Health promotion efforts are commonly directed towards encouraging people to discard ‘unhealthy’ and adopt ‘healthy’ behaviours in order to tackle chronic disease. Typical targets for behaviour change interventions include diet, physical activity, smoking and alcohol consumption, sometimes described as ‘lifestyle behaviours.’ In this paper, I discuss how efforts to raise awareness of the impact of lifestyles on health, in seeking to communicate the need for people to change their behaviour, can contribute to a climate of ‘healthism’ and promote the (...) moralisation of people’s lifestyles. I begin by summarising recent trends in health promotion and introducing the notion of healthism, as described by Robert Crawford in the 1980s. One aspect of healthism is moralisation, which I outline and suggest is facilitated by efforts to promote health via information provision and educational strategies. I propose that perceived responsibility plays a role in mediating the tendency to moralise about health and behaviour. Since I argue that states ought to avoid direct and indirect moralisation of people’s health-related behaviour, this suggests states must be cautious with regard to the use of responsibility-indicating interventions to promote health. (shrink)

When scientists consider the interaction of science and value judgments, debates often occur. When public policy grows out of science, disagreements between scientists can become even more spirited. This paper examines the case of nutrition policy in the United States, which has been both at the interface between agriculture and medicine and the object of serious discord concerned with the strength and validity of the scientific evidence and the responsibility for action. The development of indirect intervention policies, designed to educate (...) and inform the public on diet and health, is traced as a practical demonstration of the effects of involvements of nutritional scientists of different disciplines and philosophic bents. Controversies centered mainly on the issues of diet and coronary heart disease and of diet and cancer in nutritional guidelines for Americans and the recommended dietary allowances. But the arguments turned on a complex web of values and interests as well as scientific questions. A remarkable turnaround by animal agriculture and its scientific support occurred, changing from a defensive, rightist stance to one that appears to recognize a moral responsibility to the public health. The convincing point was likely the changing market. Nutritional scientists, however, remained divided on the issue of whether a public health strategy keyed to public education should replace a strategy to identify persons of high risk and modify the risk by treatment. Our analysis suggests that the tension between libertarian and utilitarian social values of scientists is at least as important as disagreements relative to validity and strengths of the scientific evidence. (shrink)

