Critics of mass culture often identify 1950s-style status competition as one of the central forces driving consumerism. Thomas Frank has challenged this view, arguing that countercultural rebellion now provides the primary source of consumerism in our society, and that ‘cool’ has become its central ideological expression. This paper provides a rearticulation and defense of Frank's thesis, first identifying consumerism as a type of collective action problem, then showing how the ‘hip consumer’ is one who adopts a free-rider strategy in this (...) context. (shrink)

Population health has recently grown from a series of loosely connected critiques of twentieth-century public health and medicine into a theoretical framework with a corresponding field of research—population health science. Its approach is to promote the public’s health through improving everyday human life: affordable nutritious food, clean air, safe places where children can play, living wages, etc. It recognizes that addressing contemporary health challenges such as the prevalence of type 2 diabetes will take much more (...) than good hospitals and public health departments. -/- Blending philosophy of science/medicine, public health ethics and history, this book offers a framework that explains, analyses and largely endorses the features that define this relatively new field. Presenting a philosophical perspective, Valles helps to clarify what these features are and why they matter, including: searching for health’s “upstream” causes in social life, embracing a professional commitment to studying and ameliorating the staggering health inequities in and between populations; and reforming scientific practices to foster humility and respect among the many scientists and non- scientists who must work collaboratively to promote health. -/- Featuring illustrative case studies from around the globe at the end of all main chapters, this radical monograph is written to be accessible to all scholars and advanced students who have an interest in health—from public health students to professional philosophers. (shrink)

Although highly relevant, philosophical theory and philosophical competences are rarely integrated in empirical public health research. We suggest a variant of applied philosophy that is valuable for the development and improvement of public health research. We call it practice-guided public health philosophy because: (i) research questions derive from public health challenges, i.e. real-life concerns that relate to the prevention of disease or the promotion of health and well-being, (ii) the ultimate test of success lies within (...) an empirical framework aiming to improve public health practices and (iii) philosophers collaborate very closely with different kinds of empirical researchers in the different stages of the research process. Using examples from current public health projects at the National Institute of Public Health at the University of Southern Denmark, we outline three paradigmatic cases of practice-guided public health philosophy: (i) by using philosophy as an idea generator of empirical research, (ii) by using philosophy as a frame of reference for interpreting ethnographic data and (iii) by using philosophy as an explanatory resource for discussing survey and register data. (shrink)

If one had to identify the biggest change within the philosophical tradition in the twenty-first century, it would certainly be the rapid rise of experimental philosophy to address differences in intuitions about concepts. It is, therefore, surprising that the philosophy of medicine has so far not drawn on the tools of experimental philosophy in the context of a particular conceptual debate that has overshadowed all others in the field: the long-standing dispute between so-called naturalists and normativists about the concepts of (...) health and disease. In this paper, I defend and advocate the use of empirical methods to inform and advance this and other debates within the philosophy of medicine. (shrink)

If one had to identify the biggest change within the philosophical tradition in the twenty-first century, it would certainly be the rapid rise of experimental philosophy to address differences in intuitions about concepts. It is, therefore, surprising that the philosophy of medicine has so far not drawn on the tools of experimental philosophy in the context of a particular conceptual debate that has overshadowed all others in the field: the long-standing dispute between so-called naturalists and normativists about the concepts of (...) health and disease. In this paper, I defend and advocate the use of empirical methods to inform and advance this and other debates within the philosophy of medicine. (shrink)

The discovery of dietetics -- Philosophy of the nature of man -- Therapy of body and soul -- The philosophical legacy of On regimen.

The Routledge Handbook of the Philosophy of Public Health is an outstanding reference source to this exciting subject and the first collection of its kind. Comprising over forty chapters by a team of international contributors the handbook covers the following central topics: What is global health?; methodology in public health science; social determinants and health equity; politics and economics; health policy and law; globalization; macroeconomics; securitization; and specific public health challenges such as obesity, cancer, (...) alcohol, tobacco and infectious diseases. Essential reading for students and researchers in political philosophy, bioethics, public health ethics and the philosophy of medicine the handbook will also be very useful for those in related fields, such public health professionals and epidemiologists. (shrink)

This work argues that philosophy is not just useful, but vital, for thinking coherently about priorities in health policy and public policy.

