The development of the science of poverty has largely been driven by the need to define more precisely what poverty is, as well as to provide theoretical and empirical criteria for identifying those who suffer from it. This thesis focuses on a notable response to these and related questions: the conception and measure of poverty by the British sociologist Peter Townsend. Townsend defines poverty as relative deprivation caused by lack of resources. This conception, along with his corresponding cut-off measure, constitutes (...) some of the key components of his theory of poverty. The theory discusses what poverty is, its causes, and how it can be eradicated, and is detailed in Poverty in the United Kingdom: A Survey of Household Resources and Standards of Living (1979), his magnum opus. The primary aim of this thesis is to interpret the theory from Townsend’s adherence to the value-free ideal. He pursued this ideal in response to what he perceived as the pervasive and deleterious influence of moral and political values on measures, theories, and policies on poverty throughout its scientific and political history. I argue that to be free from such influence, Townsend aimed to be as guided by epistemic values as possible, which resulted in a systematic theory of poverty. -/- The thesis is structured as follows: In Chapter 1, I situate Townsend’s conception and measurement of poverty within the context of both the recent history of scientific poverty lines and the most important approaches to measuring the phenomenon. Chapter 2 discusses the systematic nature of the theory, including its role as a middle-range theory that bridges broad-range theories with empirical data. This connection is achieved through several elements: a conception of poverty; hypotheses and anthropological observations related to the elements of the conception; measures to test these hypotheses; an explanation of poverty; and reports on how the research was conducted. Furthermore, Townsend’s theory aligns with Bradburn et al.’s (2017) measurement theory, which asserts that a good measure must include a conception of the relevant phenomenon, a representation, and procedures to gather data. Additionally, all three components must be supported by arguments showing that they fit together properly. -/- In the remaining chapters, I present and discuss the main elements of the theory: his conception of poverty as relative deprivation caused by lack of resources, along with the related hypotheses and observations (Chapter 3); the representations of this conception and the procedures for data collection, processing, as well as ensuring their reliability (Chapter 4); and the explanation of poverty (Chapter 5). I conclude by presenting what Townsend considered the “policy prescriptions” of his theory. Despite its potential shortcomings, I also argue that Townsend’s theory fulfills an important epistemic value: fruitfulness. (shrink)

This article explores the implications of what it means to moralize about future technological innovations. Specifically, I have been invited to comment on three papers that attempt to think about what seems to be an impending social reality: the availability of life-like sex robots. In response, I explore what it means to moralize about future technological innovations from a secular perspective, i.e., a perspective grounded in an immanent, socio-historically contingent view. I review the arguments of Nancy Jecker, Mark Howard and (...) Robert Sparrow, and Wang Jue and respond to their arguments concerning the permissible limits of human-robot sexual interaction. I argue that we are in a poor epistemic position regarding what the actual future human response will be towards sex robots and how it affects society generally. Given this poor epistemic position, I argue that moralizing about future trends like human-robot sex is difficult because we do not have the relevant facts to work with. Furthermore, I remain skeptical as to policy recommendations based on socio-historically contingent moral viewpoints both because they do not carry in principle moral authority to say what future others may or may not do with their property and they may not even appeal to future secular others, insofar as secular morality is plural and consistently develops anew. (shrink)

The books’ goal is to answer the question: Do the weaknesses of value-free economics imply the need for a paradigm shift? The author synthesizes criticisms from different perspectives (descriptive and methodological). Special attention is paid to choices over time, because in this area value-free economics has the most problems. In that context, the enriched concept of multiple self is proposed and investigated. However, it is not enough to present the criticisms towards value-free economics. For scientists, a bad paradigm is better (...) than no paradigm. Therefore, the author considers whether value-based economics with normative approaches such as economics of happiness, capability approach, libertarian paternalism, and the concept of multiple self can be the alternative paradigm for value-free economics. This book is essential reading to everyone interested in the current state of economics as a discipline. (shrink)

This paper aims to provide autonomy-based reasons in favour of limitarianism. Limitarianism affirms it is of primary moral importance that no one gets too much. The paper challenges the standard assumption that having more material resources always increases autonomy. It expounds five mechanisms through which having too much material wealth might undermine autonomy. If these hypotheses are true, a theory of justice guided by a concern for autonomy will support a limitarian distribution of wealth. Finally, the paper discusses two issues (...) autonomy-based limitarianism would raise. First, insofar as coercion invades autonomy, do autonomy-based reasons legitimate coercive measures to secure a limitarian distribution of wealth? Second, is a limitarian ethos consistent with the incentive to produce enough wealth to secure distributive justice? (shrink)

Research Ethics, Volume 18, Issue 1, Page 51-63, January 2022. Aboriginal and Torres Strait Islander peoples in Australia, have historically experienced research as another means of colonialization and oppression. Although there are existing frameworks, guidelines and policies in place that respond to this history, the risk of exploitation and oppression arising from research still raises challenging ethical questions. Since the 1990s the National Health and Medical Research Council in Australia has developed specific sets of guidelines that govern research with these (...) populations in an attempt to redress injustices of the past. The current guidelines: Ethical Conduct in Research with Aboriginal and Torres Strait Islander Peoples and Communities: Guidelines for Researchers and Stakeholders, 2018, emphasis six core values which are bound together by “spirit and integrity.” The values are reflected through respect for cultural inheritance, and genuine negotiation of partnerships between researchers, other stakeholders, and communities. We examine whether these guidelines can lead to research and research practices that redress some of the ongoing traumas of colonialization and racism. We draw upon Margaret Urban Walker’s formulation of restorative justice, based upon her “pragmatics of repair” which relies upon “voice, validation and vindication” and at its core, the restoration of relationships. (shrink)

