Attributions of what we shall call normative responsibilities play a central role in everyday moral thinking. It is commonly thought, for example, that parents are responsible for the wellbeing of their children, and that this has important normative consequences. Depending on context, it might mean that parents are morally required to bring their children to the doctor, feed them well, attend to their emotional needs, or to see to it that someone else does. Similarly, it is sometimes argued that countries (...) that emit most greenhouse gases are responsible for preventing catastrophic climate change. This responsibility might imply that these countries are morally required to take necessary steps individually and jointly to come to an agreement on and implement a workable plan, and to avoid steps that worsen the situation. More trivially, the grading of your student’s essays might be your responsibility, as might making sure there is wine at tomorrow’s picnic, and you might thus be required to see to it that essays are competently graded and suitable wine brought to the picnic. -/- Though attributions of normative responsibilities are legion, such responsibilities have received surprisingly little philosophical attention compared to its normative relatives, obligations and reasons, and compared to retrospective responsibility. This chapter hopes to improve on this situation by taking on two main tasks. The first, attempted in section 1, is to spell out the general structure of normative responsibility, in particular the relation between normative responsibilities and corresponding obligations and demands. We suggest that normative responsibilities are constituted by normative requirements that the responsible agents care appropriately about how well things go in certain regards, and that obligations generally can be seen as straightforward upshots of requirements to care. -/- The second task, taken on in section 2, is to provide an overview of prominent sources of normative responsibility and its distribution among agents. Why would the children’s wellbeing be the parents’ responsibility? Why not the neighbor’s, or the state’s, or everyone’s? Here we discuss a range of possible sources, including agents’ abilities, costs involved in taking on the responsibility in question, retrospective responsibility for the situation, promises or contracts, and certain social relationships. (shrink)

The purpose of this article is to present a normative theory of the goals of medicine (a theory that tells us in what respects medicine should benefit the patient) that is both comprehensive and unified. A review of the relevant literature suggests that there are at least seven plausible goals that are irreducible to each other, namely to promote functioning, to maintain or restore normal structure and function, to promote quality of life, to save and prolong life, to help the (...) patient to cope well with her condition, to improve the external conditions under which people live, and to promote the growth and development of children. However, it seems that all these goals need to be qualified in different ways, e.g. it does not seem reasonable to improve physiological function or functional ability unless this is expected to have positive effects on quality of life and/or length of life, or to improve the quality of life in any respect, or by any means. These qualifications all suggest that the proposed goals are, as goals, conceptually, and not just causally, related to one another, and that they should therefore not be regarded in isolation. Instead, we should think of the medical enterprise as having a multidimensional goal structure rather than a single goal. In order to depict clearly how the different goals are related to one another, a multidimensional model is constructed. (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)

Trust is often perceived as having great value. For example, there is a strong belief that trust will bring different sorts of public goods and help us preserve common resources. A related concept which is just as important, but perhaps not explicitly discussed to the same extent as “trust”, is “reliance” or “confidence”. To be able to rely on some agent is often seen as a prerequisite for being able to trust this agent. Up to now, the conceptual discussion about (...) the definition of trust and reliance has been rational in the sense that most people involved have offered arguments for their respective views, or against competing views. While these arguments rely on some criterion or other, these criteria are rarely explicitly stated, and to our knowledge, no systematic account of such criteria has been offered. In this paper we give an account of what criteria we should use to assess tentative definitions of “trust” and “reliance”. We will also offer our own well-founded definitions of “trust” and “reliance”. Trust should be regarded as a kind of reliance and we defend what we call “the accountability view” of trust, by appealing to the desiderata we identify in the first parts of the paper. (shrink)

The recent discussion of the concept of mental disorder has focused on what makes a mental disorder a disorder. A question that has received less attention is what makes a mental disorder mental rather than somatic. We examine three views on this issue -- namely, the internal cause view, the symptom view, and the pluralist view -- and assess to what extent these accounts are plausible. Three strategies used to pinpoint the mental in psychiatry are identified, namely negative characterizations, exemplification (...) of paradigmatic mental features, and an appeal to intentional content. We also examine different versions of nihilism. Finally, it is observed that the discussion of what makes a mental disorder mental has largely been unaffected by conceptions of the mental in the philosophy of mind. (shrink)

It is now generally agreed that we have to rely on value judgments to distinguish mental disorders from other conditions, but it is not quite clear how. To clarify this, we need to know more than to what extent attributions of disorder are dependent on values. We also have to know (1) what kind of evaluations we have to rely on to identify the class of mental disorder; (2) whether attributions of disorder contain any implicit reference to some specific evaluative (...) standard; and (3) whether the concept of mental disorder is value laden in the definitional or in the epistemic sense. I will argue that the evaluations we have to rely on are mainly considerations of harm, but that we also need to rely on other evaluations; that there should be no references to specific evaluative standards; and that even though mental disorders are necessarily undesirable, "mental disorder" may well be a descriptive phrase. (shrink)

