"In this article, I argue that under current resource constraints, institutional arrangements seeking to ensure commonly accepted egalitarian goals would engender the decrease of health status of many who do not currently enjoy particularly high levels of health.".

Economist-philosopher Amartya Sen's writings on social and political issues have attracted wide audiences. Section 2 introduces his contributions on: how people reason as agents within society; social determinants of people's (lack of) access to goods and of the effective freedoms and agency they enjoy or lack; and associated advocacy of self-specification of identity and high expectations for ‘voice’ and reasoning democracy. Section 3 considers his relation to social theory, his tools for theorizing action in society, and his limited degree of (...) attention to work by sociologists and to capitalism and power structures. Section 4 characterizes a style marked by conceptual refinement, emphases on complexity and individuality, including personal individuality, and reformist optimism. Section 5 shows the features from Sections 3 and 4 at work in his conception of personhood that advocates freedom to make a reasoned composition of personal identity. Similarly, Section 6 addresses his conception of public reasoning and neglect of the sociology of democracy. It contrasts the ideal of a reasoning polity with features in many countries. Sen's programmes for critical autonomy in personhood and for reasoned politics play, nevertheless, a normic role, while his analytical formats help investigation of obstacles to more widespread agency, voice, and democratic participation. (shrink)

A thorough understanding of what needs are is fundamental for design- ing well-behaved information systems for many social applications and in partic- ular for public services. Talking about needs pervades indeed the jargon of Public Administrations when motivating their service offering. In this paper, we propose an ontological analysis of needs, aiming at a principled disentangling of the differ- ent uses of the term. We leverage philosophical tradition on intentionality, for its rich understanding of mental entities, we compare it with (...) the well-established BDI (Belief-Desire-Intention) tradition in knowledge representation, and we propose a formalisation of needs within the foundational ontology DOLCE. Throughout the paper, we motivate our analysis focusing on needs in public services. (shrink)

Social work has long been concerned with the respective roles of the social work profession and the social welfare system in addressing human needs. Social workers engage in needs assessment together with client systems. They provide and advocate for the needs of clients, as well enabling and empowering clients and communities to address their needs. They also advocate for social welfare benefits and services and overall social policies that take human needs into account. However, explicit ethical content was not present (...) in earlier Codes of Ethics of the National Association of Social Workers. Furthermore, until very recently, little published literature in peer-reviewed journals has human needs theories to guide models of social work practice or inform social work research. Universalistic assumptions about human needs have long been found within social work’s literature on human development (see Jani and Reisch 2011, under General Overviews). However, these assumptions were often inexplicit. They did not fully utilize theories of human need, which have long recognized that although human needs may be universal, they are addressed in culturally and environmentally specific manners. Also, in practice, social workers have often conflated human needs with the need for the services or benefits available at any one time. This bibliography will explore the history and evolution of the interdisciplinary body of human needs theory and research on which social work has drawn historically, with special attention to the recent surge in interest in human needs theories. In doing so, the entry will discuss a number of key debates that have arisen regarding needs, including whether they are universal or specific to particular cultures; what the relationship is between human needs, human rights, and social justice; and how to reconcile theories of human needs and of human capabilities. (shrink)

The role that need plays in dealing with problems of distributive justice is examined in a series of vignette studies. Among other things, it becomes clear that impartial observers make gradual assessments of justice that depend on the extent to which the observed individuals are endowed with a good. If it is known how high their need for that good is, the assessments are made relative to this reference point. In addition, impartial decision-makers make hypothetical distribution decisions that take into (...) account need, productivity, and accountability. The need of individuals is partially compensated even if they have contributed less to the available amount than they themselves require. However, the willingness to do so decreases if they are accountable for needing more than others or for having contributed less than others. Lastly, both impartial observers and impartial decision-makers distinguish between different types of needs, the fulfillment of which is given different levels of importance. (shrink)

