It is an imperative within health care, medicine, and public health to restore, preserve, and enhance health. Therefore, it is important to determine what kinds of enhancement are increases in health and what kinds are not. Taking as its point of departure two conceptions of health, namely, “manifest health” and “fundamental health,” the paper discusses various means used to enhance ability and well-being, and if those means, such as wheelchairs, implants, medicines, stimulants, or narcotics, enhance health. The fact that some (...) means that enhance ability or well-being are not usually considered health enhancing, for example, narcotics, constitutes a problem. The paper ends with a discussion of some suggestions about how to distinguish between those enhancements that are health related and those that are not. One plausible idea holds that an enhancement is health related when the substance, or aid, increases ability or well-being, is integrated into the body, and does not harm the individual’s fundamental health. (shrink)

The discussion about theories of health has recently had an important new input through the work of Sridhar Venkatapuram. He proposes a combination of Lennart Nordenfelt's holistic theory of health and Martha Nussbaum's version of the capability approach. The aim of the present article is to discuss and evaluate this proposal. The article starts with a discussion of Nordenfelt's theory and evaluates Venkatapuram’ critique of it, that is, of its relativism, both regarding goals and environment, and of the subjectivist theory (...) of happiness used. Then the article explains why Nordenfelt's idea of a reasonable environment is not a problem for the theory, and it critiques Venkatapuram's own incorporation of the environment into the concept of health, suggesting that this makes the concept too wide. It contends, moreover, that Venkatapuram's alternative theory retains a problem inherent in Nordenfelt's theory, namely, that health is conceived of as a second-order ability. It is argued that health should, instead, be defined as first-order abilities. This means that health cannot be seen as a capability, and also that health cannot be seen as a meta-capability of the kind envisioned by Venkatapuram. It is, furthermore, argued that the theory lacks one crucial aspect of health, namely, subjective wellbeing. Finally, the article tries to illustrate how health, in the suggested alternative sense, as first-order abilities, fits into Nussbaum's capability theory, since health as an ‘actuality’ is part of all the ‘combined capabilities’ suggested by Nussbaum. (shrink)

One important ethical issue for health promotion and public health work is to determine what the goals for these practices should be. This paper will try to clarify what some of these goals are thought to be, and what they ought to be. It will specifically discuss two different approaches to health promotion, such as, behavior change and empowerment. The general aim of this paper is, thus, to compare the behavior-change approach and the empowerment approach, concerning their immediate goals or (...) aims, and to morally evaluate the strengths and weaknesses of these two goal models, in relation to the ultimate goal of health promotion. The investigation shows that the behavior-change approach has several moral problems. First of all, it is overly paternalistic and often disregards the individual’s or group’s own perception of what is important—something that also increases the risk of failed interventions. Furthermore, it risks leading to ‘victim blaming’ and stigmatization, and to increased inequalities in health, and it puts focus on the ‘wrong’ problems, i.e., behavior instead of the ‘causes of the causes’. It is thereafter shown that the empowerment approach does not have any of these problems. Finally, some specific problems for the empowerment approach are discussed and resolved, such as, the idea that empowering some groups might lead to power over others, the objection that the focus is not primarily on health, and the fact that empowered people might choose to live lives that risk reducing their health. (shrink)

Value-freedom or value-neutrality is a well-known topic in the philosophy of science. But what about the value-neutrality of technology, medical or other? Is it too far-fetched to imagine technology as in some sense value-neutral — in view of its intimate connection with purposeful human action? No; unexpected perhaps, but less far-fetched than expected. If we try to conceive of technology as a cognitive possibility abstracted from each and every specific social context, we shall find (at least) three senses in which (...) it may be regarded as value-neutral: (1) neutral vis-à-vis different possible uses and ends; (2) neutral before action; (3) neutral qua cognitive object, analogous to the cognitive core of science. The further meanings and implications of these three senses of value-neutrality are discussed.What is this exercise good for? The nature of technology is indeed worth pondering in its own right, not least from this rather unusual angle. But beyond that: as the possible meanings of value-neutrality are tried out, the radical nature of human responsibility for the social implementation of technology will be highlighted. (shrink)

A common intuition is that there is a moral difference between ‘making people happy’ and ‘making happy people.’ This intuition, often referred to as ‘the Asymmetry,’ has, however, been criticized on the grounds that it is incoherent. Why is there, for instance, not a corresponding difference between ‘making people unhappy’ and ‘making unhappy people’? I argue that the intuition faces several difficulties but that these can be met by introducing a certain kind of reason that is favouring but non-requiring. It (...) is argued that there are structural similarities between the asymmetry and moral options and that the asymmetry can be defended as an instance of a moral option. (shrink)

