Grounded in ideas about sense-making and whole-person care with a long intellectual heritage, the movement for Philosophical Health—with its specific conceptions of philosophical care and counselling—is a relatively recent addition to the ongoing debate about understanding better the perspectives of patients to improve health practice. This article locates the development of this movement within the context of broader discussions of person-centred care (PCC), arguing that the approach advocated by defenders of philosophical health can provide (...) a straightforward method for implementing PCC in actual cases. This claim is explained and defended with reference to the SMILE_PH method created by Luis de Miranda (Sense-Making Interviews Looking at Elements of Philosophical Health), an approach recently trialled convincingly with people living with traumatic spinal cord injury. (shrink)

In this chapter, I propose a minimal construal of philosophical health that contains two core elements: variegated coherence and intentional directedness at a trans-subjective good. Combining elements from the works of Iris Murdoch and Marshall Rosenberg, I sketch a practice I dub non-violent just communication and argue that it promotes philosophical health as per the minimal construal and that we can derive from it a principle of philosophical health to complement the list of five (...) principles of philosophical health that have been proposed by Luis de Miranda. I then show that the practice of non-violent just communication promotes what Miranda Fricker has characterized as hermeneutic virtue and testimonial sensibility and, finally, suggest that my minimal notion of philosophical health is a useful tool to contrast various conceptions of philosophical counselling. (shrink)

The style of Wittgenstein's writing in his Philosophical Investigations seems quite peculiar to many readers, and is in many way unlike any other style of writing in the history of philosophy. In Philosophical Health, Richard Gilmore argues that Wittgenstein's ultimate goal in the "Investigations" is to restore us to a condition of philosophical health. The traditional methods and styles of doing philosophy, Gilmore suggests, led to a strange kind of philosophical sickness. Philosophical (...) class='Hi'>health is a condition that does not repudiate the philosophical search or philosophical wonder, but does free us from a kind of sickness that results from looking in the wrong places for the wrong kinds of answers. According to Gilmore, Wittgenstein thought that to do philosophy in the right way we have to pay careful attention to the way we speak and think about things in our everyday lives. Philosophical Health is an original and thought-provoking look at Wittgenstein's later philosophy. (shrink)

The style of Wittgenstein's writing in his Philosophical Investigations seems quite peculiar to many readers, and is in many way unlike any other style of writing in the history of philosophy.

In a world described or experienced as unfair, what can philosophical practitioners propose in order to help individuals and communities strive for a meaningful life? One answer, empirically informed by the author’s practice as philosophical counselor in therapeutic, self-care and organizational contexts, is five principles for the cultivation of philosophical health, namely mental heroism, deep orientation, critical creativity, deep listening, and the “Creal” (the creative Real as ultimate possibility). In the light of Hadot’s rediscovery of philosophy (...) as a way of life and in dialogue with his reading of ancient philosophy, it is asserted that the embodied and socially embedded mind can, through these five principles or modalities, be prepared to maintain a pragmatic elevation of view and creative resilience in everyday events, especially in critical situations. This meta-analytic and meta-dialectic practice of philosophical health, termed “crealectics,” presupposes that we are of the same creative cosmological flesh (the Creal), and therefore we are bound to comprehend and care for each other philosophically. (shrink)

Background We investigated the personal philosophies of eight persons with a tetraplegic condition (four male, four female), all living in Sweden with a chronic spinal cord injury (SCI) and all reporting a good life. Our purpose was to discover if there is a philosophical mindset that may play a role in living a good life with a traumatic SCI. Methods Two rounds of in-depth qualitative interviews were performed by the same interviewer, a philosophical practitioner by training (de Miranda). (...) The second round systematically covered the following elements: bodily sense, sense of self, sense of belonging, sense of the possible, sense of purpose and philosophical sense. This six-step method developed by de Miranda is called SMILE_PH, an acronym for Sense-Making Interviews Looking at Elements of Philosophical Health. Results All the interviewees, as a consequence of their trauma, reported having gone through a reinvention of themselves which implied questioning the meaning and purpose of their life in particular and life in general. A philosophical rather than realistic sense of the possible was abstracted toward teleological growth. All interviewees developed a sense of purpose based on self-interested altruism and solidarity with disabled peers. Conclusions To reinvent a good life with SCI, in addition to physical training and willpower, one needs to consider philosophical questions about the self and life, what Kant called the cosmic interests of reason: What may I hope? What must I do? What can I know? Our results indicate that we should, in the future, explore what the philosophical health approach may bring to rehabilitation processes in the months or years that follow the trauma. (shrink)

What is the method that Wittgenstein claimed to have discovered in the early 1930s? By common agreement, it is one of providing perspicuous representations of the grammar of words. Richard Gilmore proposes to explain how this method works, what its point is, and why Wittgenstein thought it was such a powerful tool.

