quality of life results from laws of nature, resource scarcity, or appropriate tradeoffs. Decisionmakers should ignore quality-of-life losses that result from injustice or exclusion when ignoring them would improve the prospects of individuals with disabilities; in contrast, they should consider quality-of-life losses that are unavoidable or stem from resource scarcity or permissible tradeoffs. On this proposal, while health systems should not amplify existing injustice against individuals with disabilities, they are not required to altogether ignore the potential effects of disability on quality of life. (shrink)

Contemporary philosopher David Benatar has advanced the self-evidently controversial claim that “coming into existence is always a harm.” Benatar’s argument turns on the basic asymmetry between pleasure and pain, an asymmetry he seeks to explain by the principle that those who never exist cannot be deprived. Benatar’s import is almost incredible: humans should cease to procreate immediately, thereby engendering the extinction of the species—a view known as “anti-natalism.” According to many of his readers, the ancient Hebrew sage Qoheleth expresses a (...) pessimistic nihilism that runs as thick as Benatar’s. Prima facie grounding for this assertion is that Qoheleth, like Benatar, raises the issue of whether coming into existence may be a harm—and gives an affirmative answer. In two passages, Ecclesiastes 6:1-6 and 4:1-3, Qoheleth declares that an unborn hypothetical person is “better off” than their existent counterpart. Yet the meaning and implication of these words is far from obvious. Does Qoheleth imply that the non-exister’s state, and non-existence in general, is universally superior to existence? Or is he instead speaking exceptionally, of particular persons in rare circumstances? By examining the two “better”-statements in their literary context, I will argue that Qoheleth intends these examples as exceptions. He does not go so far as to make the supremely nihilistic claim that coming into existence is always, or even generally, a net harm; yet, he does concede that in certain cases, it can be. Beyond this, I will explore how the two thinkers’ divergent conclusions can be traced to a deeper difference of philosophical method. This question concerning non-existence opens a window to Qoheleth’s broader scheme of values and therefore serves as a surprisingly useful entry point by which to engage his philosophy. The paper utilizes the methodology Jaco Gericke has recently termed “philosophical criticism,” but specifically applied to Qoheleth. (shrink)

This paper explores the relationship between disability and quality of life and some of its implications for bioethics and healthcare. It focuses on the neglected perfectionist approach that ties well-being to the flourishing of human nature, which provides the strongest support for the common view of disability as a harm. After critiquing the traditional Aristotelian version of perfectionism, which excludes the disabled from flourishing by prioritizing rationalistic goods, I defend a new version that prioritizes the social capacities of human nature (...) and the goods of personal relationship. This relationship-centered perfectionism is able to accommodate and explain disabled thriving. I also show how these issues have important implications for specific bioethical debates and clinical practices, using a cluster of issues related to Down syndrome as timely illustrations. My goal is to sketch a perfectionist theory that gives a more plausible account of the relationship between disability and well-being, and that provides better practical guidance in cases involving judgments about the quality of disabled lives. (shrink)

In his book, The Human Predicament, David Benatar claims that our individual lives and human life, in general, do not make a difference beyond Earth and, therefore, are meaningless from the vast, cosmic perspective. In this paper, I will explain how what we do matters from the cosmic perspective. I will provide examples of how human beings have transcended our limits, thereby giving human life some meaning from the cosmic perspective. Also, I will argue that human life could become even (...) more meaningful by making some fundamental achievements, such as determining how life originated. (shrink)

What is the relationship between negative experience, artistic production, and prudential value? If it were true that (for some people) artistic creativity must be purchased at the price of negative experience (to be clear: currently no one knows whether this is true), what should we conclude about the value of such experiences? Are they worth it for the sake of art? The first part of this essay considers general questions about how to establish the positive extrinsic value of something intrinsically (...) negative. The second part emphasizes the importance of various distinctions within the realm of the negative. We must distinguish between adversity (which is non-mental) and negative mental states, and between negative thoughts (or attitudes) and negative affect. Within the realm of negative affect, we must distinguish between negative emotions and moods, on the one hand, and negative affective perspectives on the other, and then between mildly negative affective perspectives and severely negative ones (for which I reserve the term ‘suffering’). These distinctions matter greatly, since different types of negative experience have very different degrees of prudential disvalue. Although many types of negative experience may be “worth it”—because their positive extrinsic value outweighs their negative value—this is rarely true of severe suffering. (shrink)

Richard Kraut presents a new theory of human well-being. Kraut's principal idea, Aristotelian in spirit, is that 'external goods' have at most an indirect bearing on the quality of our lives. A good internal life - one with quality emotional, intellectual, social, and perceptual experiences - is what well-being consists in.