This paper examines the psychology of existential guilt with Martin Heidegger and Rollo May’s conceptualizations as the point of departure. The concept of existential guilt describes preconditions for responsibility and accountability in life choices and the relationship to the potential given in the life of a human. It might also be used as a starting point to examine an individual’s relationship to the potential offered in their life and life context and, in this way, the hitherto unlived life of an (...) individual. The following questions are discussed in contexts of identity development, perfectionism, and current cultural shifts in conceptualizations of selfhood: How can humans relate to the fact that only limited parts of who they might be can ever be actualized? Moreover, how can they relate to the fundamental ambiguity and “groundlessness” in the contexts of life where choices are made? There are striking parallels between the role of exploration in the Eriksonian approaches to healthy identity development and the ontological groundlessness that stands out as a premise for existential guilt. There are also parallels between identity fore-closure and normative identity styles and “falling” into das Man in the existential framework. Perfectionistic ideals easily become an objectivization – and closure – of possible alternatives and choices. In contemporary theories of constructions of selfhood, the dangers of alienation from the community on the one hand and escape into what might become totalitarian collectivism on the other is pointed out. The contextualization of personal responsibility offered through the concept of existential guilt might address both dangers. It provides a perspective on how personal responsibility is embedded in contexts of human relationships, relationships to nature, and the finitude, freedom, uncertainties, and suffering that is given through human existence. Existential guilt can wake sorrow and regret over opportunities overlooked and lost. However, most of all, it can be seen as a drive toward repair in the relationship toward both oneself and the other. It takes the form of receptivity, an openness to a life not yet lived, and creative use of imagination. (shrink)

ABSTRACT I contend that Miranda Fricker’s ambitious new pluralist account of forgiveness is too inclusive and counts as forgiveness practices that are psychologically and normatively quite different. I raise three worries: First, her account of proleptic Gifted Forgiveness as temporally displaced Moral Justice Forgiveness seems to allow for Preemptive Forgiveness. Second, proleptic Gifted Forgiveness seems to resemble communicative blame more than forgiveness. Finally, an alternative account of forgiveness—explained in terms of reasons to forswear blame—seems capable of meeting Fricker’s desiderata for (...) an adequate theory (e.g., giftedness, pluralism, ambivalence, and genealogy), while avoiding the inclusivity worry. (shrink)

Temporal Logic: From Ancient Ideas to Artificial Intelligence deals with the history of temporal logic as well as the crucial systematic questions within the field. The book studies the rich contributions from ancient and medieval philosophy up to the downfall of temporal logic in the Renaissance. The modern rediscovery of the subject, which is especially due to the work of A. N. Prior, is described, leading into a thorough discussion of the use of temporal logic in computer science and the (...) understanding of natural language. Temporal Logic: From Ancient Ideas to Artificial Intelligence thus interweaves linguistic, philosophical and computational aspects into an informative and inspiring whole. (shrink)

There are great health disparities in the world today, both between countries and within them. This problem might be seen as related to the access to various kinds of capabilities. It is not fully clear, however, what the exact relation is between health and capabilities. Neither Amartya Sen nor Martha Nussbaum has explicitly formulated a theory of health to go with their theories of capabilities. This paper attempts to present a clarification of the conceptual relation between health and capabilities. Health, (...) it is argued, should be seen as a holistic multi-dimensional phenomenon, made up of basic abilities and subjective well-being, and of fundamental states and processes. Using this theory, the paper shows how health is related to Nussbaum’s ten capabilities. It is argued that health, in the senses described, is a necessary part of all ten capabilities. Moreover, some of the capabilities on Nussbaum’s list, such as thinking and imagining, and practical reasoning, refer to health. Finally, it is shown that even though health is part of all capabilities, health cannot itself primarily be seen as a capability. An acceptable degree of health is required as a functioning for any theory of human flourishing to be reasonable. (shrink)

How did the Vedic Indians think of life, consciousness, and personhood? How did they envisage man's fate after death? Did some part of the person survive the death of the body and depart for the beyond? Is it possible to speak of a "soul" or "souls" in the context of Vedic tradition? This book sets out to answer these questions in a systematic manner, subjecting the relevant Vedic beliefs to a detailed chronological investigation. Special attention is given to the ways (...) in which the early Indians' answers to the above problems changed over time, with an early pluralism of soul-like concepts later giving way to the unified "self" of the Upaniṣads. (shrink)

Drawing on contemporary debates and responding to an analytic lacuna in organization and management studies and calls from organizational practice, Phenomenology of the Embodied Organization explores the fundamental and integral role of the body and embodiment in organizational life-worlds.