Friedrich von Hayek’s classical liberalism argued that free markets allow individuals the greatest opportunity to achieve their ends. This paper develops an internal critique of this claim. It argues that once externalities are introduced, the forms of economic knowledge Hayek thought to undermine government action and orthodox utilitarianism also rule out relative welfarist assessments of more or less regulated markets. Given the pervasiveness of externalities in modern economies, Hayek will frequently be unable to make comparative welfarist claims, or he must (...) relax his epistemic assumptions and allow for greater government action than his classical liberalism would wish to accept. (shrink)

The article discusses the conditions under which can we say that people enter the economic system voluntarily. “The Need for an Exit Option” briefly explains the philosophical argument that voluntary interaction requires an exit option—a reasonable alternative to participation in the projects of others. “The Treatment of Effective Forced Labor in Economic and Political Theory” considers the treatment of effectively forced interaction in economic and political theory. “Human Need” discusses theories of human need to determine the capabilities a person requires (...) to have an acceptable exit option. “Capability in Cash, Kind, or Raw Resources” considers what form access to that level of capability should take—in cash, kind, or raw resources, concluding that a basic income guarantee is the most effective method to ensure an exit option in a modern, industrial economy. (shrink)

According to HealthCare.gov, by improving access to quality health for all Americans, the Affordable Care Act (ACA) will reduce disparities in health insurance coverage. One way this will happen under the provisions of the ACA is by creating a new health insurance marketplace (a health insurance exchange) by 2014 in which “all people will have a choice for quality, affordable health insurance even if a job loss, job switch, move or illness occurs”. This does not mean that everyone will have (...) whatever insurance coverage he or she wants. The provisions of the ACA require that each of the four benefit categories of plans (known as bronze, silver, gold and platinum) provides no less than the benefits available in an “essential health benefits package”. However, without a clear understanding of what criteria must be satisfied for health care to be essential, the ACA’s requirement is much too vague and open to multiple, potentially conflicting interpretations. Indeed, without such understanding, in the rush to provide health insurance coverage to as many people as is economically feasible, we may replace one kind of disparity (lack of health insurance) with another kind of disparity (lack of adequate health insurance). Thus, this paper explores the concept of “essential benefits”, arguing that the “essential health benefits package” in the ACA should be one that optimally satisfies the basic needs of the people covered. (shrink)

(2000). Caring at a Distance: (Im)partiality, Moral Motivation and the Ethics of Representation - Introduction. Ethics, Place & Environment: Vol. 3, No. 3, pp. 303-309. doi: 10.1080/713665900.

People who are involuntarily childless need to use assisted reproductive technologies if they want to have a genetically related child. Yet, from an ethical point of view it is unclear to what extent assistance to satisfy this specific desire should be warranted. We first show that the subjectively felt harm due to the inability to satisfy this reproductive desire does not in itself entail the normative conclusion that it has to be met. In response, we evaluate the alternative view according (...) to which the satisfaction of this desire is regarded as a way to meet one’s presumed intermediate need for parenthood. This view presupposes that parenthood is one of those general categories of experiences and activities that contribute an irreplaceable value to people’s lives, but the central difficulty is to find those characteristics that mark out parenthood as an irreplaceable constituent of a valuable life. We go on to argue, however, that even if one assumes that parenthood is such an irreplaceable constituent that makes life more valuable, this does not necessarily entail a moral duty to satisfy the desire for genetic parenthood. We conclude that there is a pro tanto obligation to help people conceive a genetically related child (if this is what they prefer), but that this can be outweighed by other moral considerations, such as safety and justice concerns. (shrink)