The present article is a primary introduction to the semi-structured interviewing method SMILE_PH, an acronym for Sense-Making Interviews Looking at Elements of Philosophical Health. Beyond grounding this new methodology theoretically (a work that is started here but will in the future necessitate several developments), the main motivation here is pragmatic: to provide the recent philosophical health movement with a testable method and show that philosophically-oriented interviews are possible in a manner that can be reproduced, compared, tested (...) and used systematically with a population that has received no training in philosophy. The SMILE_PH approach was conceived by the author during an ethically approved pilot study focused on the philosophy of life of persons living with spinal cord injury (SCI), with the intention of rectifying the epistemic obstacles generated by rationalist, Socratic or unstructured ways of in-depth interviewing. The six-step structure of the method is also inspired by hundreds of individual dialogue sessions with philosophical counselees, led by the author between 2018 and 2022: the SMILE_PH method progressively gathers phenomenological data about 1 – our bodily sense, 2 – our sense of self, 3 – our sense of belonging, 4 – our sense of the possible, 5 – our sense of purpose and 6 – our philosophical sense. (shrink)

This open access book is a systematic update of the philosophical and scientific foundations of the biopsychosocial model of health, disease and healthcare. First proposed by George Engel 40 years ago, the Biopsychosocial Model is much cited in healthcare settings worldwide, but has been increasingly criticised for being vague, lacking in content, and in need of reworking in the light of recent developments. The book confronts the rapid changes to psychological science, neuroscience, healthcare, and philosophy that have occurred (...) since the model was first proposed and addresses key issues such as the model’s scientific basis, clinical utility, and philosophical coherence. The authors conceptualise biology and the psychosocial as in the same ontological space, interlinked by systems of communication-based regulatory control which constitute a new kind of causation. These are distinguished from physical and chemical laws, most clearly because they can break down, thus providing the basis for difference between health and disease. This work offers an urgent update to the model’s scientific and philosophical foundations, providing a new and coherent account of causal interactions between the biological, the psychological and social. (shrink)

This article seeks to show one way in which moral philosophy, considered by the authors to be essential to the nursing and midwifery curricula, can be presented to achieve an optimal learning experience for nurses and midwives. It demonstrates that what might be considered a standard approach, that is, one that begins with ethical principles concerned with rights and duties and then often follows a linear pattern of teaching, may be in danger of promoting a focus on standardized outcomes. Such (...) use of philosophy could therefore actually detract from the process of care. Moral philosophy underpinning health care ethics is commonly misperceived as a method of problem solving when there is an obvious dilemma regarding appropriate care and/or treatment. However, it is readily recognized that key principles within philosophy, for example, deontology and utilitarianism, despite their approach to a standard or criterion of right action, are both deficient in terms of providing ready-made right decisions. This is because their main virtue is to expose the difficulty rather than to solve the problem. Given these difficulties, any subsequent principles such as respect, beneficence, nonmaleficence and justice, incur the same deficiencies a fortiori. It can be argued that the complexity of the environment in which nurses and midwives now practice requires them to develop a capability that begins with the philosophical construction of an issue. This can subsequently enable a recognition of the essential nature of their own involvement as a nurse or midwife. By so doing, nurses and midwives can then bring issues into a nursing or midwifery paradigm and ensure that this perspective informs debate. Ultimately the focus is on the process by which care decisions are made. The intent therefore, is not simply for nurses or midwives to learn moral philosophy or to copy what is considered by others to be right action, but to recognize that a number of right actions are possible and, in so doing, develop their ability either to choose or influence a final action through a valid process. This article proposes and demonstrates by case example that what is often considered as a chance effect for nurses and midwives learning moral philosophy should be seen as the main effect and intended outcome. (shrink)