Some fictions deliberately omit all fictional statements about the mental functioning of fictional agents. This presents an interpretive dilemma, as when we read fiction we ought to reconstruct the fictional minds of characters significant to the plot. Fictions that present the reader with an opaque fictional mind resist the general imaginative project prescribed by fiction-making and seem to demand a novel approach to imagining their fictional entities. Such fictional entities demand the reader commit to one of at least two different (...) ways of imagining nothing about a fictional mind, without explicitly authorizing either. One approach has already been described by H. Porter Abbott. Another can be extracted from Simone De Beauvoir, whose ethics of ambiguity is well suited to dealing with fictional entities about which nothing is fixed nor determined. (shrink)

This article argues that there should be a stronger emphasis on morality, involving a clear articulation of a normative point of view, in education as well as in child raising, with a continuity from early childhood to higher age levels, such that the asymmetry of roles (child – adult) gradually gives way to genuine reciprocity and a shared sense of responsibility. Drawing on Zygmunt Bauman’s work, we explore the historical conditions of moral education. Solid modernity was an age of authorities, (...) sometimes changing into authoritarian education and politics. This prompted a reaction in the form of liquid modernity, followed by anxiety and indecision among parents and teachers now that the old certainties informing normative thinking and practice were gone. Today, wee again witness a reaction and a change in cultural trends: a rebirth of solidity that carries a potential for a new normativity, a potential we consider betrayed in the current wave of claims of productivity, competitiveness and self‐sufficiency in neoliberalism, notions we regard as difficult to unify with moral education, if not in outright conflict with its deeper aspiration. Accordingly, authority in school these days is a matter of obtaining discipline and achievement, not promoting values or serious engagement with moral issues. This calls for a new discussion about education as well as an extended framework of morality. We urge that such a framework question the anthropocentric premises on which Bauman’s understanding of the discontents of late modernity is premised, highlighting the crises and pathologies involving human society at the expense of those affecting nonhumans. (shrink)

This paper examines the existential context of physical and mental health. Hans Georg Gadamer and The World Health Organization’s conceptualizations are discussed, and current medicalized and idealized views on health are critically examined. The existential dimension of health is explored in the light of theories of selfhood consisting of different parts, Irvin Yalom’s approach to “ultimate concerns” and Martin Heidegger’s conceptualization of “existentials.” We often become aware of health as an existential concern during times of illness, and health and illness (...) can co-exist. The paper discusses how existential suffering in Western culture is described, to an increasing degree, as disorders or psychological deficits, and perfectionistic health goals easily can become a problem. We seek to avoid suffering rather than relate to it, with all the tension that may create. The paper argues that suffering is an unavoidable aspect of people’s experience of their lives, and actively relating to suffering must be regarded as a fundamental aspect of health. The need and usefulness of a concept of “existential health” is discussed. (shrink)

This article contends that an ethics of care has a particular moral ontology that makes it suitable to argue for the normative significance of relational responsibilities within professional health care. This ontology is relational. It means that moral choices always have to account for the web of relationships, the relational networks and responsibilities that are an essential part of particular moral circumstances. Given this ontology, the article investigates the conditions for health care professionals to be partial and to act on (...) the basis of particular responsibilities to their patients. We will argue that priorities could be partial in three ways: first, because there may be exceptional circumstances that allow for giving priority to one patient over another; second, because the integrity of the patient and a health care worker may be connected in special ways; and, finally, even if impartiality is essential, the institutional basis of health care must always give ample space for an ethically qualified individual and personal care for patients. Even if difficult priorities may be necessary, the conditions of institutional health care should always seek to create the prerequisites for nurses and doctors to administer proper care. (shrink)

Historical Teleologies in the Modern World tracks the fragmentation and proliferation of teleological understandings of history--the notion that history had to be explained as a goal-directed process--in Europe and beyond throughout the 19th and into the 20th century. Historical teleologies have profoundly informed a variety of other disciplines, including modern philosophy, natural history, literature, humanitarian and religious philanthropism, the political thought and practice of revolution, emancipation, imperialism, colonialism and anti-colonialism, the conceptualization of universal humankind, and the understanding of modernity in (...) general. By exploring the extension and plurality of historical teleology, the essays in this volume revise the history of historicity in the modern period. Historical Teleologies in the Modern World casts doubt on the idea that a single, if powerful, conception of time could function as the unifying principle of all modern historicity, instead pursuing an investigation of the plurality of modern historicities and its underlying structures. By bringing together Western and non-Western histories, this book provides the first extended treatment of the idea of historical teleology. It will be of great value to students and scholars of modern global and intellectual history"--From publisher's website. (shrink)