In the previous issue of Health Care Analysis, Dr. Andrew Edgar wrote an editorial to round off his 8 years as editor of the journal. His commitment to the journal has provided a remarkable contribution to a range of fields of inquiry that focus on the relationships between health care, policy, practice, and philosophy. As Dr. Edgar indicates, under his stewardship, the journal has published papers addressing both long-standing and novel debates. As he notes, furthermore, his editorial approach (...) has afforded a platform not only for established scholars, but also scholars at the start of their careers. Indeed, when I was amongst that latter category, I was a fortunate and grateful beneficiary of Dr. Edgar’s thoughtful, patient, and generous editorial guidance, and can attest first hand to the important influence he has had in mentoring many of us working in the field, as well as on our scholarship itself.As I now move to the position of editor, I would like here to reflect on my own out. (shrink)

The progress of history rests on the battle for supremacy of competing ideas.... The power and wealth of western countries give them a dominant role in shaping the international public discourse. This is a privileged position... [an] imbalance of voice in the international discourse [that] has built up a dangerous sense of resentment by the silent majority of the world’s people. The dominant bioethical paradigm that provides the context for research ethics discourse has evolved within western philosophy’s powerful normative framework (...) and is built on a relationship model that explains and underpins the obligations doctors have to their patients. In this one-to-one relationship, the doctor is... (shrink)

Employs philosophy to help illuminate the nature of nursing and provide a holistic view of both nursing and persons.

A number of theoretical ideas have emerged recently in the legal, bioethical and philosophical fields that could usefully be applied to these and other issues ...

The goal of improving public health involves the use of different tools, with the law being one way to influence the activities of institutions and individuals. Of the regulatory mechanisms afforded by law to achieve this end, criminal law remains a perennial mechanism to delimit the scope of individual and group conduct. However, criminal law may promote or hinder public health goals, and its use raises a number of complex questions that merit exploration. This examination of the interface (...) between criminal law and public health brings together international experts from a variety of disciplines, including law, criminology, public health, philosophy and health policy, in order to examine the theoretical and practical implications of using criminal law to improve public health. (shrink)

To practise ‘fairly and justly’ a clinician must balance the needs of both the many and the few: the individual patient in front of them, and the many unseen patients in the waiting room, and in the county. They must consider the immediate clinical needs of those in the present, and how their actions will impact on future patients. The good medical practice guidance ‘Make the care of your patient your first concern’ provides no guidance on how doctors should act (...) when they care for multiple patients with conflicting needs. Moreover, conflicting needs extend far past simply those between different patients. At an organisational level, financial obligations must be balanced with clinical ones; the system must support those who work within it in a variety of roles; and, finally, in order for a healthcare service to be sustainable, the demands of current and future generations must be balanced.The central problem, we propose, is that there is no shared philosophical framework on which the provision of care or the development of health policy is based, nor is there a practical, fair and transparent process to ensure that the service is equipped to deal justly with new challenges as they emerge. Many philosophers have grappled with constructing a set of principles which would lead to a ‘good’ society which is just to different users; prominent among them is Rawls.Four important principles can be derived using a Rawlsian approach: equity of access, distributive justice, sustainability and openness. However, Rawls’ approach is sometimes considered too abstract to be applied readily to policymaking; it does not provide clear guidance for how individuals working within existing institutions can enact the principles of justice. We therefore combine the principles derived from Rawls with Scanlonian contractualism: by demanding that decisions are made in a way which cannot be ‘reasonably rejected’ by different stakeholders, we ensure that conflicting needs are considered robustly.We demonstrate how embedding this framework would ensure just policies and fair practice. We illustrate this by using examples of how it would help prevent injustice among different socioeconomic groups, prevent intergenerational injustice and prevent injustice in a crisis, for example, as we respond to new challenges such as COVID-19.Attempts to help individual doctors practise fairly and justly throughout their professional lives are best focused at an institutional or systemic level. We propose a practical framework: combining Scanlonian contractualism with a Rawlsian approach. Adopting this framework would equip the workforce and population to contribute to fair policymaking, and would ultimately result in a healthcare system whose practice and policies—at their core—were just. (shrink)