In projects concerning big data, ethical questions need to be answered during the design process. In this paper the Value Sensitive Design method is applied in the context of data-driven health services aimed at disease prevention. It shows how Value Sensitive Design, with the use of a moral dialogue and an ethical matrix, can support the identification and operationalization of moral values that are at stake in the design of such services. It also shows that using this method can support (...) meeting the requirements of the General Data Protection Regulation. (shrink)

The intellectual property regimes we have currently in place are heavily under attack. One of the points of criticism is the interaction between two elements of article 27 of the Universal Declaration of Human Rights, the widely discussed issue of being able to benefit from scientific progress and the less argued for position of having a right to take part in scientific enterprises. To shine light on the question if we should balance the two elements or prioritize one of them, (...) an exploration will be offered on how benefiting from scientific progress and the ability to participate in the advancement of science relate to securing human capabilities. A different perspective to the question will be gained by identifying the problem as an issue of misrecognition, especially the failure to recognize many willing collaboration partners in scientific research as peers. Lastly, I will argue that cooperative justice requires that if we have an innovation incentive system that disproportionally benefits one particular group, a certain duty to counterbalance this advantage exists when we are relying on mutual cooperation for the recognition of intellectual property rights. (shrink)

Agroecology has been criticized for being more labor-intensive than other more industrialized forms of agriculture. We challenge the assertion that labor input in agriculture has to be generally minimized and argue that besides quantity of work one should also consider the quality of work involved in farming. Early assessments on work quality condemned the deskilling of the rural workforce, whereas later criticisms have concentrated around issues related to fair trade and food sovereignty. We bring into the discussion the concept of (...) contributive justice to welcome the added labor-intensity of agroecological farming. Contributive justice demands a work environment where people are stimulated to develop skills and learn to be productive. It also suggests a fairer distribution of meaningful work and tedious tasks. Building on the notion of contributive justice we explore which capabilities and types of social relationships are sustainably promoted and reinforced by agroecological farming practices. We argue that agroecological principles encourage a reconceptualization of farm work. Farmers are continuously stimulated to develop skills and acquire valuable experiential knowledge on local ecosystems and agricultural techniques. Further, generalized ecological studies recognize the significance of the farmer’s observations on natural resources management. This contributes to the development of a number of capabilities and leads to more bargaining power, facilitating self-determination. Hereby farm work is made more attractive to a younger generation, which is an essential factor for safeguarding the continuity of family farms. (shrink)

The capability approach, which is closely connected to the works of Amartya Sen and Martha Nussbaum, is one possible theoretical framework that could be used to answer the question as to why poverty is a problem from a moral point of view. In this paper we will focus on the normative philosophical capability approach rather than the social scientific and descriptive perspective. We will show that the approach characterizes poverty mainly as a limitation of freedom and that it is precisely (...) this aspect, from its point of view, that makes poverty morally significant. This insight shifts the discussion away from questions regarding specific capabilities or lists of them-questions treated extensively in the literature-to the more general level of what constitutes the normative core of the capability approach. But as we will also discuss and argue, the role of freedom alone does not give us a complete picture of poverty but only presents us with one aspect relevant to evaluating it. A further aspect which we consider has not been adequately recognized and taken into account by most capability theorists is the experience of disrespect and humiliation, or to put it differently, a lack of recognition. (shrink)

This article critically examines the competitive, adversarial nature of the Western neoliberal style of democracy. Specifically, this article focuses on Amartya Sen’s notion of a “universal democracy” as a means of addressing socio-economic inequalities through Sen’s capability approach. Sen’s capability theory has become an acclaimed and widely used theory to evaluate and understand development and inequalities. However, we employ a distinctive critique by engaging Amartya Sen through Herbert Marcuse’s analysis of one dimensionality and the adversarial nature of Western democracy. We (...) further highlight how contemporary neoliberal society employ a particular, adversarial form of public participation. Through this, we underline the various neoliberal problemata, such as Western idealism, political passivity, and a “flattening of choice,” within contemporary democracies and locate how their competitive, winner-take-all nature has become essential to contemporary, Western democratic models. Consequently, we argue that democracy, as a functional concept and form of public engagement, should be fundamentally re-examined in order to address inequalities. (shrink)

Biomedical innovations are making possible the enhancement of human capabilities. There are two philosophical stances on the role that medicine should play in this respect. On the one hand, naturalism rejects every medical intervention that goes beyond preventing and treating disease. On the other hand, welfarism advocates enhancements that foster subjective well-being. We will show that both positions have considerable shortcomings. Consequently, we will introduce a third characterization in which therapies and enhancements can be reconciled with the legitimate objectives of (...) medicine inasmuch as they improve the capabilities that enable the freedom to pursue personal well-being. (shrink)

This paper examines two different ways of understanding the concept of bodily integrity and their political implications. In Drucilla Cornell's use of the concept, the body cannot be separated from the mind. Protecting bodily integrity means protecting possibilities of imagining the self as whole. Martha Nussbaum's theorizing is based on a liberal way of conceptualizing subjectivity, in which the mind and the body are separate, and bodily integrity is used to refer to physical inviolability.