Health is a value-laden concept. The state of being that it designates is a fundamental human goal. As a value, the concept is normative, governing both clinical practice and the therapeutic treatment developed by medical research. Also, the promise of health plays a pivotal role in health-policy discourse. Almut Caspary considers philosophical and theological concepts of health in the context of its practical significance, both in the past and today. This conceptual analysis culminates in a (...) preliminary sketch of a concept of health; focusing on the stem-cell debate, it offers a discriminating approach to contemporary ethical problems in medicine. "Gesundheit" ist ein wertgeladener Begriff. Er bezeichnet einen grundsatzlich wunschenswerten Zustand menschlicher Existenz, der das arztliche Handeln im klinischen Alltag leitet. Daruber hinaus werden (gesundheits-)politische Debatten mit Verweis auf den Nutzen fur die Gesundheit entschieden. Vor diesem Hintergrund setzt sich Almut Caspary epochenubergreifend mit philosophischen und theologischen Uberlegungen zur Gesundheit auseinander. Die konzeptuelle Diskussion erlaubt die Skizzierung eines Gesundheitsverstandnisses, das - wie am Beispiel der Stammzelldebatte gezeigt wird - ein differenziertes Abwagen in medizinethischen Konfliktfallen zulasst. (shrink)

This commentary delves into Elizabeth Barnes’ upcoming publication, “Health Problems,” which embarks on the bold and essential journey of scrutinizing established philosophical frameworks surrounding health and its definition. Examining Barnes’ method of unraveling the complexities within our comprehension of health, this review sheds light on the significance of her work, especially for philosophers of medicine, bioethicists, and related scholars. It challenges the ingrained philosophical impulse to rigidly define and clarify health, arguing that such endeavors (...) often only exacerbate the entanglement of this crucial concept, central to human existence. (shrink)

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)

In response to crises, people sometimes prioritize fewer specific identifiable victims over many unspecified statistical victims. How other factors can explain this bias remains unclear. So two experiments investigated how complying with public health recommendations during the COVID19 pandemic depended on victim portrayal, reflection, and philosophical beliefs (Total N = 998). Only one experiment found that messaging about individual victims increased compliance compared to messaging about statistical victims—i.e., "flatten the curve" graphs—an effect that was undetected after controlling for (...) other factors. However, messaging about flu (vs. COVID19) indirectly reduced compliance by reducing perceived threat of the pandemic. Nevertheless, moral beliefs predicted compliance better than messaging and reflection in both experiments. The second experiment’s additional measures revealed that religiosity, political preferences, and beliefs about science also predicted compliance. This suggests that flouting public health recommendations may be less about ineffective messaging or reasoning than philosophical differences. (shrink)

This paper offers a realist critique of socialresearch on health inequalities. A conspectus of thefield of health inequalities research identifies twomain research approaches: the positivist quantitativesurvey and the interpretivist qualitative `casestudy'. We argue that both approaches suffer fromserious philosophical limitations. We suggest that aturn to realism offers a productive `third way' bothfor the development of health inequality research inparticular and for the social scientific understandingof the complexities of the social world in general.

In a warm and enjoyable dialogue the meaning of health, in its fullest sense, becomes a philosophical issue as much as a biological. For isn't the essence of health a general sense of well-being? Health can be seen as reflecting satisfaction with our quality of life; but how do we achieve that? Here, a character who is heading off for a job teaching health has an extended conversation with a trusted mentor, and they test various (...) definitions, various visions, and some of the infinite possibilities of the idea of health, in the process coming to a deeper and more invigorating understanding of life itself. They arrive at the notion of symbiosis - a living together to the advantage of each. And isn't a good conversation a sort of living together to the advantage of each? In such dialogue, we engage with our hearts and minds. When are we more alive than that? What is the peak of health if not this life, this engagement? The two friends want to know what health is. But they want more: They want to be healthy. They see three basic types of health - bodily, mental, and societal. These three types affect one another. How they affect one another matters in a critical way. But there is more. A friendly conversation allows special access to what is critical. Our guard is down in such a conversation. We are less likely to be defensive. We are more likely to keep our minds open and clear. We are likely to feel the confidence it takes to learn. (shrink)

