Philosophy strives to give us a firmer hold on our concepts. But what about their hold on us? Why place ourselves under the sway of a concept and grant it the authority to shape our thought and conduct? Another conceptualization would carry different implications. What makes one way of thinking better than another? This book develops a framework for concept appraisal. Its guiding idea is that to question the authority of concepts is to ask for reasons of a special kind: (...) reasons for concept use, which tell us which concepts to adopt, adhere to, or abandon, thereby shoring up—or undercutting—the reasons for action and belief that guide our deliberations. Traditionally, reasons for concept use have been sought either in timeless rational foundations or in concepts’ inherent virtues, such as precision and consistency. Against this, the book advances two main claims: that we find reasons for concept use in the conceptual needs we discover when we critically distance ourselves from a concept by viewing it from the autoethnographic stance; and that sometimes, concepts that conflict, or exhibit other vices such as vagueness or superficiality, are just what we need. By considering not what concepts are absolutely best, but what concepts we now need, we can reconcile ourselves to the contingency of our concepts, determine the proper place of efforts to tidy up thought, and adjudicate between competing conceptions of things,—even things as contested as liberty or free will. A needs-based approach separates helpful clarification from hobbling tidy-mindedness, and authoritative definition from conceptual gerrymandering. (shrink)

The war on terror is commonly characterized as a fundamentally different kind of war from more traditional armed conflict. Furthermore, it has been argued that, in this new kind of war, different rules, both moral and legal, must apply. In the first part of this paper, three practices endemic to the war on terror -- torture, assassination, and enemy combatancy status -- are identified as exceptions to traditional norms. The second part of the paper uses these examples to motivate a (...) generalized account of exceptionalism; a taxonomy of different exceptionalisms is derived, including temporal, spatial, and group-based exceptionalisms. The third part of the paper considers the ethical status of exceptionalism, paying particular attention to the group-based exceptionalisms that are argued to be prevalent in the war on terror. It is concluded that there is nothing inherently wrong with group-based exceptionalism and, furthermore, that the proper locus of ethical evaluation lies not with the norms that are being excepted, but rather with the groups that are being excepted from them. (shrink)

The concept of responsibility for health is a significant feature of health discourse and public health policy, but application of the concept is poorly understood. This paper offers an analysis of the concept in two ways. Following an examination of the use of the word ‘responsibility’ in the nursing and wider health literature using three examples, the concept of ‘responsibility for health’ as fulfilling a social function is discussed with reference to policy documents from the UK. The philosophical literature on (...) moral responsibility is introduced, and in considering two versions, reactive attitudes and accountability, it is argued that in application both can be regarded, though with different emphasis, as being constituted in three parts: a responsible agent; having obligations ; and being susceptible to being held responsible if he fails to meet them. The three‐stage model is consistent with the examples of the word responsibility in use, but application to the social function model causes a number of problems for healthcare practice, especially for the reactive attitudes account. Apart from considerable problems in stating what exactly the obligations are and how they can be justified; and how blame might justly be apportioned and by whom, the very ideas of obligation and blame are in conflict within healthcare systems and professional nursing practice which have foundations deeply embedded in the notion of the supremacy of personal autonomy. It is concluded that current application of the concept of responsibility for health is conceptually incoherent, and if it is to retain its place in health policy and discourse, urgent remedy is required. (shrink)

If it is true, as suggested by Sir Michael Marmot and other researchers, that status impacts health and therefore accounts for some of the social gradient in health, then it seems to be the case that it would be possible to bring about more equality in health by equalizing status. The purpose of this article is to analyze this suggestion. First, we suggest a working definition of what status precisely is. Second, following a luck egalitarian approach to distributive justice, we (...) consider whether and to which extent individuals are responsible themselves for their position in a status hierarchy. Third, we consider the contours of a difficult question, namely which political measures are feasible in order to reduce health-affective inequalities in status and fourth, whether or to what extent such measures are legitimate. We argue that on the basis of these considerations, we have at least some prima facie reasons to counter (at least some) status inequalities in order to equalize health. (shrink)

Even where an act appears to be responsible, and satisfies all the conditions for responsibility laid down by society, the response to it may be unjust where that appearance is false, and where those conditions are insufficient. This paper argues that those who want to place considerations of responsibility at the centre of distributive and criminal justice ought to take this concern seriously. The common strategy of relying on what Susan Hurley describes as a 'black box of responsibility' has the (...) advantage of not taking responsibility considerations to be irrelevant merely because some specific account of responsibility is mistaken. It can, furthermore, cope perfectly well with an absence of responsibility, even of the global sort implied by hard determinism and other strongly sceptical accounts. Problems for the black box view come in where responsibility is present, but in a form that is curtailed in one significant regard or another. The trick, then, is to open the box of responsibility just enough that its contents can be the basis for judgements of justice. I identify three 'moderately sceptical' forms of compatibilism that cannot ground judgements of justice, and are therefore expunged by the strongest 'grey box' view. (shrink)

The issue of distributive justice receives substantial amount of attention in our society. On the one hand, we are sensitive to whether and the extent to which people are responsible for being worse off. On the other hand, we are mindful of society’s worst-off members. There has been a debate over luck egalitarianism, which relates to the former concern, and relational egalitarianism, which echoes the latter. By investigating the psychological processes of these two concerns, this paper examines the reliability of (...) the argument that Elizabeth Anderson, a renowned relational egalitarian, presents against luck egalitarianism and for relational egalitarianism. It also considers whether it is possible to support luck egalitarianism and relational egalitarianism simultaneously, using an online experiment. The results of the experiment show that, first, for ordinary people, the luck consideration is as important as the basic capabilities consideration. Second, while real people consider the degree of compensation through the factors of causality and responsibility, the lack of basic capabilities directs them to determine how much victims of bad luck should be compensated. This suggests that pluralist egalitarianism is on the right track. (shrink)

Combatting chronic, lifestyle-related disease has become a healthcare priority in the developed world. The role personal responsibility should play in healthcare provision has growing pertinence given the growing significance of individual lifestyle choices for health. Media reporting focussing on the ‘bad behaviour’ of individuals suffering lifestyle-related disease, and policies aimed at encouraging ‘responsibilisation’ in healthcare highlight the importance of understanding the scope of responsibility ascriptions in this context. Research into the social determinants of health and psychological mechanisms of health behaviour (...) could undermine some commonly held and tacit assumptions about the moral responsibility of agents for the sorts of lifestyles they adopt. I use Philip Petit's conception of freedom as ‘fitness to be held responsible’ to consider the significance of some of this evidence for assessing the moral responsibility of agents. I propose that, in some cases, factors outside the agent's control may influence behaviour in such a way as to undermine her freedom along the three dimensions described by Pettit: freedom of action; a sense of identification with one's actions; and whether one's social position renders one vulnerable to pressure from more powerful others. (shrink)

What does it take for an individual to be personally responsible for behaviors that lead to increased risk of disease? We examine three approaches to responsibility that cover the most important aspects of the discussion of responsibility and spell out what it takes, according to each of them, to be responsible for behaviors leading to increased risk of disease. We show that only what we call the causal approach can adequately accommodate widely shared intuitions to the effect that certain causal (...) influences—such as genetic make-up or certain social circumstances—diminish, or undermine personal responsibility. However, accepting the causal approach most likely makes personal responsibility impossible. We therefore need either to reject these widely shared intuitions about what counts as responsibility-softening or undermining or to accept that personal responsibility for behaviors leading to increased risk of disease rests on premises so shaky that personal responsibility is probably impossible. (shrink)