There are increasing calls for rejecting the ‘dead donor’ rule and permitting ‘organ donation euthanasia’ in organ transplantation. I argue that the fundamental problem with this proposal is that it would bestow more worth on the organs than the donor who has them. What is at stake is the basis of human equality, which, I argue, should be based on an ineliminable dignity that each of us has in virtue of having a rational nature. To allow mortal harvesting would be (...) to make our worth contingent upon variable quality of life of judgments that can only be based on properties that come in degrees. Thus, rejecting the ‘dead donor’ rule comes at the expense of our egalitarian principles with respect to the value each individual human life has in relation to the protections against killing. (shrink)

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)

Some proponents of the Anthropocene argue that it is time adopt a future-oriented outlook: natural baselines no longer matter, and humans should remake the planet for the better. This raises questions about whose vision should guide such remaking, and whether the past deserves any consideration in adapting for the future. I argue that the past remains relevant, because the natural, cultural, and social worlds people enter into – shaped by those who came before us – matter. On this view, there (...) are reasons to value ‘nature’, even in a human-altered world, and climate adaptation should take that into account. (shrink)

The debate over the civilian use of nuclear power is highly polarised. We argue that a reasonable response to this deep disagreement is to maintain that advocates of both camps should modify their positions. According to the analysis we propose, nuclear power is neither entirely right nor entirely wrong, but rather right and wrong to some degree. We are aware that this non-binary analysis of nuclear power is controversial from a theoretical point of view. Utilitarians, Kantians, and other moral theorists (...) make sharp, binary distinctions between right and wrong acts. However, an important argument speaking in favour of our non-binary analysis is that it better reflects our considered intuitions about the ethical trade-offs we face in discussions of nuclear power. The aim of this article is to make this argument sharp by explaining how it can be rendered compatible with, and supported by, the Capability Approach, which is quickly becoming one of the most influential frameworks for thinking about human development. (shrink)

This paper provides a critical exploration of the capability approach to human rights (CAHR) with the specific aim of developing its potential for achieving a synthesis between “humanist” or “naturalistic” and “political” or “practical” perspectives in the philosophy of human rights. Section II presents a general strategy for achieving such a synthesis. Section III provides an articulation of the key insights of CAHR (its focus on actual realizations given diverse circumstances, its pluralism of grounds, its emphasis on freedom of choice, (...) its demand for public reasoning, its context-sensitive universalism, and its broad view of obligations). These insights go some way toward the achievement of the desired synthesis. But, as explained in IV.1, in its current form CAHR faces two serious objections by the defenders of the political perspective: the Gap Between Capabilities-Interests and Rights Objection and the Disconnect From Practice Objection. Answering these criticisms requires some amendments to CAHR. Section IV.2 suggests a response to the first objection based on the introduction of a contractualist framework of justification. Sections IV.3 and IV.4 tackle the second objection by introducing a re-characterization of the cosmopolitan standard underlying the humanist perspective and by identifying the differences and relations between various dimensions of a conception of human rights and their significance for actual political practice. The paper illustrates the practical implications of CAHR, in its modified form, for the pursuit of some important rights. (shrink)

This article draws on Martha Nussbaum's distinction between basic, internal, and external capacities to better specify possible locations for children's ‘incapacity’ for autonomy. I then examine Maria Montessori's work on what she calls ‘normalization’, which involves a release of children's capacities for autonomy and self-governance made possible by being provided with the right kind of environment. Using Montessori, I argue that, in contrast to many ordinary and philosophical assumptions, children's incapacities for autonomy are best understood as consequences of an absence (...) of external conditions necessary for children to exercise capacities they already have internally, rather than intrinsic limitations based on their stage of life. In a closing section, I show how Montessori proposes a model wherein both children and adults have autonomy, power, and responsibility, but over different spheres, and suggest implications of these differences for who has responsibility for establishing the conditions under which children can flourish. (shrink)

This paper demonstrates how ubuntu relational philosophy may be used to ground beneficial coercive care without necessarily violating a patient’s dignity. Specifically, it argues that ubuntu philosophy is a useful theory for developing necessary conditions for determining a patient’s potential dangerousness; setting reasonable limits to the duty to protect; balancing the long-term good of providing unimpeded therapy for patients who need it with the short-term good of protecting at-risk parties; and advancing a framework for future case law and appropriate regulations (...) in the care of psychotherapy patients. Issues regarding the decision to breach medical confidentiality in psychotherapeutic care are ultimately reserved for the courts. Professional assessment might be an important first step in this process, and court rulings govern most aspects of this assessment. However, current case law, especially in the United States, places an unreasonable expectation on psychotherapists to protect all at-risk parties or foresee that a patient intends to follow through on said threats. It has largely failed to guarantee psychotherapy patients unlimited access to care, while potentially inhibiting future honest communication between patients and health professionals and endangering the safety of others. Of these decisions, the two most prominent are the 1976 Tarasoff decision and the 2016 Volk decision. This paper argues for the possibility of grounding good laws in ubuntu African philosophy in a way that protects others from harm and ensures unimpeded access to care without necessarily breaching medical confidentiality. (shrink)