In this book, an international group of philosophers, economists and theologians focus on the relationship between justice, luck and responsibility in health care. Together, they offer a thorough reflection on questions such as: How should we understand justice in health care? Why are health care interests so important that they deserve special protection? How should we value health? What are its functions and do these make it different from other goods? Furthermore, how much equality should there (...) be? Which inequalities in health and health care are unfair and which are simply unfortunate? Which matters of health care belong to the domain of justice, and which to the domain of charity? And to what extent should we allow personal responsibility to play a role in allocating health care services and resources, or in distributing the costs? With this book, the editors meet a double objective. First, they provide a comprehensive philosophical framework for understanding the concepts of justice, luck and responsibility in contemporary health care; and secondly, they explore whether these concepts have practical force to guide normative discussions in specific contexts of health care such as prevention of infectious diseases or in matters of reproductive technology. Particular and extensive attention is paid to issues regarding end-of-life care. (shrink)

COVID19 pandemic has clarified that public health policies are central for the future of human societies from several perspectives. As a matter of fact, they are based on certain premises that are practical-political (e.g., ensuring the health of citizens), moral (e.g., health is a value), or epistemological (e.g., certain ideas concerning expertise and shared knowledge). Indeed, effective policies require first and foremost not only to be based on reliable data and models (i.e., so-called evidence-based policy) but also (...) to ensure that these policies are democratically accepted, shared (e.g., considering both cognitive and social dimensions), and hopefully formed after a deliberative process involving experts from various fields alongside citizens. (shrink)

The idea that there is such a thing as a human right to health has become pervasive. It has not only been acknowledged by a variety of international law documents and thus entered the political realm but is also defended in academic circles. Yet, despite its prominence the human right to health remains something of a mystery - especially with respect to its philosophical underpinnings. Addressing this unfortunate and intellectually dangerous insufficiency, this book critically assesses the stipulation (...) that health is a human right which - as international law holds - derives from the inherent dignity of the human person. Scrutinising the concepts underlying this stipulation, it shall conclude that such right cannot be upheld from a philosophical perspective. (shrink)

This book is a collection of contributions written by philosophers and scientists active in different fields, such as mathematics, logics, social sciences, computer sciences and linguistics. They comment on and discuss various parts of and subjects and propositions introduced in the Handbook of Analytical Philosophy of Medicine from Kadem Sadegh-Zadeh, published by Springer in 2012. This volume reports on the fruitful exchange and debate that arose in the fuzzy community upon the publication of the Handbook. This was not only very (...) much appreciated by the community but also seen as a critical starting point for beginning a new discussion. The results of this discussion, which involved many different perspectives from science and the humanities and was warmly encouraged by Kadem Sadegh-Zadeh himself, are accurately reported in this volume, which is intended to be a critical companion to Kadem Sadegh-Zadeh ́s handbook. Rudolf Seising is currently an adjunct researcher at the European Centre for Soft Computing in Mieres, Asturias (Spain) and a college lecturer at the Faculty of History and Arts, at the Ludwig Maximilians University of Munich (Germany). Marco Elio Tabacchi is currently the Scientific Director of the Italian National Research & Survey Organization Demopolis, and a research assistant in the Soft Computing Group at University of Palermo (Italy). (shrink)

The author's aim here is to philosophically analyze the notion of positive mental health. Defining characteristics of positive mental health are described, drawing on modern psychiatric, psychoanalytical, psychological, and philosophical literature. The author finds that it is impossible to draw decisive conclusions about what characteristics constitute positive mental health, and suggests a general theory of health. Lennart Nordenfelt's holistic theory of general health is chosen to guide the rest of the discussion. The author is (...) affiliated with Malmo University, Sweden. This book is based on his PhD thesis in the Department of Health and Society at Linkoping University. Annotation copyrighted by Book News Inc., Portland, OR. (shrink)

This interdisciplinary volume gathers selected, refereed contributions on various aspects of public health from several disciplines and research fields, including the philosophy of science, epidemiology, statistics and ethics. The contributions were originally presented at the 1st Barcelona conference of “Philosophy of Public Health”. This book is intended for researchers interested in public health and the contemporary debates surrounding it.