Corporate social responsibility has been intensively discussed in business ethics literature, whereas the social responsibility of private consumers appears to be less researched. However, there is also a growing interest from business ethicists and other scholars in the field of consumer social responsibility. Nevertheless, previous discussions of ConSR reveal the need for a viable conceptual basis for understanding the social responsibility of consumers in an increasingly globalized market economy. Moreover, evolutionary aspects of human morality seem to have been neglected despite (...) the fact that private consumers are undoubtedly human beings. In addition to that, empirical studies suggest that many consumers believe themselves to be responsible but do not act according to their alleged values or attitudes. This raises the question of what deters them from doing so. Therefore, the contribution of this conceptual paper is threefold: we conceptualize ConSR in terms of a combination of a Max Weber-inspired approach with the social connection approach to shared responsibility proposed by Iris Marion Young; shed light on the previously neglected implications of an evolutionarily induced bounded morality for ConSR, and identify potential obstacles to socially responsible consumption, particularly against the backdrop of shared social responsibility and bounded morality. In this latter respect, the paper focuses specifically on the obstacles of low moral intensity, moral stupefaction, informational complexity, and the lack of perceived consumer effectiveness. In sum, the paper advances knowledge in the field of ConSR by using a transdisciplinary, literature-based approach. (shrink)

Need-claims are ubiquitous within moral and political theory. However, need-based theories are often criticized for being too narrow in scope and too focused on the material preconditions for leading a decent life for grounding a substantial theory of social justice. The aim of this paper is threefold. Firstly, it will investigate the nature and scope of needs by analysing existing conceptualizations of the idea of needs. In so doing, we will get a better understanding of needs, which will help us (...) to carve out the importance and singularity of basic need claims. Secondly, on the basis of the analysis of needs, it will argue for the concept of a fundamental interest in free social agency, which is much better suited than the idea of basic needs actually to ground a theory of social justice, as it highlights the social and institutional conditions for free agency. Thirdly, using the distinction between basic needs and fundamental interests, it will clarify their respective role in and importance for grounding moral principles. Overall, the paper offers a friendly critique of need-based theories, while arguing for a shift of focus to the idea of fundamental interests. (shrink)

Elements comprising a set of building blocks for a feminist reconstruction of citizenship might include: a critical synthesis of citizenship as a status and a practice; strengthening the inclusive side of citizenship (within and across nation-states); the principle of differentiated universalism, addressing tensions between an analysis grounded in difference and the universalism standing at the heart of citizenship; and a challenge to the binary thinking that constrains the articulation of women's claims to citizenship.

The concept of well-being is central to the subject matter of moral philosophy as well as economics. According to some moral theorists morality is about the maximization of social well-being. According to others, notably John Rawls we ought to give particular priority to the worst off members in society. Both these and other moral positions, whatever the priority they attach to different members of society in arriving at moral judgements, require an account of well-being or advantage. The concern with well-being (...) is thus of foundational importance in moral philosophy, even if well-being is not thought of as all that matters. Furthermore, those who want to distinguish ‘morality’ from ‘self-interest’ must furnish us with an account of human interests, so that we can distinguish the moral realm from that of self-interest or prudence. The concerns of moral philosophers, here, clearly overlap with those of economists. Economists are much concerned with questions of how well people are doing, with their ‘standard of living’ or ‘quality of life’. However, there are very different ways of thinking about each of these ideas. Indeed, we need to discriminate between different views of the quality of life and to decide which is the most appropriate for the purposes of moral theory and the normative parts of economics. (shrink)

For more than three decades, business ethics has suggested and evaluated strategies for multinationals to address abject deprivations and weak regulatory institutions in developing countries. Critical appraisals, internal and external, have observed these concerns being severely constrained by the overwhelming prioritization of economic values, i.e., economism. Recent contributions to business ethics stress a re-imagination of the field wherein economic goals are downgraded and more attention given to redistribution of wealth and well-being of the weaker individuals and groups. Development ethics, a (...) lesser known field of normative enquiry, already offers nuanced justifications against economism which business ethicists can use in their current attempts to wean the field from old habits. (shrink)