Health services internationally struggle to ensure health care is “person-centered” (or similar). In part, this is because there are many interpretations of “person-centered care” (and near synonyms), some of which seem unrealistic for some patients or situations and obscure the intrinsic value of patients’ experiences of health care delivery. The general concern behind calls for person-centered care is an ethical one: Patients should be “treated as persons.” We made novel use of insights from the capabilities approach to characterize person-centered care (...) as care that recognizes and cultivates the capabilities associated with the concept of persons. This characterization unifies key features from previous characterisations and can render person-centered care applicable to diverse patients and situations. By tying person-centered care to intrinsically valuable capability outcomes, it incorporates a requirement for responsiveness to individuals and explains why person-centered care is required independently of any contribution it may make to health gain. (shrink)

There are various reasons why efforts to promote “support for self-management” have rarely delivered the kinds of sustainable improvements in healthcare experiences, health and wellbeing that policy leaders internationally have hoped for. This paper explains how the basis of failure is in some respects built into the ideas that underpin many of these efforts. When support for self-management is narrowly oriented towards educating and motivating patients to adopt the behaviours recommended for disease control, it implicitly reflects and perpetuates limited and (...) somewhat instrumental views of patients. It tends to: restrict the pursuit of respectful and enabling ‘partnership working’; run the risk of undermining patients’ self-evaluative attitudes ; limit recognition of the supportive value of clinician-patient relationships; and obscure the practical and ethical tensions that clinicians face in the delivery of support for self-management. We suggest that a focus on enabling people to live well with their long-term conditions is a promising starting point for a more adequate conception of support for self-management. We then outline the theoretical advantages that a capabilities approach to thinking about living well can bring to the development of an account of support for self-management, explaining, for example, how it can accommodate the range of what matters to people for living well, help keep the importance of disease control in perspective, recognize social influences on people’s values, behaviours and wellbeing, and illuminate more of the rich potential and practical and ethical challenges of supporting self-management in practice. (shrink)

In this paper I make a contribution to three distinct, but deeply interwoven subjects. Firstly, I argue that, at the level of ideal theory, the distribution of educational goods should follow a sufficientarian pattern and that the evaluative space of children’s advantage should be inspired by the capability approach. Secondly, the paper is delving into the more policy-oriented debates on the desirability of school choice. I argue that, given the non-ideal circumstances in which decision makers have to act, giving parents (...) the opportunity to choose the school for their children is a sine qua non condition for even approaching the ideals of sufficientarian justice. Lastly, I move the discussion on more empirical grounds, advancing a criticism of the Romanian educational legislation. I argue that the sufficiency-constrained school choice system that I envision could solve some of the problems that the Romanian educational system faces today. (shrink)

In this paper, two central questions will be addressed: ought we to implement medical AI technology in the medical domain? If yes, how ought we to implement this technology? I will critically engage with three options that exist with respect to these central questions: the Neo-Luddite option, the Assistive option, and the Substitutive option. I will first address key objections on behalf of the Neo-Luddite option: the Objection from Bias, the Objection from Artificial Autonomy, the Objection from Status Quo, and (...) the Objection from Inscrutability. I will thereafter present the Demographic Trends Argument and the Human Enhancement Argument in support of alternatives to the Neo-Luddite option. In the second half of the paper, I will argue against the Substitutive option and in favour of the Assistive option, given the existence of two chief formal deficits in medical AI technology: the causality deficit and the care deficit. (shrink)

Este artículo pone en cuestión la adecuación de los enfoques convencionales de la Calidadde Vida e intenta realizar una contribución al debate existente acerca de la revisión, integración o mejora de las métricas del bienestar tal como son usadas tradicionalmente en la bibliografía de indicadores estadísticos. Como una alternativa, este estudio basa sus principales supuestos en el Enfoque de la Capacidad de Amartya Sen. La principal hipótesis es que los análisis del bienestar que se basan en mediciones puramente monetarias o (...) que olvidan la importancia del valor intrínseco de la libertad impiden adquirir imágenes adecuadas de las auténticas condiciones de vida de la gente en las complejas sociedades contemporáneas y, de ese modo, perjudican el diseño de la política pública. Esta hipótesis es verificada y comprobada tanto a través de una discusión teórica como también por medio de un análisis empírico de datos estadísticos de la OCDE. Lo que nuestras conclusiones indican es la gran importancia de incrementar la libertad para conseguir mejores resultados sociales e individuales. (shrink)

What is new about poverty? A question that anyone can answer and mostly can validate it through life experiences. Poverty is a concern for everyone, so it is hoped that everyone will work to interfere. However, with the number of research on poverty in a global context, it is practically difficult to track how each country addresses global poverty on its own. Hence, poverty is broad as its concept is concerned. Poverty is a difficult concept to describe, especially because it (...) is a complicated and contentious social reality. Despite the challenges in obtaining a consensus description of poverty, the understanding for such concept is a significant endeavor, not just theoretically or empirically, but also practically, because this definition may be used in the future to orient public policies aimed at combating poverty or improving the living conditions of the impoverished. In most cases, poverty is associated to lack of income and to address as such is just a matter of wealth distribution. Which happens in the Philippines through a poverty reduction program the Pantawid Pamilyang Pilipino Program that aims to end poverty and yet, poverty remains a main concern and continue to persist. Thus, the aim of this paper is to scrutinize the Pantawid Pamilyang Pilipino Program (4Ps) implemented by the government as human development measure to end the vicious cycle of poverty. It aims to look at the purpose if the 4Ps is really gird towards human development or it lacks the principle of a fully human development measure in addressing poverty. This critical analysis is brought for the reason that researches are limited only as to the effects of 4Ps to its beneficiaries if the 4Ps is helpful or not. However, the paper wants to dig deeper as the goal of the 4Ps is concerned. Also, to contribute in the strengthening of the human development program of the government in the lenses of philosophical undertaking. In doing so, it applies the capability approach of Amartya Sen in the analysis of the 4Ps. As this paper argued that the capability approach of Sen gives us a holistic perspective of poverty in which Sen envisions a fully human development for the poor. (shrink)