We thank Zohar Lederman and Benjamin Capps for engaging with our paper on One Health and ethical frameworks, however we want to take issue with them on three points. First, they appear to misunderstand the distinction we appeal to between ethical theory and ethical frameworks, and so misinterpret what we are trying to achieve in our paper. Second, in spite of what they seem to imply, we agree that an OH approach can obscure differences in values, and that to (...) progress the field there needs to be recognition of competing values and their implications for OH. Finally, we are puzzled by their interest in pursuing a deliberative process, as this seems at odds with other positions they take in their paper, and also opens up many questions that need to be addressed. (shrink)

1. Imagine the following hypothetical scenario: Sarah is often called an expert on depression: after all, she graduated from medical school and has a PhD in neuroscience. She knows all theories of...

My assigned task in today’s colloquium is to review philosophers’ perspectives on the broad question of whether health care rationing ought to target the elderly. This is a revolutionary question, particularly in a society that is so sensitive to apparent discrimination, and the question must be approached carefully if it is to be successfully dealt with. Three subordinate questions attend this one and must be addressed in the course of answering it. The first such question has to do with (...) the issue of justice: how is it fair to target the elderly in achieving reductions in health care costs? Isn’t the proposal, or for that matter, isn’t targeting any age group, morally objectionable as a species of ageism, just as targeting members of a particular race or sex would be racist or sexist? The second subordinate question has to do with the issue of fittingness. Given that we can show in some way that targeting the elderly is not inherently unjust, why would limiting health care to them be a fitting thing for medicine to do? How would it fit, for example, with the traditional commitments of medicine, to sustain life, to relieve suffering, to heal and cure and restore function? And in particular, if medicine has the ability to save and relieve and restore the elderly, why should it replace that set of commitments with a different set for this particular population? The third subordinate question seems political, an arena reserved for one of my speaker colleagues today. There are, I believe, some underlying philosophical dimensions to its answer, and so I will say something about it. The philosophical/political questions is, Given that rationing health care to the elderly is not patently unjust, and given that a case can be made out that the ends of medicine are not violated by such limitation, shy should the elderly, as a group, assent to such a limitation? I want to address these subordinate questions, for I believe them to be the chief stumbling blocks for the possibility of an affirmative answer to our... (shrink)

A collection of essays that cover a range of topics of relevance to health care professionals. The book is intended to fill a gap between introductory texts on medical ethics and in-depth specialized books. It shows the importance of combining philosophical and ethical discussion.