What are we doing to our climate? Emissions from fossil fuel burning have raised carbon dioxide concentrations 35 percent higher than in the past millions of years. This increase is warming our planet via the greenhouse effect. What is climate change doing to and for us? Dry regions are drier and wet ones wetter. Wildfires have increased threefold, hurricanes more violent, floods setting record heights, glaciers melting, and seas rising. Parts of Earth are increasingly uninhabitable. Climate change requires us to (...) act as a global community. Climate justice enjoins emitters to pay the social‐environmental costs of fossil fuel burning. This would expedite green solar, wind, and next‐generation nuclear energy sources. Individuals should conserve resources, waste less food, and eat a plant‐rich diet. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Sigewiza’s CureJennifer H. Radden (bio)Keywordsbiopsychosocial model, Hildegard of Bingen, associationist presuppositions, causation, power of suggestionSuzanne Phillips and Monique Boivin provide us with a sympathetic and compelling account of how the various elements of Hildegard’s sophisticated amalgam of ritual, magic, religion, dietary and other medical remedies, caring, and community, formed a seamless cure for Sigewiza’s affliction. Whether Hildgard’s approach reflects an early instance of the biopsychosocial “model” is a separate (...) claim, and may be challenged. But that her ministrations somehow effected a cure in this case seems—if not without a doubt, then very likely.Descriptions of Sigewiza’s condition, with its “clumping together of blackness and steam” caused by a “constellation of humors,” echo those of other medieval writers speaking of the humoral disorder of melancholia—at that time an encompassing category for a range of symptoms and syndromes that would today be assigned as different mental disorders. In these descriptions a variety of explanations for mental illness are quite typically introduced, including biological, social, supernatural, dietary and astrological ones. Phillips and Boivin take care to point out that Hildegard was not offering her remedies as alternatives, but rather proposing them as at work jointly and in a range of causal directions, exhibiting mutual influence, and feedback loops. As these authors say, multiple explanations “were often held simultaneously... in reference to a specific case” (Phillips and Boivin 2007, XX). And the factors that might cause the system to move out of balance are many: food, emotions, the soul, the mind, actions, and spiritual forces. So although deeds may cause bodily changes and their psychological accompaniments, “problems in the diet might affect the humors which would then have psychological effects, which demons might... use as opportunities to cause further trouble in the spirit, mind, and body” (Phillips and Boivin 2007, 365).What first struck me about Hildegard’s description of these many distinct causes interacting in complex ways is its compatibility with the multi-causal accounts of depression (and other mental disorder) frequently proffered in our own time. Daily habits (e.g., diet, sleep and exercise regimes), genetic predispositions, including biological states of fragility, external events, experiences of loss, social roles, and cultural beliefs—not to mention spontaneous recovery, and placebo effects—are all regularly implicated in the onset and course of conditions such as depression.Still, the similarity to these modern causal accounts may be somewhat misleading and we must beware of overstating it. In favoring and pressing on Hildegard’s holistic understanding, moreover, Phillips and Boivin perhaps insufficiently emphasize significant dissimilarities between Hildegard’s and our contemporary accounts.It is the interaction between the various elements making up Sigewiza’s cure that is most noteworthy [End Page 373] in this account, as Phillips and Boivin recognize. Yet that relationship itself seems in some ways surprisingly problematic: difficult for us to make sense of, and profoundly unmodern. Granted, we think we see the way these approaches probably influenced how Sigewiza felt and responded; but it is not so clear how Hildegard saw things. Like a lot of thinking in medieval times, Hildegard’s account provides us with glimpses of an understanding of the world that today looks prescientific and in that respect, almost precausal. (So, to the extent that the biopsychosocial model is understood as a causal one, the case of Sigewiza may exemplify it only inexactly.)It is not merely the range and type of causes, including supernatural and astrological ones, in accounts such as Hildegard’s that distinguish it from today’s analyses. It is also the reliance of such accounts on what seems to be a different metaphysics, one of associations or qualities.Associationist presuppositions can be found in accounts of health and illness from before, during, and long after, Hildegard’s time. Three examples of this pervasive, but puzzling thinking serve to illustrate. The melancholiac’s perceived swarthiness and darkened skin color—regularly noted from the time of the Greek physicians and an established part of the medieval iconography in images of melancholy—were not, or not primarily, thought to be a causal result of the darkness of his bile, as one might suppose. Instead, this coloring seems... (shrink)

The neuropsychology of religious activity in normal and selected clinical populations is reviewed. Religious activity includes beliefs, experiences, and practice. Neuropsychological and functional imaging findings, many of which have derived from studies of experienced meditators, point to a ventral cortical axis for religious behavior, involving primarily the ventromedial temporal and frontal regions. Neuropharmacological studies generally point to dopaminergic activation as the leading neurochemical feature associated with religious activity. The ventral dopaminergic pathways involved in religious behavior most closely align with the (...) action-extrapersonal system in the model of 3-D perceptual–motor interactions proposed by Previc . These pathways are biased toward distant space and also mediate related extrapersonally dominated brain functions such as dreaming and hallucinations. Hyperreligiosity is a major feature of mania, obsessive-compulsive disorder, schizophrenia, temporal-lobe epilepsy and related disorders, in which the ventromedial dopaminergic systems are highly activated and exaggerated attentional or goal-directed behavior toward extrapersonal space occurs. The evolution of religion is linked to an expansion of dopaminergic systems in humans, brought about by changes in diet and other physiological influences. (shrink)