PORTER S and O’HALLORAN P. Nursing Inquiry 2012; 19: 18–28The use and limitation of realistic evaluation as a tool for evidence-based practice: a critical realist perspectiveIn this paper, we assess realistic evaluation’s articulation with evidence-based practice (EBP) from the perspective of critical realism. We argue that the adoption by realistic evaluation of a realist causal ontology means that it is better placed to explain complex healthcare interventions than the traditional method used by EBP, the randomized controlled trial (RCT). However, we (...) do not conclude from this that the use of RCTs is without merit, arguing that it is possible to use both methods in combination under the rubric of realist theory. More negatively, we contend that the rejection of critical theory and utopianism by realistic evaluation in favour of the pragmatism of piecemeal social engineering means that it is vulnerable to accusations that it promotes technocratic interpretations of human problems. We conclude that, insofar as realistic evaluation adheres to the ontology of critical realism, it provides a sound contribution to EBP, but insofar as it rejects the critical turn of Bhaskar’s realism, it replicates the technocratic tendencies inherent in EBP. (shrink)

In answering normative questions, researchers sometimes appeal to the concept of basic needs. Their guiding idea is that our first priority should be to ensure that everybody is able to meet these needs—to have enough in terms of food, water, shelter, and so on. This article provides an opinionated overview of basic needs in normative contexts. Any basic needs theory must answer three questions: (1) What are basic needs? (2) To what extent do basic needs generate reasons for action and (...) how are these reasons to be understood? (3) How are basic needs and their satisfaction to be measured? I address these questions in turn. Then I also briefly discuss the theoretical potential of appealing to basic needs in normative contexts. It turns out that future research in this area could benefit from a higher degree of interdisciplinarity and methodological reflection, and that, generally speaking, basic needs theories are more promising than they have often been claimed to be. (shrink)

Some normative theorists appeal to the concept of basic needs. They argue that when it comes to issues such as global justice, intergenerational justice, human rights or sustainable development our first priority should be that everybody is able to meet these needs. But what are basic needs? We attempt to inform discussions about this question by gathering evidence of ordinary English speakers’ intuitions on the concept of basic needs. First, we defend our empirical approach to analyzing this concept and identify (...) a number of its potential features. Then we present three preregistered empirical studies that were conducted to investigate the extent to which ordinary speakers endorse these features. The studies yield convergent evidence for the following three claims: (1) ordinary speakers sometimes apply the concept of basic needs to necessities for a flourishing (not just a minimally decent) life, (2) most ordinary speakers attribute at least some degree of subjectivity to the concept, and (3) most ordinary speakers attribute at least some degree of relativity to the concept. We discuss the implications of these findings for philosophical analyses of _basic needs_. (shrink)

A key concern of global ethics is the equitable distribution of benefits and burdens amongst persons belonging to different populations. Until recently, the philosophical literature on global distribution was dominated by the question of how benefits and burdens should be divided amongst contemporaries. Recent years, however, have seen an increase in research on the scope and content of our duties to future generations. This has led to a number of innovative attempts to extend principles of distribution across time while retaining (...) a focus on the entitlements of the existing poor. In this article, I examine a key aspect of intergenerational justice, namely, the appropriate 'pattern' of well-being that should be obtained across generations. With the aid of research into the impacts of global climate change, I evaluate a number of rival accounts of the pattern of justice and go on to explore the merits of a 'global sufficientarian' ethic, which holds that as many persons as possible should enjoy a satisfactory level of well-being regardless of when or where they live. (shrink)

The idea of sustainable development as a normative concept emphasizes the necessity for a wider consensus on meeting human needs, ensuring social equity, and respecting planetary boundaries. The purpose of the article focuses on the deontological orientation in perceiving sustainable development. It is expected that looking at sustainability from the deontological perspective might increase individuals’ awareness of responsibility towards respecting the needs of the world’s poor, environmental boundaries, and moral equity, which emphasizes that all people are equal. Any attempt to (...) achieve sustainability demands, first of all, rational action placed on moral duties/obligations before individual people or institutions can achieve their particular desires and goals. According to this perspective, sustainability should be treated as a prior constraint in obtaining economic maximization. (shrink)