In line with recent proposals for experimental philosophy and philosophy of science in practice, we propose that the philosophy of medicine could benefit from incorporating empirical research, just as bioethics has. In this paper, we therefore take first steps towards the development of an empirical philosophy of medicine, that includes investigating practical and moral dimensions. This qualitative study gives insight into the views and experiences of a group of various medical professionals and patient representatives regarding the conceptualization of health (...) and disease concepts in practice and the possible problems that surround them. This includes clinical, epistemological, and ethical issues. We have conducted qualitative interviews with a broad range of participants (n = 17), working in various health-related disciplines, fields and organizations. From the interviews, we highlight several different practical functions of definitions of health and disease. Furthermore, we discuss 5 types of problematic situations that emerged from the interviews and analyze the underlying conceptual issues. By providing theoretical frameworks and conceptual tools, and by suggesting conceptual changes or adaptations, philosophers might be able to help solve some of these problems. This empirical-philosophical study contributes to a more pragmatic way of understanding the relevance of conceptualizing health and disease by connecting the participants’ views and experiences to the theoretical debate. Going back and forth between theory and practice will likely result in a more complex but hopefully also better and more fruitful understanding of health and disease concepts. (shrink)

Philosophical discussions about health and disease often refer to a 'medical model' of bodily disease, in which diseases are regarded as causes of illness; diagnosis consists in identifying the disease affecting the patient, and this determines the appropriate treatment. This view is plausible only for diseases whose cause is known, though even in such instances the disease is the effect on the affected person, and must not be confused with its own cause. But in fact the medical diagnostic process (...) which progresses from recognition of patterns of symptoms and signs, through search for abnormalities of structure and/or function, towards knowledge of causation often stops short of this desirable end-point; and at whatever point it comes to a halt, its result is expressed in terms of 'diseases'. Thus in medical discourse the names of diseases are a convenient device by which the current conclusion of the diagnostic process can be stated briefly; and they have widely varying factual implications. This nominalist analysis of the medical usages of the names of diseases has consequences for definitions of health and disease, and for some problems in medical ethics. (shrink)

We are never illness or disease, but, rather, always their sum in the world of day-to-day experience. Disease and illness are not closed systems, but mutually constitutive and continuously interacting worlds. In the patient’s case it is always experience as well. Pain, sickness and death help make that particular experienced identity unavoidable, and at some level ultimately inaccessible to medicine’s changing understanding of disease and tools for managing it. Health—rather than cost containment, specific conditions, or technologies—should be the central (...) focus for health care and health-care reform. A compelling reason to focus on health comes from the observation that the prevalence of disease over the .. (shrink)

In Righting Health Policy, MacDougall argues that bioethics has not developed the tools best suited for justifying health law and policy. Using Kant’s practical philosophy as an example, he explores the promise of political philosophy for making normatively justified recommendations about health law and policy.

The papers in this issue of Public Health Ethics arise from a workshop on the role of political philosophy in public health ethics, held at Manchester Metropolitan University in September 2008.1 Part of the reason for exploring the role of political philosophy in relation to public health (and public health ethics) is the thought that the political is ineliminably social: it is about how we live together. Exactly what public health is and what it ought (...) to be is contested, but it surely involves the two senses of public in the sense of the object of attention (i.e., societal or population health) and also the mode of delivery (i.e., collective or participatory action) (Verweij and Dawson, 2007). Political philosophy is concerned with actions in the public sphere related to both these elements. (shrink)

Philosophers of medicine have long debated the possibility of a/the definition of health, but they have yet to fully reflect on the intriguing observation that there is still no theory of health within the medical sciences similar to general theories in other sciences. In this chapter, I provide some reasons for why this lack persists and why philosophers have not been particularly helpful or even interested in filling it. After clarifying why such a theory could be useful, I (...) discuss five general features of medical theories and how one could evaluate the utility of a given proposal. With these features in mind, I suggest that philosophers and scientists work together on analyzing actual medical research (experimental analysis), and the ways in which a theoretical construct of ‘health’ is being progressively identified and measured therein. I conclude by suggesting that research fields studying stress and aging might be particularly helpful in developing candidates for theory construction due to their broad scope, specificity, and potentially integrative explanations. (shrink)

This collection of previously unpublished papers discusses a number of related ethical and philosophical issues in health care. The papers range widely, from problems in dealing with embryos, foetuses and neonates, through our treatment of the dying and newly-dead and the issue of fair resource allocation in health care, to our response to mental illness. Throughout, the aim is to combine detached philosophical analysis with a sense of medical realities and a sensitivity to human values.