This article presents the most important strands of the philosophical debate about markets. It offers some distinctions between the concept of markets and related concepts, as well as a brief outline of historical positions vis-à-vis markets. The main focus is on presenting the most common arguments for and against markets, and on analyzing the ways in which markets are related to other social institutions. In the concluding section questions about markets are connected to two related themes, methodological questions in economics (...) and the topics of business ethics and corporate social responsibility. (shrink)

People are increasingly subject to algorithmic decisions, and it is generally agreed that end-users should be provided an explanation or rationale for these decisions. There are different purposes that explanations can have, such as increasing user trust in the system or allowing users to contest the decision. One specific purpose that is gaining more traction is algorithmic recourse. We first pro- pose that recourse should be viewed as a recommendation problem, not an explanation problem. Then, we argue that the capability (...) approach provides plausible and fruitful ethical standards for re- course. We illustrate by considering the case of diversity constraints on algorithmic recourse. Finally, we discuss the significance and implications of adopting the capability approach for algorithmic recourse research. (shrink)

There are two leading accounts of the principles of educational adequacy by Elizabeth Anderson and Debra Satz. Anderson’s and Satz’s accounts have been criticized for being insufficiently value-pluralist, and both lack a metric of justice. In this paper, I revise the principle of educational adequacy in order to address these problems. I argue that although the principle of educational adequacy cannot be the only principle in a complete theory of educational justice, it can tell us what basic justice in education (...) requires in measurable terms. I highlight two core commitments that Anderson and Satz share: a commitment to 1) democratic egalitarianism and 2) sufficientarian equal citizenship. Then, I reformulate these commitments in a way that accounts for the role that other egalitarian values have to play in a complete theory of justice in education. Finally, I claim that progress towards educational adequacy can be measured using the capabilities approach. (shrink)

New technologies such as smart sensors improve rehabilitation processes and thereby increase older adults’ capabilities to participate in social life, leading to direct physical and mental health benefits. Wearable smart sensors for home use have the additional advantage of monitoring day-to-day activities and thereby identifying rehabilitation progress and needs. However, identifying and selecting rehabilitation priorities is ethically challenging because physicians, therapists, and caregivers may impose their own personal values leading to paternalism. Therefore, we develop a discussion template consisting of a (...) series of adaptable questions for the patient–physician encounter based on the capability approach. The goal is to improve geriatric rehabilitation and thereby increase participation in social life and well-being. To achieve this goal, we first analyzed what is considered important for participation on basis of the capability approach, human rights, and ethics of care. Second, we conducted an ethical analysis of each of the four identified dimensions of participation: political, economic, socio-cultural, and care. To improve compliance with rehabilitation measures, health professionals must align rehabilitation measures in an open dialogue with the patient’s aspiration for participation in each dimension. A discussion template based on the capability approach allows for a proactive approach in patient information and stimulates a critical assessment of treatment alternatives while reducing the risk of imposing personal values. (shrink)