Attention to individual choice is a valuable dimension of public health policy; however, the creation of effective public health programmes requires policy makers to address the material and social structures that determine a person’s chance of actually achieving a good state of health. This statement summarizes a well understood and widely held view within public health practice. In this article, we (i) argue that advocates for public health can and should defend this emphasis on ‘structures’ by reference to citizen autonomy (...) and not simply by emphasizing concern for counter-balancing values such as ‘population health’ or ‘fairness’, (ii) map and critically explore the contrasting conceptions of autonomy that feature in such debates, with particular attention to conceptions of autonomy that might feature in the defence of an emphasis on structures. We draw on (i) a relational conception of autonomy and (ii) the distinction that can be made between autonomous deliberation and autonomous action to suggest that offering people the opportunity to make choices about their health without also supporting their capability to achieve the object of these choices falls short of what is often considered to be morally and politically important about promoting autonomy in relation to health. (shrink)

This paper is a review essay of two collections of essays focused on the work of Alasdair MacIntyre. The review focuses on three core themes. First, it discusses those papers that explore the central role that the relationship between practices and institutions plays in MacIntyre’s critique of modernity. Second, it turns to those papers that examine the foundational role that human needs play in MacIntyre’s ethics. Third, it places in dialogue those papers that defend MacIntyre’s politics as a form of (...) ‘revolutionary Aristotelianism’ with those that contest the soundness of this categorization. (shrink)

The article is a critical examination of Marcuse's speculations about the possibility of determining a biological foundation for ethical norms. It considers three key objections to this project: that Marcuse fails to adequately define needs, that he misinterprets Freud, and that, details aside, he fundamentally misunderstands what a `biological' foundation for ethics would entail. The objections are accepted, to varying degrees, as regards the content of Marcuse's argument. The article concludes, however, with a different account of biological foundations designed to (...) rescue the deeper aims of Marcuse's project. Key Words: biology • ethics • foundation • Herbert Marcuse • needs • socialism. (shrink)

One major objection to social rights is a failure of determining which precise social and economic claims should be granted rights status. The social rights debate has grappled with this ‘indeterminacy problem’ for quite some time, and a number of proposals have emerged aimed at fixing the content of these rights. In what follows I examine three distinct approaches to fleshing out the idea of a minimum threshold: social rights as the fulfilment of basic needs, social rights as the securing (...) of a minimally decent life and social rights as a requirement of citizenship. Each of these proposals progressively expands on what the minimum threshold of social rights requires and, conversely, what obligations they generate on part of the state. I will show that none of these approaches is entirely satisfactory and suggest that the social rights debate look elsewhere to determine its content. (shrink)

Instrumentalists about need believe that all needs are instrumental, i.e., ontologically dependent upon ends, goals or purposes. Absolutists view some needs as non-instrumental. The aims of this article are: clearly to characterize the instrumentalism/absolutism debate that is of concern (mainly §1); to establish that both positions have recent and current adherents (mainly §1); to bring what is, in comparison with prior literature, a relatively high level of precision to the debate, employing some hitherto neglected, but important, insights (passim); to show, (...) on grounds not previously to the fore in the literature, that insofar as instrumentalism’s advocates have provided arguments for the position, these are unsound (§2); to argue against instrumentalism using a new dilemma concerning whether ‘end’, ‘goal’ and ‘purpose’ are interpreted in a mentalistic manner (§3); to elucidate the implications of the needs/need-satisfiers and preconditions/means distinctions for the debate (§4). (shrink)