Many of the major challenges facing global society are unstructured collective harms (e.g., global warming): collective in the sense that they arise as the result of the actions of, or interactions among, multiple agents, and unstructured in the sense that there is no coordination or intention to cause harm among these agents. But how should we distribute moral responsibility for these harms? In this paper, an answer is proposed to this question. This answer builds on but develops existing proposals by (...) drawing together literatures that speak to different aspects of the question. First, it is argued that the notion of causal contribution needs to be broadened to include the idea of causation as production. Second, it is discussed how the voluntariness and foreseeability conditions are best interpreted in this context. Third, literature on moral taint is drawn to introduce additional objective (external) criteria. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Art and Science, Facts and KnowledgeBengt Brülde (bio)Keywordsart, definitions, epistemology, facts and values, mental disorder, metaphysical realism, nominalism, physical disorder, social constructivismThe main purpose of my original article was to find out how the evaluative content of the concept of mental disorder, i.e. its "value component," should be characterized. Both Tyreman and Ross are focusing on other things, however. Tyreman seems to agree with my analysis, and his primary (...) objective is to find out whether my general analytical approach can be extended to other areas, e.g. whether it can be used to analyze the concept of physical disorder or the concept of art. It is hard to tell whether Ross agrees with my view, since her entire commentary is focused on a few assumptions I made in the beginning of the paper, mainly in passing, to make my evaluative investigation more manageable. In short, the main content of my original paper is never really challenged, and I do not think I have to revise my view on the evaluative content of the concept of mental disorder. Both commentaries give rise to questions that are interesting in their own right, however, e.g. questions about art and science, and about facts and knowledge. This gives me the opportunity to develop my views on a number of topics that I never touched upon in the original article, e.g. the purpose of defining "mental disorder," the factual component of the concept, the connection between ontological and epistemological issues, and the value-neutrality of science. I am very grateful to the editors for allowing me to give such an extensive reply.My Reply to TyremanTyreman wants to know whether the same kind of analysis given in my original paper can be applied just as usefully to other areas of health care. That is, the question is whether the same type of analytical approach can be extended to other areas where evaluative considerations seem to play a crucial part. In his commentary, Tyreman has mainly four areas in mind, namely physical disorder, art, good art, and good (competent) clinical practice. Or more specifically, the question is whether the kind of evaluative analysis I used in my original paper can help us answer the following four questions: (a) How should we define the concept of physical disorder, i.e. according to what criteria should we draw the line between physical disorders and other physical conditions? (b) How should we define the concept of art, i.e. according to what criteria should we draw the line between art and other artifacts and performances? (c) What is good art, i.e. according to what criteria should we evaluate those artifacts (etc.) that we have decided to categorize as works of art? (d) What makes a clinical performance or practice good or competent, according to what criteria should we evaluate such practices?The first two questions are conceptual, i.e. the question is how certain concepts should be [End Page 111] defined, and in what way or ways values enter the picture. The last two questions are straightforwardly evaluative, however, and it goes without saying that we have to rely on value judgments to answer these questions. This difference suggests that the conceptual analyses needed in the first two cases are somewhat different from the evaluative analyses needed in the last two cases. It is also far more likely that my analysis of mental disorder can be extended to the first two cases. After all, my approach is designed to capture the evaluative content of concepts that are not purely evaluative. (We will return to this below.)To see whether my analysis can be of any help in any of Tyreman's four cases, we need to recapitulate what it is all about. The analysis in question is specifically concerned with how the evaluative content of the concept of mental disorder should be characterized, i.e. how and to what extent we have to rely on value judgments to distinguish mental disorders from other conditions. The first part of the analysis consists in the formulation of four questions that any reasonably complete account needs to answer. These questions are: (0... (shrink)

A challenge for the theorising of climate justice is that even when the agents whose actions are supposed to be regulated are cooperative and act in good faith, they may still disagree about how the burdens and benefits of dealing with climate change should be distributed. This article is a contribution to the formulation of a useful role for normative theorising in light of this bounded nature of climate justice. We outline a theory of pure procedural climate justice; its content, (...) function in relation to international climate diplomacy, and justification. The theory is ‘pure’ in the sense that it does not rely on an independent criterion of what are just outcomes in negotiations of climate responsibilities. Rather, it specifies procedural fairness norms, such as transparency, reciprocity and participation, which make the process of negotiation fair independently of which account of substantive climate justice happens to be correct. Such procedural fairness norms are justified in part by being expressions of an ideal of a reasonable negotiator, an ideal which itself commands respect. They are also justified as means to an effective coordinated response to dangerous climate change in virtue of their capacity to create trust, predictability and accountability. (shrink)