Sugar, pork, beer, corn, cider, scrapple, and hoppin' John all became staples in the diet of colonial America. The ways Americans cultivated and prepared food and the values they attributed to it played an important role in shaping the identity of the newborn nation. In A Revolution in Eating, James E. McWilliams presents a colorful and spirited tour of culinary attitudes, tastes, and techniques throughout colonial America. Confronted by strange new animals, plants, and landscapes, settlers in the colonies and (...) West Indies found new ways to produce food. Integrating their British and European tastes with the demands and bounty of the rugged American environment, early Americans developed a range of regional cuisines. From the kitchen tables of typical Puritan families to Iroquois longhouses in the backcountry and slave kitchens on southern plantations, McWilliams portrays the grand variety and inventiveness that characterized colonial cuisine. As colonial America grew, so did its palate, as interactions among European settlers, Native Americans, and African slaves created new dishes and attitudes about food. McWilliams considers how Indian corn, once thought by the colonists as "fit for swine," became a fixture in the colonial diet. He also examines the ways in which African slaves influenced West Indian and American southern cuisine. While a mania for all things British was a unifying feature of eighteenth-century cuisine, the colonies discovered a national beverage in domestically brewed beer, which came to symbolize solidarity and loyalty to the patriotic cause in the Revolutionary era. The beer and alcohol industry also instigated unprecedented trade among the colonies and further integrated colonial habits and tastes. Victory in the American Revolution initiated a "culinary declaration of independence," prompting the antimonarchical habits of simplicity, frugality, and frontier ruggedness to define American cuisine. McWilliams demonstrates that this was a shift not so much in new ingredients or cooking methods, as in the way Americans imbued food and cuisine with values that continue to shape American attitudes to this day. (shrink)

My office is in a medical building in suburban Washington, D.C. —in Bethesda, named for the Biblical healing pool. All of the offices of my building are occupied by medical specialists, representing the most sophisticated training in the application of the scientific method. Downstairs and of service to all of us is a pharmacy, looking for all the world like a research laboratory with its gleaming surface, meticulous cleanliness, micro-balances, records, reference books, and cash register. It is neatly stocked with (...) modern, physiologically-defined preparations of active, predictable drugs. Among the enzymes, hormones, antibiotics, and chemo therapeutics for neoplasm, are a few newly hatched, unfledged remedies, but most are dependable and thoroughly assayed. The intently busy, white-coated, unsentimental pharmacists serve a hard-headed group of practitioners and a neighborhood of upper-class, well-educated patients. It is disconcerting, then, to see the undersurface of this sophistication, the irrational shadows beneath the science. On the front counter of the pharmacy are displayed attractive colored advertisements and pleasantly seductive inducements to self-improvement through diet cults and foods, tranquilizers, energizers, protein supplements, happiness promisers, preparations to enhance sexuality, vitamins artfully combined, and many packeted stuffs of no rational or pretended use whatsoever. “Why,” I ask the gimlet-eyed pharmacist, “do you have this large display of ‘Il Wah Genuine Chinese Ginseng, the Miraculous Herb of Life’? Doesn't it violate your university training? Your integrity as a modernist?” “Oh,” says he, “ginseng makes you feel better! You have more energy. You can do more! Lots of athletes use it, and people who work too hard and feel exhausted. It's only $3.45 a package. The prescriptions you give me once in a while yield no profit, but I sell a lot of ginseng. I use it myself!” Bemused, I walk back to my office, wondering about the easy abandonment of rationality, and pull down a box of medicinals collected the year before at an open-air pharmacy in the riverside markets of Brazil. The box gives forth deliciously rich forest smells. The packets within contain barks, roots, seeds, all of purported medical value. Other packets have amulets, charms, and protectives. The colorful labels on some of the patent medicines invoke ancient saints and healers, and promise happiness, health, prosperity and power. The essential rationale for their use in indigenous medicine was illusive to me despite many conversations with indigenous healers, and many times I have gone through the hundreds of items trying to find the key to what Brazilian and North American people fundamentally want from a pharmacy. In both cultures, where does magic stop and science begin? Do shops in both countries vend talismans in the search for the enhanced life, and fetishes against death? How much of all drug use is ritual and inchoate expectation? How can we reduce the mystification and incrementally increase the rationality of our pharmacopeia? (shrink)

The evolution of human diet is the product of both biological and cultural adaptations to various plants and animals in the environment. This paper develops a new theory for the evolution of cuisine practices which attempts to account for how food processing provided a critical link in enhancing the nutrient balance of major domesticated plants.