Schools often aim at creating opportunities for good life and at promoting a good society. Liberal theorization on schooling is premised on a functioning liberal democracy with a capitalist economy. However, postcolonial societies are characterized by poverty and inequality, cultural diversity, and an ongoing project of state and nation building. This challenges some of the foundational assumptions of liberal conceptions of schooling aimed at promoting good life and good society in postcolonial societies. Realization of good life through schools is shaped (...) both by shaping of ‘consciousness, identities, and desires’ [Bernstein ] and through imparting knowledge and skills that help realize these desires in particular contexts. These schooling practices have different influences on opportunities for good life in short, medium, and long terms in these societies. A conceptual model of schooling that addresses these complexities is key to understanding the processes that influence the opportunities for a pursuit of good life through schooling in postcolonial societies. Such a model could draw upon the existing theories of liberal schooling but would have to adapt them to respond to the contexts of postcolonial societies. (shrink)

A synthesis of rights and participatory approaches to citizenship, linked through the notion of human agency, is proposed as the basis for a feminist theory of citizenship. Such a theory has to address citizenship's exclusionary power in relation to both nation-state ‘outsiders’ and ‘insiders’. With regard to the former, the article argues that a feminist theory and politics of citizenship must embrace an internationalist agenda. With regard to the latter, it offers the concept of a ‘differentiated universalism’ as an attempt (...) to reconcile the universalism which lies at the heart of citizenship with the demands of a politics of difference. Embracing also the reconstruction of the public-private dichotomy, citizenship, reconceptualized in this way, can, it is argued, provide us with an important theoretical and political tool. (shrink)

Citizenship can be represented as both a status and a practice, reflecting the liberal/social rights and civic republican traditions but also moving beyond them in a critical synthesis. A key challenge for contemporary feminist and radical citizenship theory is how to move beyond the bogus universalism that underpinned both of these traditions, as well as that implied by the category `woman', so as to accommodate citizenship's universalist promise to the demands of diversity and difference. The article suggests how citizenship as (...) both a status and a practice can be rethought so as to respond to this challenge. Drawing on a range of social and political theorists, it offers the concept of a `differentiated universalism' as a means of encapsulating the creative tension between the universal and the particular that lies at the heart of this approach to citizenship. (shrink)

From a feminist perspective, I am interested in ‘women's ways of knowing’ ( et al., ) and the relationship between knowledge, difference and power ( et al., ). Here I trace the relevance of Gramsci to my own feminist consciousness, and the part he played in my journey to praxis. I also address feminism's intellectual debts, most particularly in relation to the concept of hegemony. The intellectual context has shifted in emphasis from macro‐ to micro‐narratives which reject Marxism as masculinist (...) and dichotomous. The dilemma has been an overemphasis on the personal‐cultural at the expense of the collective‐political, distracting us from action for social justice at the same time as globalisation is creating escalating world crises of justice and sustainability. In conclusion, I advocate a re‐reading of Gramsci in the light of key feminist critiques of class and patriarchy in order to develop i) analyses based on multiple sites of oppression and ii) action which reaches from local to global through alliances to achieve a more integrated feminist praxis. Throughout, I use ‘dis’ability and ‘race’ to denote the socially constructed nature of these concepts. (shrink)

This chapter contains sections titled: My Journey to Praxis The Concept of a Male Hegemony in Relation to Patriarchy Hattersley Women for Change The Changing Theoretical and Political Context Gramsci's Continuing Relevance to Feminism To Return to My Original Question: What Relevance Have Gramsci's Ideas to Feminist Pedagogy Today? References.

The principles of equality and equity, respectively in the Bill of Rights and the white paper on health, provide the moral and legal foundations for future health care for children in South Africa. However, given extreme health care need and scarce resources, the government faces formidable obstacles if it hopes to achieve a just allocation of public health care resources, especially among children in need of highly specialised health care. In this regard, there is a dearth of moral analysis which (...) is practically useful in the South African situation. We offer a set of moral considerations to guide the macro-allocation of highly specialised public health care services among South Africa's children. We also mention moral considerations which should inform micro-allocation. (shrink)