"In comparison to medicine, the professional field of public health is far less familiar. What is public health, and perhaps as importantly, what should public health be or become? How do causal concepts shape the public health agenda? How do study designs either promote or demote the environmental causal factors or health inequalities? How is risk understood, expressed, and communicated? Who is public health research centered on? How can we develop technologies so the benefits (...) are more fairly distributed? Do people have a right to public health? How should we integrate ethics into public health practice? The Routledge Handbook of Philosophy of Public Health addresses these questions and more, and is the first collection of its kind. Comprising twenty-six chapters by an international and interdisciplinary team of contributors, the handbook is divided into four clear parts: Concepts and Distinctions Reasons and Actions Distribution and Inequalities Rights and Duties. The Routledge Handbook of Philosophy of Public Health is a field-defining and sustained reflection on the various ethical, political, methodological and conceptual aspects of global public health. As such it is an essential reference source for students and scholars working in political philosophy, bioethics, public health ethics, and the philosophy of medicine, as well as for professionals and researchers in related fields such public health and epidemiology"--. (shrink)

In this book by the award-winning author of Just Healthcare, Norman Daniels develops a comprehensive theory of justice for health that answers three key questions: what is the special moral importance of health? When are health inequalities unjust? How can we meet health needs fairly when we cannot meet them all? Daniels' theory has implications for national and global health policy: can we meet health needs fairly in ageing societies? Or protect health in (...) the workplace while respecting individual liberty? Or meet professional obligations and obligations of justice without conflict? When is an effort to reduce health disparities, or to set priorities in realising a human right to health, fair? What do richer, healthier societies owe poorer, sicker societies? Just Health: Meeting Health Needs Fairly explores the many ways that social justice is good for the health of populations in developed and developing countries. (shrink)

This paper represents a preliminary investigation relating Bernard Lonergan’s thought to health science and the healing arts. First, I provide background for basic elements of Lonergan’s theoretical terminology that I employ. As inquiry is the engine of Lonergan’s method, next I specify two questions that underlie medical insights and define several terms, including health, disease, and illness, in relation to these questions. Then I expand the frame of reference to include all disciplines involved in the cycle of clinical (...) interaction under the heading health science and the healing arts. Finally, I analyze the cycle of clinical interaction in terms of Lonergan’s cognitive theory. I compare and contrast my analysis, based on Lonergan, with that of Pellegrino, Thomasma and Sulmasy as I proceed. In closing, I comment briefly on the next stage of this project regarding Lonergan’s theory of the human good in relation to the practice of the healing arts. (shrink)

The categories of health and disease/illness are conceptualized from the perspective of the philosophy of medicine. Philosophical contradictions are revealed, which, fueling the debate between naturalism and normativism, prevent biomedicine from developing a single satisfactory understanding of these categories. The theoretical and practical consequences of such biomedicine features as pathocentrism, identification of health with complete well-being, dichotomy of health and disease in the absence of a clear criterion for their differentiation are analyzed. The role of humanistic approaches (...) to the medicine rehumanization is investigated with a focus on their balanced view of health and disease/illness, attentive to the fundamental vulnerability of human nature. (shrink)

Situating medical and scientific research within a framework or theory of social justice is long overdue. Attempting to extend principles of research ethics beyond the clinic and lab to other affected people or consequences tolerates or obfuscates injustice. While it must be done, the timescales, methodologies, and commitment to real-world impact are quite different in research ethics versus political philosophy.

In the late 1720s and early 1730s, Christian Wolff writes a series of short treatises on general medical concepts such as health, disease, cause of disease, symptom, etc. The paper makes the claim that these texts should be considered as a pioneering attempt at developing a systematic philosophy of medicine based on metaphysical and epistemological investigations on medical concepts, doctrines, and practices. The main focus is on Wolff’s analysis of the concepts of health and disease in functional terms (...) and its connection to his teleological characterization of both natural and artificial machines. This also explains Wolff’s use of the normatively loaded concepts of fitness and nature to clarify the distinction between health as good functioning and disease as dysfunction. The conclusion is that Wolff’s mechanist view of living bodies and his realism about biological functions are just one side of the coin; the other is his commitment to a normative view of the human body’s nature and purposes. (shrink)