The strong correlation between people’s socioeconomic position and health within high income countries is a well-documented fact. A person’s occupation, income and education level tell us a lot about that person’s prospects on a long and healthy life, such that we can speak of a ‘social gradient in health’, or a ‘socioeconomic health gap’. This association is often perceived to be unjust. Therefore, it is generally thought that governments should aim to reduce socioeconomic health inequalities. However, this idea needs ethical (...) justification, for it is not evident if and why exactly these inequalities are unjust. For instance, are inequalities in health unjust per se? Or because the underlying socioeconomic inequalities are unjust? And does justice require equal health levels, or a minimum level of health? What complicates the issue, is that the width of the health gap, or the steepness of the social gradient, depends on what health measures are used. Overall, the more subjective the measure, the greater the inequalities appear to be. But are all these measures equally morally relevant? This dissertation aims to give a better understanding of these philosophical questions. It does so by investigating the question of what we should understand by health in the first part, after which it addresses the question of how to evaluate socioeconomic health inequalities in the light of justice. The introduction begins with a description of the phenomenon of socioeconomic health inequalities, and how it has been addressed by politicians, epidemiologists and philosophers in the past and today. The chapter continues by formulating the central question of the dissertation – that of which health inequalities should be focused in the light of a concern with social justice. It explicates how this dissertation contributes to answering that question, by discussing the potential relation between the conceptualisation of health and justice evaluations, and by discussing which questions are addressed in each of the following chapters. The chapter 2 addresses the question of how health is conceptualised in the philosophical and public heath literature, and how theoretical concepts of health differ. It proposes to approach health concepts as a Wittgensteinian family of thick concepts and argues that while theories on health generally argue in favour of one specific concept, a comparison of concepts shows that we may need different concepts of health given the variety of health practices. By explicating the differences between five concepts of health, this chapter argues that each captures aspects of health that all seem relevant when we talk and think about health. Classifying these concepts based on their distinctions reveals them as members of a conceptual family: each of the discussed concepts differs from the others in at least one respect and resembles the others in several respects. Moreover, the discussion of the concepts shows that ‘health’ always both describes a condition and values that condition at the same time. Having both descriptive and evaluative dimensions, we can see health concepts as ‘thick concepts’. Given this evaluative dimension, it is important to reflect on the question of what understanding of health guides specific practices. Moreover, the distinctions revealed by the classification can serve as a conceptual toolbox for reflection on the assumptions and purposes of health practices. How such reflection could work is illustrated by a brief exploration of what health aspects are focused upon in three specific health practices. Chapter 3 presents a study into the question of how health is conceptualised by ordinary citizens and to what extent conceptualisations of health differ between socioeconomic groups. By making use of the method of concept mapping, this study analyses how different socioeconomic groups formulate their own answers regarding the question ‘what does health mean to you?’. It presents concept maps of health for three different socioeconomic groups living in the city of Utrecht that reveal that all groups have a multidimensional understanding of health. An interpretation of the concept maps reveals nuanced differences between groups. The multiple aspects of health were also ranked by importance. It appears that each group assigned most importance to mental health. All in all, the study shows that people in lower socioeconomic groups are more likely to show a conceptualisation of health that refers to 1) the absence of health threats, 2) a person within his/her circumstances, 3) the value of functional notions, and 4) an accepting attitude towards life. Chapter 4 addresses the question of what the theoretical and empirical study to concepts of health could imply for health equity practices. It does so by exploring further the suggestions made in chapters 2 and 3. Regarding the question of which health aspects should guide health equity policies, this chapter discusses the question of whether we should primarily look at subjective or objective health measures, and whether a universal or relative standard of health should be central. While justice-related concerns of impartiality and equal treatment may seem to favour an objective perspective and a universal health standard, it appears that we have good reason to account for the subjective perspective as well. It is also argued that a concern for recognition and participatory parity gives room for relative health standards. Th room for relative health standards confronts us with the question of how to deal with mechanisms like adaptive preferences that the concept maps reveal. It proposes a way out, by arguing for society-relative health standards. Chapter 5 examines the question of whether inequalities in health should be evaluated ‘directly’, thus independently of a distribution of their social determinants. It proposes a sufficientarian perspective, such that the central question of evaluation is that of whether everyone is – or can be – healthy enough. By discussing two sufficientarian approaches to health and social justice – by Powers & Faden and by Nussbaum – this chapter distinguishes two ways of setting a threshold level for health. Both approaches appear to provide an unsatisfactory basis for justice evaluations and lead us away from direct evaluation if we try to settle health minima that are less arbitrary. In anticipation to chapters 6 and 7, it is argued that the perspective of sufficient health for relational equality escapes this arbitrariness: compared to that of a decent human life, it better helps to answer both the question of what socioeconomic health inequalities a society is due to avoid, and the question of when socioeconomic health inequalities are unjust considering their consequences. Chapter 6 discusses to what extent Daniels’s theory of health justice provides a satisfactory answer to the question of what health inequalities a society is due to avoid. Daniels proposes an indirect evaluative approach by arguing that we should evaluate socioeconomic health inequalities in the light of Rawls’s principles of justice as fairness. That is, if socioeconomic inequalities are in accordance with fair equality of opportunity and with the difference principle, the corresponding health inequalities would be just. It is shown that the suggestion that Rawls’s principles regulate the social determinants of health neglects that not all social determinants of health belong to society’s basic structure as conceived of by Rawls and are thereby not subjected to the principles of justice. To acknowledge the social mechanisms leading to socioeconomic health inequalities in their full complexity, it is argued that we should broaden our understanding of society’s structure in accordance with Young’s notion of social structural processes. This renders the question of what health inequalities a society is due to avoid into a question of what we can expect from the side of the various actors that uphold the social structures that produce socioeconomic health inequalities. Lastly, it is discussed how a shift to Young’s theory completes the shift to non-ideal theorising that seem already initiated by Daniels, and that with this, the distinction between direct and indirect evaluation dissolves. Chapter 7 discusses to what extent equality in health is of instrumental value for a society of free and equals. It thus takes up the idea proposed in chapter 5, that an evaluation of the consequences of health inequalities is also due. Taking relational equality as an evaluative framework reveals three ways in which inequalities in life expectancy threaten this ideal. That is, via unequal risks to stigmatisation, unequal risks to unemployment and the risk of unequal pension enjoyments. It is thereby shown that these risks are especially great for those lower down the socioeconomic strata. It thus concludes that equality in health is of instrumental value to relational equality. The chapter continues to argue that our instrumental approach opens a new perspective: to mitigate the identified injustices by changing society, rather than by reducing inequalities in health. This is argued to be an advantage in the light of the realistic assumption that of the socioeconomic health inequalities will persist. The paper thus offers a complementary approach to both the evaluation and the mitigation of the injustice of socioeconomic inequalities in health. The discussion chapter summarises the central findings of the analyses of health concepts and discusses questions regarding the philosophical and practical merits of comparing theoretical health concepts, the need for developing new health measures or concepts and the importance or nonsense of studying citizen’s views on health. Repeating this for the dissertation’s second part, the central findings of the chapters on justice evaluation are summarised and followed by a discussion of questions and issues that have remained unaddressed so far. Here, central points of discussion are my take on rules of distribution, the distinction of direct and indirect evaluation, the role of ideal and non-ideal theory, the idea of relational equality, and personal responsibility for health. The chapter concludes by noting that also in the light of justice evaluations, all commonly used health measures are relevant for justice. Therefore, my recommendations for policy and further research entail that inequalities in each of these measures deserve attention by both policymakers and researchers. Specifically, policymakers and researchers should give attention to how exactly each of these health inequalities come about, in such a way that a discussion about the question of who can be assigned responsibility to alleviate them is well-informed; and both should give attention to the effects of health inequalities on the opportunities for people to live on equal standing, in such a way that when these opportunities are diminished, actions can be considered to aim to restore relational equality. (shrink)