Pregnancy involves puzzling aversions to nutritious foods. Although studies generally support the hypotheses that such aversions are evolved mechanisms to protect the fetus from toxins and/or pathogens, other factors, such as resource scarcity and psychological distress, have not been investigated as often. In addition, many studies have focused on populations with high-quality diets and low infectious disease burden, conditions that diverge from the putative evolutionary environment favoring fetal protection mechanisms. This study tests the fetal protection, resource scarcity, and psychological distress (...) hypotheses of food aversions in a resource-constrained population with high infectious disease burden. The role of culture is also explored. In the first of two studies in Tamil Nadu, India, we investigated cultural explanations of pregnancy diet among non-pregnant women (N = 54). In the second study, we conducted structured interviews with pregnant women (N = 94) to determine their cravings and aversions, resource scarcity, indices of pathogen exposure, immune activation, psychological distress, and emic causes of aversions. Study 1 found that fruits were the most commonly reported food that pregnant women should avoid because of their harmful effects on infants. Study 2 found modest support for the fetal protection hypothesis for food aversions. It also found that pregnant women most commonly avoided fruits as well as “black” and “hot” foods. Aversions were primarily acquired through learning and focused on protecting the infant from harm. Our findings provide modest support for the fetal protection hypothesis and surprisingly strong support for the influence of cultural norms and learning on dietary aversions in pregnancy. (shrink)

This article aims to read feminist new materialisms (Barad), together with ‘postulated’ linguistic or cultural primacy of Queer Theory (Butler), to show how both are engaged in similar critical-ethical endeavours. The central argument is that the criticism of Barad and new materialisms misses Butler’s materialistic insights due to a narrow interpretation of Butler's alleged social-constructivist position. There is, therefore, a specific focus on where they both make similar ethical appeals. Moreover, the article relies on Adorno's negative dialectic to highlight an (...) interpretation of Barad and Butler as being part of the same dialectical movement, in which materialism and idealism fluctuate in their mutual criticisms, thus continuing the procession towards 'new knowledge' and emancipation, or freedom, through their motions back and forth. (shrink)

The book challenges the values of much of contemporary bioethics and health care policy by confronting their failure to secure the moral norms they seek to apply.

Provability, Computability and Reflection.

This is the first complete, one-volume English translation of the ancient Chinese text Xunzi, one of the most extensive, sophisticated, and elegant works in the tradition of Confucian thought. Through essays, poetry, dialogues, and anecdotes, the Xunzi articulates a Confucian perspective on ethics, politics, warfare, language, psychology, human nature, ritual, and music, among other topics. Aimed at general readers and students of Chinese thought, Eric Hutton’s translation makes the full text of this important work more accessible in English than ever (...) before. Named for its purported author, the Xunzi has long been neglected compared to works such as the Analects of Confucius and the Mencius. Yet interest in the Xunzi has grown in recent decades, and the text presents a much more systematic vision of the Confucian ideal than the fragmented sayings of Confucius and Mencius. In one famous, explicit contrast to them, the Xunzi argues that human nature is bad. However, it also allows that people can become good through rituals and institutions established by earlier sages. Indeed, the main purpose of the Xunzi is to urge people to become as good as possible, both for their own sakes and for the sake of peace and order in the world. In this edition, key terms are consistently translated to aid understanding and line numbers are provided for easy reference. Other features include a concise introduction, a timeline of early Chinese history, a list of important names and terms, cross-references, brief explanatory notes, a bibliography, and an index. (shrink)

La demande éducative ne peut être réduite à une résistance à la psychanalyse. Elle doit être resituée dans la contextualité sociale historique et par rapport au sens et à la fonctionnalité de l’échec scolaire comme syndrome ethnique. C’est dans cette perspective anthropologique et institutionnelle que l’auteur propose de réinterroger les relations entre demandes éducatives et psychanalyse, en illustrant son propos par des observations permettant de repérer les conflictualités et les paradoxes présents dans la clinique contemporaine.

