Challenging, with several powerful arguments, some of our deepest beliefs about rationality, morality, and personal identity, Parfit claims that we have a false view about our own nature. It is often rational to act against our own best interersts, he argues, and most of us have moral views that are self-defeating. We often act wrongly, although we know there will be no one with serious grounds for complaint, and when we consider future generations it is very hard to avoid conclusions (...) that most of us will find very disturbing. (shrink)

This paper argues that the medical conception of health as absence of disease is a value-free theoretical notion. Its main elements are biological function and statistical normality, in contrast to various other ideas prominent in the literature on health. Apart from universal environmental injuries, diseases are internal states that depress a functional ability below species-typical levels. Health as freedom from disease is then statistical normality of function, i.e., the ability to perform all typical physiological functions with at least typical efficiency. (...) This conception of health is as value-free as statements of biological function. The view that health is essentially value-laden, held by most writers on the topic, seems to have one of two sources: an assumption that health judgments must be practical judgments about the treatment of patients, or a commitment to "positive" health beyond the absence of disease. I suggest that the assumption is mistaken, the commitment possibly misdescribed. (shrink)

In a Different Voice is the little book that started a revolution, making women's voices heard, in their own right and with their own integrity, for virtually the first time in social scientific theorizing about women. Its impact was immediate and continues to this day, in the academic world and beyond.

The starting point for the contemporary debate about theories of health should be the holistic theory of Lennart Nordenfelt, claims George Khushf, not the refuted theory of Christopher Boorse. The present paper is an attempt to challenge Nordenfelt and to present an alternative theory to his and other theories, including Boorse’s. The main problems with Nordenfelt’s theory are that it is relativistic, that it leads to counter-intuitive results as to what goals can count as healthy, that it focuses on the (...) wrong kind of abilities, that it makes measuring health extra difficult, and that it does not give us a sufficient account of health, at most a necessary one. The alternative theory proposed is two-dimensional. First, health is to have developed the abilities and dispositions that members of one’s culture typically develop, and be able to use them, in acceptable circumstances; and second, health is to experience positive moods and sensations, the kinds that have internal causes. The theory solves the problems attached to Nordenfelt’s theory by not being individual relativistic, by eliminating the goals in the definition, by giving an alternative interpretation of “ability,” by making health easier to measure, and by adding the dimension of well-being that, together with health as ability, not only gives us a necessary, but also a sufficient, account of health. (shrink)

In this unique study Fulford combines the disciplines of rigorous philosophy with an intimate knowledge of psychopathology to overturn traditional hegemonies. The patient replaces the doctor at the heart of medicine. Moral theory and the logic of evaluation replace epistemology as the focus of philosophical enquiry. Ever controversial, mental illness is at the interface of philosophy and medicine. Mad or bad? Dissident or diseased? Dr Fulford shows that it is possible to achieve new insights into these traditional dilemmas, insights at (...) once practically relevant and philosophically significant. (shrink)

All definitions of mental disorder are backed up by arguments that rely on general criteria (e.g., that a definition should be consistent with ordinary language). These desiderata are rarely explicitly stated, and there has been no systematic discussion of how different definitions should be assessed. To arrive at a well-founded list of desiderata, we need to know the purpose of a definition. I argue that this purpose must be practical; it should, for example, help us determine who is entitled to (...) publicly funded health care. I then propose eight conditions of adequacy that can be used to assess competing definitions (e.g., the ordinary language condition, the coherence condition, and the condition of normative adequacy). These conditions pull in different directions, however, and we must decide which are most important. I also suggest that there is no single definition that can help us deal with all the relevant practical issues. (shrink)

This inspirational book provides the philosophical backbone tocountless courses for health professionals. It poses twofundamental questions - "What is health?" and "How can more healthbe achieved?" - and answers them at a depth unmatched by any othertext in this field. David Seedhouse shows that these questions lieat the heart of health practice, and explains why all healthworkers should ponder them deeply. This second edition retains the freshness and enthusiasm of thefirst, while making the foundations theory and its practicalapplications clearer and (...) more accessible than ever. The bookincludes additional material and discussion, new case studies andrevised illustrations. * Describes and explores competing theories of health * Establishes a practical and ethical foundation for healthpromotion and education * Explains the foundations theory - a novel and comprehensive wayto understand health * Shows how the foundations theory might be used to create morehumane health services. (shrink)