This thesis explores the relationship between the capability approach to justice and liberal philosophy. I argue that the most compelling articulation of the capability approach—one given by Martha Nussbaum—suffers from an unattractive kind of inconsistency. On the one hand, Nussbaum is committed to formulating a robust account of a dignified human life which can give rise to a range of individual entitlements which ought to be guaranteed to all individuals. On the other hand, Nussbaum is committed to political liberalism which (...) requires state institutions to uphold strict neutrality between a variety of reasonable conceptions of the good. Nussbaum’s first commitment results in the formulation of a list of ten central human capabilities. However, I argue that the content and justification of this list cannot be successfully established in a way that is consistent with Nussbaum’s second commitment. Therefore, in this thesis, I propose a novel capability approach: a two-step approach which consists of two principles arranged in lexical priority. First, governments have a moral obligation to secure individuals with a meta-capability of autonomy. That is to say, governments must provide the conditions which are conducive to individuals exercising a range of agentic competencies which are constitutive of autonomous judgement. Second, governments have a moral obligation to provide opportunities for individuals to exercise this meta-capability in six domains of well-being: health, politics, knowledge, relationships, self-expression, and work. I argue that exercising autonomous choice in the pursuit of welfare is necessary for a good life, regardless of the specific choices individuals eventually make, and even if they choose to forgo some supposedly valuable choices altogether. My proposal has two striking features which set it apart from other articulations of the capability approach. First, my proposal is comprehensive in that it relies on a particular view about what is a valuable way of life. In my view, a way of life is valuable if it is pursued autonomously, that is to say, if it involves an individual exercising a set of agentic competencies and standing in appropriate relations with other people. And second, by virtue of being based in this particular comprehensive claim, my account of justice is anti-perfectionist. That is to say, my proposal does not aim to compel people to make valuable choices. Rather, it aims to equip people with the means to live the kind of life they find valuable and worth living. I then apply this capability approach to the domain of education, and I argue it can be useful in formulating an ambitious and transformative approach to education. In particular, I develop a program of civic education aimed at responding to the problems associated with disinformation and ‘post-truth’ trends in politics. (shrink)

In this chapter, I propose the mechanism of cognitive enhancement based on studies of cognitive-enhancing drugs and behavioral training. I argue that there are mechanistic differences between cognitive-enhancing drugs and behavioral training due to their different enhancing effects. I also suggest possible mechanisms for cognitive-enhancing drugs and behavioral training and for the synergistic effects of their simultaneous application.

This transdisciplinary doctoral thesis presents various theoretical, methodological and empirical approaches that together form an ecological approach to the study of social sciences. The key argument follows: to understand how sustainable behaviours and cultures may emerge, and how their development can be facilitated, we must further learn how behaviours emerge as a function of the person and the material and social environment. Furthermore, in this thesis the sustainability crises are framed as sustain-ability crises. We must better equip our cultures with (...) abilities to deal with the complexity and uncertainty of socio-ecological systems, and use these cultural skillsets to survive in and adapt to an increasingly unpredictable world. This thesis employs a plurality of ecological social sciences and related methodologies—such as ecological psychology, ecological rationality and agent-based modelling—to enlighten the question of how the collective adoption of sustainable behaviours can be leveraged, particularly by changing the affordances in the material environment. What is common to these ecological approaches is the appreciation of ‘processes’ over ‘products’: we must understand the various processes through which sustainable forms of behaviour or decision-making emerge to truly locate leverage points in social systems. Finally, this thesis deals extensively with uncertainty in complex systems. It proposes that we can look to local and traditional knowledge in learning how to deal adaptively with uncertainty. (shrink)