How should medical services be distributed within society? Who should pay for them? Is it right that large amounts should be spent on sophisticated technology and expensive operations, or would the resources be better employed in, for instance, less costly preventive measures? These and others are the questions addreses in this book. Norman Daniels examines some of the dilemmas thrown up by conflicting demands for medical attention, and goes on to advance a theory of justice in the distribution of (...) class='Hi'>health care. The central argument is that health care, both preventive and acute, has a crucial effect on equality of opportunity, and that a principle guaranteeing equality of opportunity must underly the distribution of health-care services. Access to care, preventive measures, treatment of the elderly, and the obligations of doctors and medical administrations are fully discussed, and the theory is shown to underwrite various practical policies in the area. (shrink)

Critical Qualitative Health Research seeks to deepen understandings of the philosophies, politics and practices shaping contemporary qualitative health related research. This accessible, lively, controversial introduction draws on current empirical examples and critical discussion to show how qualitative research undertaken in neoliberal healthcare contexts emerges and the complex issues qualitative researchers confront. This book provides readers with a critical, interrogative discussion of the histories and the legacies of qualitative research, as well as of the more recent calls for renewed (...) criticality in research to respond to global health concerns. Contributions further showcase a range of contemporary work engaging with these issues and the complex encounters with philosophies, politics and practices this involves; from seeking explicit engagements with posthuman ideas or detailed explorations of deeply engaged humanist approaches, to critical discussions of the politics and practices of emerging novel, digital and creative methods. This book offers postgraduate researchers, health researchers and students alike opportunities to engage more deeply with the emergent, complex and messy terrain of qualitative health related research. (shrink)

Any attempt to describe a "best health service' must make political assumptions. For example, should it help everyone? Do different people have different entitlements to its support? Should its help be offered according to need, value for money or ability to benefit? These assumptions are not always clear to health service decision-makers immersed in clinical and economic technicalities, so HCA invited two philosophers --John Shand and David Seedhouse -- to engage in conversation about the political philosophy of (...) class='Hi'>health care. (shrink)

It is often taken for granted that notions of health and disease are generally applicable across the biological world, in that they are not restricted to contemporary human beings, and can be unproblematically applied to a variety of organisms both past and present (taking relevant differences between species into account). In the historical sciences it is also common to normatively contrast health states of individuals and populations from different times and places: e.g., to say that due to nutrition (...) or pathogen load, some lived healthier lives than others. However, health concepts in contemporary philosophy of medicine have not been developed with such cross-lineage, non-human, or diachronic uses in mind, and this generates what I call the ‘new normal’ problem. I argue that the new normal problem shows that current naturalistic approaches to health (when based on biological reference classes) are worryingly incomplete. Using examples drawn from evolutionary archaeology and the human fossil record, I outline an alternative, function-based strategy for naturalizing health that might help address the new normal problem. Interestingly, this might also reconstruct a certain uniqueness for humans in the philosophy and science of health, due to the deep history of obligate enculturation and cultural adaptation that archaeology demonstrates. (shrink)

Knowledge of one's self -- Composition of the world as it is -- Things that will improve this world and its nations -- Treatments and remedies of proper medicine -- Proper medicine derived from human nature -- Brief exposition on human nature : foundations of the art of -- Medicine -- Proper philosophy of the nature of composite things, of humans.

An introductory text on the philosophy of chiropractic, for both chiropractic students and practitioners and those interested in the practice and philosophy of ...

What counts as health or ill health? How do we deal with the fallibility of our own bodies? Should illness and disease be considered simply in biological terms, or should considerations of its emotional impact dictate our treatment of it? Our understanding of health and illness had become increasingly more complex in the modern world, as we are able to use medicine not only to fight disease but to control other aspects of our bodies, whether mood, blood (...) pressure, or cholesterol. This collection of essays foregrounds the concepts of health and illness and patient experience within the philosophy of medicine, reflecting on the relationship between the ill person and society. Mental illness is considered alongside physical disease, and the important ramifications of society's differentiation between the two are brought to light. Health, Illness and Disease is a significant contribution to shaping the parameters of the evolving field of philosophy of medicine and will be of interest to medical practitioners and policy-makers as well as philosophers of science and ethicists. (shrink)