The concept of ‘empowerment’ is used frequently in a number of professional areas, from psychotherapy to social work. But even if the same term is used, it is not always clear if the concept denotes the same goals or the same practice in these various fields. The purpose of this paper is to clarify the discussion and to find a plausible and useful definition of the concept that is suitable for work in various professions. Several suggestions are discussed in the (...) paper, for example control over life or health, autonomy, ability, self-efficacy, self-esteem, and freedom, and it is concluded that there are two plausible complementary uses, one as a goal and one as a process or approach. Empowerment as a goal is to have control over the determinants of one’s quality of life, and empowerment as a process is to create a professional relation where the client or community takes control over the change process, determining both the goals of this process and the means to use. (shrink)

When we forgive, we do so for reasons. One challenge for forgiveness theorists is to explain which reasons are reasons to forgive and which are not. This paper argues that we forgive in response to a perceived change of heart on the part of the offender. The argument proceeds in four steps. First, I show that we forgive for reasons. Second, I argue that forgiveness requires the right kind of reason. Third, I show that these two points explain a common (...) distinction between forgiving and letting go and, in doing so, solve a problem facing many accounts of forgiveness. Finally, I consider candidate reasons to forgive and argue that all of them are either the wrong kind of reason or are instances of a more general reason of the right kind, namely, a perceived change of heart. (shrink)

The precautionary principle is frequently invoked in environmental law and policy, and the debate around the principle indicates that there is little agreement on what 'taking precautions' means. The purpose of the present paper is to provide an improved conceptual foundation for this debate in the form of an explication of the concept of precaution. Distinctions between precaution and two related concepts, prevention and pessimism, are briefly discussed. The concept of precaution is analysed in terms of precautionary actions. It is (...) argued that precautionary actions are implicitly assumed to be precautionary with respect to something, and that this assumption should be made explicit. A definition of a precautionary action involving three necessary and jointly sufficient conditions (intentionality, uncertainty and reasonableness) is proposed, and the implications of this analysis for the debate on the precautionary principle are discussed. (shrink)

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)

This paper argues that there is a dimension of human consciousness which allows for a pre-intentional and non-cognitive intuition of sensibility. A sensibility which allows for the vulnerability of the human other is by nature characterized by passivity and receptivity. Moreover, sensibility invokes the significance of relating to the human other in an affective way of being touched by his or her pain and suffering. This capacity of being distressed by the distress of another person opens up for ethical responsibility (...) and even in a fundamental sense is a presupposition for full-fledged clinical knowledge in medical care and health care. (shrink)

Abolitionism is the view that if no one is responsible, we ought to abandon the reactive attitudes. This paper defends abolitionism against the claim, made by P.F. Strawson and others, that abandoning these attitudes precludes the formation and maintenance of valuable personal relationships. These anti-abolitionists claim that one who abandons the reactive attitudes is unable to take personally others’ attitudes and actions regarding her, and that taking personally is necessary for certain valuable relationships. I dispute both claims and argue that (...) this objection exaggerates the role of the reactive attitudes and underestimates the importance of non-reactive moral emotions. (shrink)

It has been argued, by Penrose and others, that Gödel's proof of his first incompleteness theorem shows that human mathematics cannot be captured by a formal system F: the Gödel sentence G(F) of F can be proved by a (human) mathematician but is not provable in F. To this argment it has been objected that the mathematician can prove G(F) only if (s)he can prove that F is consistent, which is unlikely if F is complicated. Penrose has invented a new (...) argument intended to avoid this objection. In the paper I try to show that Penrose's new argument is inconclusive. (shrink)

Once relegated to the margins of the responsibility debate, moral influence theories have recently been rehabilitated. This paper offers a moral influence theory with two parts: a theory of responsibility as influenceability and an act-consequentialist justification of blame. I defend this account against six concerns commonly raised both by opponents and by advocates of similar views. Some concerns target act consequentialism, claiming that it 1) permits blaming innocents; 2) permits coercion, manipulation, and other objectionable forms of influence; and 3) fails (...) to capture intuitions about desert. Other concerns target responsibility as influenceability, claiming that influenceability accounts are 4) unsophisticated, 5) make ascriptions of responsibility dependent on assessments of permissible blame, and 6) have various counterintuitive implications. (shrink)