While basic income (BI) has long been advocated for its social benefits, some scholars also propose it in response to the ecological crises. However, the empirical evidence to support this position is currently lacking and the concept of an ecological BI (EBI) is underdeveloped. Part one of this paper attempts to develop such a concept, arguing that an EBI should seek to reduce aggregate material throughput, improve human needs satisfaction, reduce inequalities, rebalance productive activity towards social activities in the autonomous (...) sphere, and promote societal values of cooperation and sufficiency. Part two examines how BI interventions consider the principles of an EBI in their designs and discusses what their findings infer about BI’s ecological credentials. The results find that while ecological considerations are largely absent from BI intervention designs, their findings suggest that interventions aligned with the principles of an EBI could play a role in addressing the ecological crises. (shrink)

ABSTRACTOne of the central claims of democratic theory is that the institutional features of democracy systematically cause government to respond to the people's needs. In fact, however, democracy might logically be expected to be especially responsive only to the people's desires, not their needs. Responses to people's objective needs can be substantially different from responses to their subjective desires. Democratic institutions therefore cannot guarantee responsiveness to basic human needs. Democracy, should, at least in principle, thus be confined to the sphere (...) of wants rather than needs. (shrink)

Assessments of health care needs are embedded in contracts for health services. Such contracts are the formal link between the identification of health care needs and the purchasing of services to satisfy those needs. They are a central part of the procedural relationship between the British health service (NHS) and the satisfaction of human needs. To evaluate contracts it is necessary to investigate this relationship. A number of headings under which it may be possible to begin to evaluate contracts are (...) described, and the potential of a ‘universalist’ approach to interrogate contract-based decision-making is briefly discussed. (shrink)

We evaluate the suitability of Nussbaum's substantive account of capabilities in light of conceptual and empirical work that has shown that positivity is widely valued and pursued as an end by many people, and evidence that positive outcomes, even economic ones, are often caused by well-being rather than the other way around. While Nussbaum sees positive emotions as incidental to the experience of well-being, we argue that the experience of such mental states is partly constitutive of flourishing.

This article presents the framework Capability Sensitive Design (CSD), which consists of merging the design methodology Value Sensitive Design (VSD) with Martha Nussbaum's capability theory. CSD aims to normatively assess technology design in general, and technology design for health and wellbeing in particular. Unique to CSD is its ability to account for human diversity and to counter (structural) injustices that manifest in technology design. The basic framework of CSD is demonstrated by applying it to the hypothetical design case of a (...) therapy chatbot for mental health. By applying CSD to a design case, the merits of this new framework over the standard VSD approach become apparent. Also, the application demonstrates what a technology design would look like when attention is paid to capabilities right from the start of the design process. (shrink)

We should not have children because (i) we have no child-regarding reasons to do so, (ii) we have child-regarding reasons not to do so, and (iii) although we have other-regarding reasons to do so, these reasons are not decisive. Objections to (i) include that life is always good and that possible individuals would choose life if given the opportunity. These fail if there is no duty to create even a good life (the argument from asymmetry), all lives are bad (the (...) argument from quality of life), and potential parents are not entitled to produce lives without the permission of the offspring (the argument from assumed consent). The failure of the objections is not, however, self-evidently inevitable if a hedonistic axiology is used. It becomes inevitable with a switch to an autonomy-respecting, need-based theory of value. There is no need to become existent (i), and there is a need to avoid frustration, pain, and suffering once an individual has been brought into existence (ii). Since any life can be or turn out to be very bad, potential parents put their children in harm’s way by creating them (the argument from risk). To see this and to see how the preferences of the potential parents do not change the situation (iii), it is necessary to assume a concept of gambling that allows genuinely serious harm in case the player loses. (shrink)

ABSTRACT:Microfinance is often assumed to be an ethically progressive industry, but in recent years it has been the target of much ethical criticism. Microfinance institutions have been accused of using exploitative lending techniques and charging usurious interest rates; and critics even question the ability of microfinance to alleviate poverty. This article reviews recent research on the microfinance sector that addresses these ethical issues. We show how this research is relevant to a number of theoretical issues, such as how to define (...) poverty, how to understand exploitation, and how to balance financial and social goals in commercial organizations. We conclude by identifying a critical agenda for future research. (shrink)