The development of transplantation technology increasingly places before society a multitude of diverse, complex ethical and legal problems. The subject is the more complex because of the various divergent interests involved. There are the interests of the donor of organs, who has a right to protection of his legal position, and those of the patient in need of an often lifesaving organ. There are also the interests of the donor’s relatives, after his death, and those of the transplantation surgeons. The (...) international dimension of transplantation technology makes the picture even more complicated. Though this article is devoted to the European situation, the problems are similar all over the world. (shrink)

The development of transplantation technology increasingly places before society a multitude of diverse, complex ethical and legal problems. The subject is the more complex because of the various divergent interests involved. There are the interests of the donor of organs, who has a right to protection of his legal position, and those of the patient in need of an often lifesaving organ. There are also the interests of the donor’s relatives, after his death, and those of the transplantation surgeons. The (...) international dimension of transplantation technology makes the picture even more complicated. Though this article is devoted to the European situation, the problems are similar all over the world. (shrink)

Catastrophic risk raises questions that are not only of practical importance, but also of great philosophical interest, such as how to define catastrophe and what distinguishes catastrophic outcomes from non-catastrophic ones. Catastrophic risk also raises questions about how to rationally respond to such risks. How to rationally respond arguably partly depends on the severity of the uncertainty, for instance, whether quantitative probabilistic information is available, or whether only comparative likelihood information is available, or neither type of information. Finally, catastrophic risk (...) raises important ethical questions about what to do when catastrophe avoidance conflicts with equity promotion. (shrink)

First published in 2000. Routledge is an imprint of Taylor & Francis, an informa company.

This study described the relationships between academic class and student moral sensitivity and reasoning and between curriculum design components for ethics education and student moral sensitivity and reasoning. The data were collected from freshman (n = 506) and senior students (n = 440) in eight baccalaureate nursing programs in South Korea by survey; the survey consisted of the Korean Moral Sensitivity Questionnaire and the Korean Defining Issues Test. The results showed that moral sensitivity scores in patient-oriented care and conflict were (...) higher in senior students than in freshman students. Furthermore, more hours of ethics content were associated with higher principled thinking scores of senior students. Nursing education in South Korea may have an impact on developing student moral sensitivity. Planned ethics content in nursing curricula is necessary to improve moral sensitivity and moral reasoning of students. (shrink)

First Published in 2000. Routledge is an imprint of Taylor & Francis, an informa company.

A promise to do some action seems to create a binding obligation to do that action. And yet, paradoxically, an obligation seems not to be a fact that we can create or bring into existence; we can create an obligation only by creating or bringing into existence something else. The only way to avoid the paradox is to show that the act of promising creates something other than an obligation, which nonetheless binds us to perform the action in question. After (...) considering and rejecting various options such as the promisee's expectation and the promisor's resolve, Prichard locates the bindingness of a promise in a prior general promise, which allows the noises we make when promising to generate an obligation to perform the promised action. (shrink)

What are 'emotions'? This book offers a balanced survey of facts and theory.

Science Without Numbers caused a stir in 1980, with its bold nominalist approach to the philosophy of mathematics and science. It has been unavailable for twenty years and is now reissued in a revised edition with a substantial new preface presenting the author's current views and responses to the issues raised in subsequent debate.

An English language translation accompanies the original Greek text of Aristotle's book about the nature of the state, constitutions, revolutions, democracy, and oligarchy.

To the question ‘What does it mean to act or to do something?’, replies that it is not easy to identify a common character in actions. Begins by examining the position of Cook Wilson, who maintains that ‘to do something’ means to originate, cause, or bring into existence, either directly or indirectly, some not yet existing state either in oneself or some other body. Although Prichard agrees that usually action involves causing something, he observes that causing a change is not (...) itself an activity. In moving one's hand, one performs that indefinable mental activity of willing some change. The movement of the hand is the effect of the action, not the action itself, a fact overlooked by thinkers like Locke. Turning to the nature of the desire behind one's willing, Prichard rejects the view that this desire is actually a desire for the change willed. Despite forceful objections, Prichard maintains that this desire is the desire for the willing of that change. (shrink)

Suppose that a decision-maker's aim, under certainty, is to maximise some continuous value, such as lifetime income or continuous social welfare. Can such a decision-maker rationally satisfy what has been called "continuity for easy cases" while at the same time satisfying what seems to be a widespread intuition against the full-blown continuity axiom of expected utility theory? In this note I argue that the answer is "no": given transitivity and a weak trade-off principle, continuity for easy cases violates the anti-continuity (...) intuition. I end the note by exploring an even weaker continuity condition that is consistent with the aforementioned intuition. (shrink)