The main question is whether chemically induced mood enhancement is likely to make us happier, or whether it may rather have detrimental effects on our long-term happiness. This question is divided into three: What effects are mood -enhancing drugs likely to have on the long-term happiness of the person who takes these drugs? How would these drugs affect the happiness of the immediate environment of the people who take them, e.g. children or spouses? What effects would a wide-spread use of (...) mood -enhancing drugs have on society as a whole, and how would this affect the long-term happiness of its citizens? My answers to these questions are very tentative, partly because we know too little about what non-hedonic effects these drugs can be expected to have. It is possible that these drugs would have detrimental effects on some determinants of happiness, however, e.g. marriage and friendship, social and physical activity, rational problem-solving and mental effectiveness, political participation and interpersonal trust. But on the other hand, there are also a number of determinants of happiness that might be positively affected by a wide-spread and frequent use of mood -enhancing drugs. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 13.2 (2006) 133-141MuseSearchJournalsThis JournalContents[Access article in PDF]Dysfunctions, Disabilities, and Disordered MindsBengt BrüldeFilip RadovicRichard Gipps' and Jerome Wakefield's commentaries on our article are so different from each other that we have decided to deal with them separately. Gipps suggests that we adopt a different framework altogether. In his view, our main question—"What makes a mental disorder mental?"—is somehow defective, and it ought to be replaced by (...) an alternative question, namely, "What makes a mind disordered?" He thinks he can answer this question by providing an alternative account of the mental in terms of intentionality and suigeneris psychological understanding. He also suggests that mental disorders are "alterations within the intentional order." Wakefield, on the other hand, shares most of our "framework assumptions"; for example, he accepts the way we formulate our central question and how we present the different possible answers. The only part of our general project to which he objects is the attempt to find a principled account of what makes a mental function (dysfunction, mechanism, ability, or the like) mental. His main purpose is to defend and develop his own version of the internal cause view, namely, the idea that mental disorders are (harmful) mental dysfunctions. Because Gipps' comments are of a far more general nature than Wakefield's, we respond to Gipps first. This gives us an opportunity to make our "framework assumptions" more explicit.Gipps' Criticism of the Notion of Mental DisorderLet us first note that Gipps' suggestions are often vague. As Gipps himself puts it, his account is "clearly in need of much further clarification and elaboration" (121). This means that we sometimes have to reconstruct what he says to attribute sufficiently clear views to him.Gipps questions our assumption that there is such a thing as a general category of disorder, of which mental and somatic disorders can be regarded as subcategories. Or more precisely, he rejects the view that "disorder" is a proper category (or "semantic category," as he puts it), and he also seems to deny that "mental disorder" is a category. This is supposed to imply that our central question is somehow wrongly formulated, and to pave the way for his reformulation of this question (from now on, "the move").To determine whether Gipps' objection is valid or not, we need to know what he means by the term "category." However, all we are told is that a noun designates a (semantic) category if and only if it has a "unitary sense." Unfortunately, he does not specify what this "unitary sense" consists in. For example, does he implicitly assume that a noun designates a category if and only if there are necessary conditions for membership that are jointly sufficient? The example he offers (see [End Page 133] p. 118) suggests another possible interpretation, however. Here, he claims that the relation between the terms "mental disorder" and "physical disorder" are analogous to the relation between the terms "chemical reaction" and "emotional reaction." This suggests that the term "disorder" as it occurs in the phrase "physical disorder" and the term "disorder" as it occurs in the phrase "mental disorder" have different senses. This is an interesting suggestion that may well be correct, but Gipps does not offer any arguments for the assumption that "disorder" behaves like "reaction." Neither does he offer any examples of proper (semantic) categories.The Move from "Mental Disorders" to "Disordered Minds"In Gipps' view, mental disorders are best conceived of as disorders of the mind, and physical disorders as disorders of the body, and he therefore suggests that we ask what makes a disordered mind disordered rather than what makes a mental disorder mental. But why does Gipps believe that this move from "mental disorder" to "disordered minds" constitutes an improvement? The first reason has already been given, namely that the term "disorder" might not designate a proper category. But this is not a good reason for making the move Gipps suggests unless we assume that "mind" and "body" are proper categories. At this... (shrink)

The paper starts with a presentation of the pure happiness theory, i.e. the idea that the quality a person’s life is dependent on one thing only, viz. how happy that person is. To find out whether this type of theory is plausible or not, I examine the standard arguments for and against this theory, including Nozick’s experience machine argument. I then investigate how the theory can be modified in order to avoid the most serious objections. I first examine different types (...) of epistemic modifications of the theory (e.g. the idea that a person’s happiness is more valuable for her if it is based on a correct perception of her own life), and then turn to a number of modifications which all make the value of a person’s happiness depend on whether the evaluative standard on which her happiness is based satisfies certain requirements. In connection with this, I present and defend my own modified version of the happiness theory. (shrink)