The concept of need is often proposed as providing an additional or alternative criterion to cost-effectiveness in making allocation decisions in health care. If it is to be of practical value it must be sufficiently precisely characterized to be useful to decision makers. This will require both an account of how degree of need for an intervention is to be determined and a prioritization rule that clarifies how degree of need and the cost of the intervention interact in determining the (...) relative priority of the intervention. Three common features of health care interventions must be accommodated in a comprehensive theory of need: the probabilistic nature of prognosis (with and without the intervention); the time course of effects; and the fact that the most effective treatments often combine more than one intervention. These common features are problematic for the concept of need. We outline various approaches to prioritization on the basis of need and argue that some approaches are more promising than others. (shrink)

Over the past few decades, “Big Tobacco” has spread its tentacles across the developing world with devastating results. The global incidence of smoking has increased exponentially in Africa, Asia and South America and it is leading to an equally rapid increase in the incidence of smoking-induced morbidity and mortality on these continents. The World Health Organization (WHO) has tried to respond to this crisis by devising a set of regulations to limit the spread of smoking, and many countries have bound (...) themselves to follow the WHO’s guidelines. This article provides an overview of these regulatory measures and the authors attempt to defend them from the perspective of liberty and autonomy. Their motivation is to countermand any attempt by the tobacco industry to attack the regulations on the grounds that they infringe the liberty rights of producers and consumers. It is also argued, however, that a blanket ban of the production, sale and consumption of tobacco cannot be justified on the grounds of autonomy alone. (shrink)

The harms of climate change are deeply uncertain. Though climate change will render most individuals more vulnerable to harm, many individuals will not actually suffer climate-related harms. In this paper, I argue that vulnerability to harms is itself a harm, because it undermines our enjoyment of the good of security. After some brief remarks on the concept of security, I give three reasons for thinking that depriving an individual of the security of basic goods harms them: it has a strong (...) contingent connection to fear and anxiety, it directly undermines their ability to make reasonable plans, and security may reasonably be valued as an end in itself. This suggests that one of our goals in determining climate policy ought to be mechanisms which ensure the security of basic goods. (shrink)

According to the so-called Classical Theory, concepts are mentally represented by individually necessary and jointly sufficient application conditions. One of the principal empirical objections against this view stems from evidence that people judge some instances of a concept to be more typical than others. In this paper we present and discuss four empirical studies that investigate the extent to which this ‘typicality effect’ holds for the concept of basic needs. Through multiple operationalizations of typicality, our studies yielded evidence for a (...) strong effect of this kind: Participants tended to recall the same core examples of the concept in a free-listing task. They judged some basic needs to be more typical than others. The items that were judged to be more typical were listed more frequently in the free-listing task. These items were listed earlier on in the free-listing task. Typical basic needs, as well as non needs, were classified faster than atypical basic needs in a reaction time study. These findings suggest that the concept of basic needs may have a non-classical structure. If so, the quest for a simple and robust intensional analysis of the concept may be futile. (shrink)

One generally considered plausible way to allocate resources in health care is according to people’s needs. In this paper I focus on a somewhat overlooked issue, that is the conceptual structure of health care needs. It is argued that what conceptual understanding of needs one has is decisive in the assessment of what qualifies as a health care need and what does not. The aim for this paper is a clarification of the concept of health care need with a starting (...) point in the general philosophical discussion about needs. I outline three approaches to the concept of need and argue that they all share the same conceptual underpinnings. The concept of need is then analyzed in terms of a subject x needing some object y in order to achieve some goal z. I then discuss the relevant features of the object y and the goal z which make a given need qualify as a health care need and not just a need for anything. (shrink)