This thesis justifies the need for and develops a new integrated model of practical reasoning and argumentation. After framing the work in terms of what is reasonable rather than what is rational (chapter 1), I apply the model for practical argumentation analysis and evaluation provided by Fairclough and Fairclough (2012) to a paradigm case of unreasonable individual practical argumentation provided by mass murderer Anders Behring Breivik (chapter 2). The application shows that by following the model, Breivik is relatively easily able (...) to conclude that his reasoning to mass murder is reasonable – which is understood to be an unacceptable result. Causes for the model to allow such a conclusion are identified as conceptual confusions ingrained in the model, a tension in how values function within the model, and a lack of creativity from Breivik. Distinguishing between dialectical and dialogical, reasoning and argumentation, for individual and multiple participants, chapter 3 addresses these conceptual confusions and helps lay the foundation for the design of a new integrated model for practical reasoning and argumentation (chapter 4). After laying out the theoretical aspects of the new model, it is then used to re-test Breivik’s reasoning in light of a developed discussion regarding the motivation for the new place and role of moral considerations (chapter 5). The application of the new model shows ways that Breivik could have been able to conclude that his practical argumentation was unreasonable and is thus argued to have improved upon the Fairclough and Fairclough model. It is acknowledged, however, that since the model cannot guarantee a reasonable conclusion, improving the critical creative capacity of the individual using it is also of paramount importance (chapter 6). The thesis concludes by discussing the contemporary importance of improving practical reasoning and by pointing to areas for further research (chapter 7). (shrink)

Inclusive design prescribes addressing the needs of the widest possible audience in order to consider human differences. Taking differences seriously, however, may imply severely restricting “the widest possible audience”. In confronting this paradox, we investigate to what extent Rawls’ theory of justice as fairness applies to design. By converting the paradox into the question of how design can be fair, we show that the demand for equitability shifts from the design output to the design process. We conclude that the two (...) main questions about justice find application in design: the question about the standards of justice and the question about its metrics. We endorse a Rawlsian approach to the former, while some revision may be due regarding the latter. (shrink)

This study is a contribution to Chinese-Western dialogue of bioethics but perhaps the first one of its kind. From a Chinese-Western comparative ethical perspective, this work brings Chinese ethical theories, especially Confucian ethics, into a contemporary context of the epidemic of HIV/AIDS, and to see how the deeply-rooted thoughts of Confucius interact, compete, or integrate with concepts from Western ethical traditions. An underlying belief is that some ideas in Confucian ethics are important and insightful beyond their cultural and historical origins (...) in China and other Confucianism influenced societies.Methodologically, this thesis employs two approaches, conceptual normative analysis combined with critical interpretation. The ‘interpretive’ approach I employ, as an important methodology supplementing my normative analysis, not only deals with Chinese ancient texts, but also explains specific beliefs and practices in China.With a critical eye, this thesis carefully examines a number of key topics in the ethics of AIDS in China from a cross-cultural perspective. Topics including: views on personhood and the vulnerability of People Living with HIV/AIDS; prioritising and balancing the role of ‘harm reduction’ and the role of ‘eradication of deviant behaviour’ in AIDS policy in China; rights-based opt-out approach and duty-based family-centred approach in HIV testing and Biobanking; blood donation; moral responsibility and personal responsibility for health; and the popular rhetoric of ‘innocent infection’ versus ‘guilty infection’ in AIDS. My overall aim in this work is to present a cross-cultural bioethics study through the investigation of some ethical issues in AIDS in China from a Chinese-Western comparative perspective and also attempt to suggest a humane and effective policy for HIV/AIDS which I believe is appropriate to both traditions. I believe this work has contributed to our knowledge in three related but independent areas: the control of the epidemic of HIV/AIDS in China; medical ethics in China; and to both the methods and the utility of cross-cultural study of bioethics between China and the West. (shrink)

Extreme inequality of opportunity leads to a number of social tensions, inefficiencies and injustices. One issue of increasing concern is the effect inequality is having on people’s fair chances of attaining meaningful work, thus limiting opportunities to make a significant positive contribution to society and reducing the chances of living a flourishing life and developing their potential. On a global scale we can observe an increasingly uneven provision of meaningful work, raising a series of ethical concerns that need detailed examination. (...) The aim of this article is to explore the potential of a normative framework based upon the idea of contributive justice to defend a fairer provision of meaningful work. (shrink)

In the wake of a steady flow of child migrants attempting to cross borders and states’ efforts to restrict immigration, various public controversies have arisen about the rights of asylum-seeking children. The ‘moral gap’ between the outcome of democratically enacted laws and the aim of controlling immigration, on the one hand, and public calls to protect the universal rights of asylum seeking children, on the other, have created a political challenge for Western democracies. This thesis sets out to examine two (...) particular settings in which norms about the rights of asylum-seeking children and immigration control have been established and contested over the years: the Swedish Migration Court of Appeal and Sweden’s largest morning paper, Dagens Nyheter. It combines empirically oriented analysis with theoretical enquiry, and it brings the issue of the rights of asylumseeking children into dialogue with the contemporary political-philosophical debate about membership, rights and borders. (shrink)

Psychopharmacological cognitive enhancements could lead to a higher quality of life of healthy individuals with lower cognitive capacities, but the current regulatory framework does not seem to enable access to this group. This article discusses why Sen’s Capability Approach could open up such access, while two other modern social justice theories – utilitarianism and Rawls’ Justice as Fairness – could not. In short, the utilitarian approach is proven to be inadequate, due to practical reasons and having a low chance of (...) real-world success. Rawls’ Justice as Fairness seems to be problematic because of conflicting stances that follow from his First Principle of Justice. The Capability Approach has the greatest chance of success in the context of these substances, because of arguments that can be identified under the banners of agency/self-respect and the way the public views those who take the capability path out of their poor situation. The article also discusses general and practical problems with psychopharmacological cognitive enhancement that should be addressed when writing new policy on this topic. (shrink)