According to the orthodox treatment of risk preferences in decision theory, they are to be explained in terms of the agent's desires about concrete outcomes. The orthodoxy has been criticised both for conflating two types of attitudes and for committing agents to attitudes that do not seem rationally required. To avoid these problems, it has been suggested that an agent's attitudes to risk should be captured by a risk function that is independent of her utility and probability functions. The main (...) problem with that approach is that it suggests that attitudes to risk are wholly distinct from people's (non-instrumental) desires. To overcome this problem, we develop a framework where an agent's utility function is defined over chance propositions (i.e., propositions describing objective probability distributions) as well as ordinary (non-chance) ones, and argue that one should explain different risk attitudes in terms of different forms of the utility function over such propositions. (shrink)

Many philosophers think that we should use a lottery to decide who gets a good to which two persons have an equal claim but which only one person can get. Some philosophers think that we should save identified persons from harm even at the expense of saving a somewhat greater number of statistical persons from the same harm. I defend a principled way of justifying both judgements, namely, by appealing to the decreasing marginal moral value of survival chances. I identify (...) four desiderata that, I contend, any such justification should satisfy, and explain how my account meets these desiderata, unlike some previous accounts. (shrink)

This volume is a wonderful introduction to Foucault and a testimony to the deep humanity of the man himself.

In this paper we briefly examine and evaluate Quine’s physicalism. On the supposition, in accordance with Quine’s views, that there can be no change of any sort without a physical change, we argue that this point leaves plenty of room to understand and accept a limited autonomy of the special sciences and of other domains of disciplinary and common-sense inquiry and discourse. The argument depends on distinguishing specific, detailed programs of reduction from the general Quinean strategy of reduction by explication. (...) We argue that the details of the relations of particular sciences, disciplines and domains of discourse depend on empirical evidence and empirical-theoretical developments and that the generalized approach of reduction by explication is also subject to related empirical-theoretical constraints. So understood, physicalism lacks much of the controversial force and many of the implications sometimes associated with it. (shrink)

Prichard's concern here is whether a person's obligation depends either on features of his or her situation or on features of his or her thoughts about that situation. Related to this contrast between the objective view and the subjective view is the issue of whether an obligation is an obligation to do some action. To the latter issue, Prichard responds that an obligation is not an obligation to do something, but an obligation to set ourselves to do something; as a (...) consequence, it is necessary to modify the terms of Prichard's primary concern. This modification diminishes the force of the objective view and does nothing to eliminate the central difficulty in the subjective view, namely, that the obligation to do some action is said to depend not on the character that the action would have, but on our belief that it would have that character. The belief that some general character picks out obligations derives from the mistaken habit of regarding the terms ‘right’ and ‘wrong’ as equivalent to ‘ought’ and ‘ought not’. Having highlighted this mistake, Prichard holds that in instances where we have considered the circumstances fully, our thoughts about the situation decide whether we ought to perform a given activity. (shrink)

The act of exchanging one thing for another seems to involve a promise. The confidence needed to relinquish something one has on the understanding that one will receive what another has in exchange can be expressed in terms of resolve. In binding oneself, one thinks that if the other binds himself or herself to perform a given action, then he or she will do that action. In cases in which one person's action does not precede the other's, one's promise involves (...) thinking that if the other binds himself or herself, then he or she will carry out the promised action. (shrink)

I defend a weak version of the Pigou-Dalton principle for chances. The principle says that it is better to increase the survival chance of a person who is more likely to die rather than a person who is less likely to die, assuming that the two people do not differ in any other morally relevant respect. The principle justifies plausible moral judgements that standard ex post views, such as prioritarianism and rank-dependent egalitarianism, cannot accommodate. However, the principle can be justified (...) by the same reasoning that has recently been used to defend the core axiom of ex post prioritarianism and egalitarianism, namely, Pigou-Dalton for well-being. The arguably biggest challenge for proponents of Pigou-Dalton for chances is that it violates State Dominance for social prospects. However, I argue that we have independent reason for rejecting State Dominance for social prospects, since it prevents a social planner from properly respecting people's preferences. (shrink)