I suggest a way in which metaphysics might cure us of our desire for immortality. Supposing that time is composed of instants, or even that time could be composed of instants, leads to the conclusion that there is nothing good that immortality offers, nothing we might reasonably want, that is in principle unavailable to a mere mortal. My argument proceeds in three stages. First, I suggest a necessary condition for a feature to ground the desirability of a life or a (...) portion thereof. Second, after distinguishing between three different features that could plausibly be meant by ’immortality’, I argue that if time could be composed of instants, only one of those features satisfies the necessary condition, and it evidently fails to ground the desirability of a life. Third, I argue that no feature that entails any of the three features grounds the desirability of a life either. I conclude with reflections on what this means for our longing for immortality. (shrink)

Background and Objectives: In recent decades, attention paid to quality of life as an important factor to evaluate the therapeutic outcomes and the effectiveness of treatments for illnesses, has increased. The purpose of this study was to investigate the association between spiritual health and quality of life in opioid-dependent men in Qom. Methods: The study population of this descriptive-correlational study consisted of 107 opioid-dependent men referring to addiction treatment centers in Qom who were selected by random sampling. Participants completed a (...) 48-item spiritual well-being questionnaire, developed by Amiri et al., and short form 36-item health survey. Data analysis was conducted by the SPSS version 21 using Pearson's correlation coefficient. Results: General spiritual health and behavioral aspect were significantly directly correlated with overall quality of life and its subscales, except for physical function, limitation in playing the role due to physical health problems, and pain. There was also a significant relationship between general spiritual health and overall quality of life. Conclusion: Behavioral aspect, among the aspects of general health, and general spiritual health are more important for the quality of life in opioid-dependent people. Spiritual health, especially spiritual behavior, is an effective supportive mechanism for opioid-dependent people that can be effective to improve their quality of life. (shrink)

It has become virtually a matter of dogma—among both philosophers and laypersons—that human lives are more valuable than animal lives. One argument for this claim dominates the philosophical literature and, despite its employment by a host of philosophers, should be found wanting. I try to show that this line of reasoning, as well as one that is less popular but still with significant appeal, are faulty. The errors in each argument seem fatal: the pervasive argument begs the question, and the (...) more selective is, at bottom, unintelligible. We should judge that the lives of humans and animals are equally valuable, an assessment that should be accompanied by major changes in some of our fundamental practices. (shrink)

Suppose we are about to enter an era of increasing technological unemployment. What implications does this have for society? Two distinct ethical/social issues would seem to arise. The first is one of distributive justice: how will the efficiency gains from automated labour be distributed through society? The second is one of personal fulfillment and meaning: if people no longer have to work, what will they do with their lives? In this article, I set aside the first issue and focus on (...) the second. In doing so, I make three arguments. First, I argue that there are good reasons to embrace non-work and that these reasons become more compelling in an era of technological unemployment. Second, I argue that the technological advances that make widespread technological unemployment possible could still threaten or undermine human flourishing and meaning, especially if they do not remain confined to the economic sphere. And third, I argue that this threat could be contained if we adopt an integrative approach to our relationship with technology. In advancing these arguments, I draw on three distinct literatures: the literature on technological unemployment and workplace automation; the antiwork critique—which I argue gives reasons to embrace technological unemployment; and the philosophical debate about the conditions for meaning in life—which I argue gives reasons for concern. (shrink)

Euthanasia advocates argue that end-of-life decisions should be based on patients’ autonomous evaluations of their own quality of life. The question is whether a patient’s quality of life has deteriorated so far as to make death a benefit. Criteria for evaluating quality of life are, however, unavoidably arbitrary and unjust. The concept is difficult to define, and human autonomy has limits. This essay discusses the moral issues raised by quality-of-life judgments at the end of life: who makes them, what criteria (...) they use, and what clinical actions the conclusions justify. It then looks at ways in which quality of life can be considered legitimately, in relation not to euthanasia, which is always illicit, but to specific proposed treatments. If a patient decides to forgo treatment, the decision should be based on the judgment that the treatment, its side effects, or its long-term consequences would be excessively burdensome or useless. (shrink)

Are the lives of those fighting on the unjust side of a war worth less than the lives of those fighting on the just side? It is tempting to answer Yes. There is a powerful and popular rationale for this verdict: Things are intrinsically better when people get what they deserve. According to this view, the goodness of a life is the product of one’s desert-adjusted welfare. In this essay, I highlight the troubling implications that adjusting for desert has in (...) the context of war. The implausibility of these implications calls into question the core idea of the desert-adjusted account: namely, that there is some level of welfare that each person deserves, and things would go best if everyone were at these levels. (shrink)