Moral philosophers agree that welfare matters. But they disagree about what it is, or how much it matters. In this vital new work, Wayne Sumner presents an original theory of welfare, investigating its nature and discussing its importance. He considers and rejects all notable theories of welfare, both objective and subjective, including hedonism and theories founded on desire or preference. His own theory connects welfare closely with happiness or life satisfaction. Reacting against the value pluralism that currently dominates moral philosophy, (...) he advances welfare as the only basic ethical value. He concludes by discussing the implications of this thesis for ethical and political theory. Written in clear, non-technical language, and including a definitive survey of other work in this area, Sumner's book is essential reading for moral philosophers, political theorists, and welfare economists. (shrink)

Morality and mental health are now inseparably linked in our view of character. Alcoholics are sick, yet they are punished for drunk driving. Drug addicts are criminals, but their punishment can be court ordered therapy. The line between character flaws and personality disorders has become fuzzy, with even the seven deadly sins seen as mental disorders. In addition to pathologizing wrong-doing, we also psychologize virtue; self-respect becomes self-esteem, integrity becomes psychological integration, and responsibility becomes maturity. Moral advice is now sought (...) primarily from psychologists and therapists rather than philosophers or theologians. This book asks: are we replacing morality with therapy, in potentially confused and dangerous ways, or are we creatively integrating morality and mental health? According to the book, it's a little bit of both. It surveys the ways in which morality and mental health are related, touching on practical concerns like love and work, self-respect and self-fulfillment, guilt and depression, crime and violence, and addictions. Terming this integrative development “the therapeutic trend in ethics,” the book uses examples from popular culture, various moral controversies, and draws on line of thought that includes Plato, the Stoics, Freud, Nietzsche, and contemporary psychotherapeutic theories. The book develops some interesting conclusions, among them that sound morality is indeed healthy, and that moral values are inevitably embedded in our conceptions of mental health. In the end, the book shows how both morality and mental health are inextricably intertwined in our pursuit of a meaningful life. (shrink)

This book presents a unique examination of mental illness. Though common to many mental disorders, delusions result in actions that, though perhaps rational to the individual, might seem entirely inappropriate or harmful to others. This book shows how we may better understand delusion by examining the nature of compulsion.

One INTRODUCTION 1. Background The theory of the nature of health and disease, or of the concepts of health and disease, has been central in modem ...

The basic work for this book was carried out during the spring of 1989 in Edinburgh, where I had been granted a research position at The Institute for Advanced Studies in the Humanities. I should like to express here my indebtedness to the Institute for the opportunity thus afforded me. I should also like to say how very grateful I am for the stimulating conversations I had there with Professor Timothy Sprigge and Dr. Elizabeth Telfer. Dr. Telfers’s own treatise Happiness (...) has been a major influence on my view of the questions involved. The basic view of health and illness presented in this book is more fully set out in my On the Nature of Health. As in the case of my previous larger projects, I have received a great amount of support and may wise comments from Professor Ingmar Pörn, Helsinki. Three Danish experts – Anton Aggernaes, Erik Ostenfeld and Peter Sandøe – have made valuable comments. Professor Heng ten Have, Nijmegen, has improved my reading of the philosophy of Jeremy Bentham. I should also like to thank my colleagues at the Department of Health and Society, University of Linköping, for helping me to avoid a number of the pitfalls that can so easily stumble into when it comes to a treatise like this. Especially I should like to mentioned Per-Erik Liss, Ingemar Nordin and Bo Petersson, all three of whom have read and commented on the entire manuscript. A Swedish version of this book, Livskvalitet och hälsa, came out in 1991. I have been made quite a number of corrections and additions, one type of addition being replies to critical points made in reviews of the Swedish version. I should like to thank Malcolm Forbes for valuable help putting my English into publishable condition. Linköping, May 1993 Lennart Noredenfelt. (shrink)

The purpose of this paper is to give an explication of the concept of health which does not rely on the concept of disease. The explication is informed by a view of the human individual as an acting subject and it therefore places the abilities of agents in the centre. Abilities may be qualified in different ways. The qualification essential for understanding the dimension of health and illness relates abilities to environmental circumstances and high-ranking projects in the life plan. For (...) this purpose generalized adaptedness is introduced as the overarching construction. The dimension of health and illness is characterized in terms of the adequacy of the repertoire for generalized adaptedness. Some immediate consequences concerning the notion of care are noted. (shrink)