The strong correlation between people’s socioeconomic position and health within high income countries is a well-documented fact. A person’s occupation, income and education level tell us a lot about that person’s prospects on a long and healthy life, such that we can speak of a ‘social gradient in health’, or a ‘socioeconomic health gap’. This association is often perceived to be unjust. Therefore, it is generally thought that governments should aim to reduce socioeconomic health inequalities. However, (...) this idea needs ethical justification, for it is not evident if and why exactly these inequalities are unjust. For instance, are inequalities in health unjust per se? Or because the underlying socioeconomic inequalities are unjust? And does justice require equal health levels, or a minimum level of health? What complicates the issue, is that the width of the health gap, or the steepness of the social gradient, depends on what health measures are used. Overall, the more subjective the measure, the greater the inequalities appear to be. But are all these measures equally morally relevant? This dissertation aims to give a better understanding of these philosophical questions. It does so by investigating the question of what we should understand by health in the first part, after which it addresses the question of how to evaluate socioeconomic health inequalities in the light of justice. The introduction begins with a description of the phenomenon of socioeconomic health inequalities, and how it has been addressed by politicians, epidemiologists and philosophers in the past and today. The chapter continues by formulating the central question of the dissertation – that of which health inequalities should be focused in the light of a concern with social justice. It explicates how this dissertation contributes to answering that question, by discussing the potential relation between the conceptualisation of health and justice evaluations, and by discussing which questions are addressed in each of the following chapters. The chapter 2 addresses the question of how health is conceptualised in the philosophical and public heath literature, and how theoretical concepts of health differ. It proposes to approach health concepts as a Wittgensteinian family of thick concepts and argues that while theories on health generally argue in favour of one specific concept, a comparison of concepts shows that we may need different concepts of health given the variety of health practices. By explicating the differences between five concepts of health, this chapter argues that each captures aspects of health that all seem relevant when we talk and think about health. Classifying these concepts based on their distinctions reveals them as members of a conceptual family: each of the discussed concepts differs from the others in at least one respect and resembles the others in several respects. Moreover, the discussion of the concepts shows that ‘health’ always both describes a condition and values that condition at the same time. Having both descriptive and evaluative dimensions, we can see health concepts as ‘thick concepts’. Given this evaluative dimension, it is important to reflect on the question of what understanding of health guides specific practices. Moreover, the distinctions revealed by the classification can serve as a conceptual toolbox for reflection on the assumptions and purposes of health practices. How such reflection could work is illustrated by a brief exploration of what health aspects are focused upon in three specific health practices. Chapter 3 presents a study into the question of how health is conceptualised by ordinary citizens and to what extent conceptualisations of health differ between socioeconomic groups. By making use of the method of concept mapping, this study analyses how different socioeconomic groups formulate their own answers regarding the question ‘what does health mean to you?’. It presents concept maps of health for three different socioeconomic groups living in the city of Utrecht that reveal that all groups have a multidimensional understanding of health. An interpretation of the concept maps reveals nuanced differences between groups. The multiple aspects of health were also ranked by importance. It appears that each group assigned most importance to mental health. All in all, the study shows that people in lower socioeconomic groups are more likely to show a conceptualisation of health that refers to 1) the absence of health threats, 2) a person within his/her circumstances, 3) the value of functional notions, and 4) an accepting attitude towards life. Chapter 4 addresses the question of what the theoretical and empirical study to concepts of health could imply for health equity practices. It does so by exploring further the suggestions made in chapters 2 and 3. Regarding the question of which health aspects should guide health equity policies, this chapter discusses the question of whether we should primarily look at subjective or objective health measures, and whether a universal or relative standard of health should be central. While justice-related concerns of impartiality and equal treatment may seem to favour an objective perspective and a universal health standard, it appears that we have good reason to account for the subjective perspective as well. It is also argued that a concern for recognition and participatory parity gives room for relative health standards. Th room for relative health standards confronts us with the question of how to deal with mechanisms like adaptive preferences that the concept maps reveal. It proposes a way out, by arguing for society-relative health standards. Chapter 5 examines the question of whether inequalities in health should be evaluated ‘directly’, thus independently of a distribution of their social determinants. It proposes a sufficientarian perspective, such that the central question of evaluation is that of whether everyone is – or can be – healthy enough. By discussing two sufficientarian approaches to health and social justice – by Powers & Faden and by Nussbaum – this chapter distinguishes two ways of setting a threshold level for health. Both approaches appear to provide an unsatisfactory basis for justice evaluations and lead us away from direct evaluation if we try to settle health minima that are less arbitrary. In anticipation to chapters 6 and 7, it is argued that the perspective of sufficient health for relational equality escapes this arbitrariness: compared to that of a decent human life, it better helps to answer both the question of what socioeconomic health inequalities a society is due to avoid, and the question of when socioeconomic health inequalities are unjust considering their consequences. Chapter 6 discusses to what extent Daniels’s theory of health justice provides a satisfactory answer to the question of what health inequalities a society is due to avoid. Daniels proposes an indirect evaluative approach by arguing that we should evaluate socioeconomic health inequalities in the light of Rawls’s principles of justice as fairness. That is, if socioeconomic inequalities are in accordance with fair equality of opportunity and with the difference principle, the corresponding health inequalities would be just. It is shown that the suggestion that Rawls’s principles regulate the social determinants of health neglects that not all social determinants of health belong to society’s basic structure as conceived of by Rawls and are thereby not subjected to the principles of justice. To acknowledge the social mechanisms leading to socioeconomic health inequalities in their full complexity, it is argued that we should broaden our understanding of society’s structure in accordance with Young’s notion of social structural processes. This renders the question of what health inequalities a society is due to avoid into a question of what we can expect from the side of the various actors that uphold the social structures that produce socioeconomic health inequalities. Lastly, it is discussed how a shift to Young’s theory completes the shift to non-ideal theorising that seem already initiated by Daniels, and that with this, the distinction between direct and indirect evaluation dissolves. Chapter 7 discusses to what extent equality in health is of instrumental value for a society of free and equals. It thus takes up the idea proposed in chapter 5, that an evaluation of the consequences of health inequalities is also due. Taking relational equality as an evaluative framework reveals three ways in which inequalities in life expectancy threaten this ideal. That is, via unequal risks to stigmatisation, unequal risks to unemployment and the risk of unequal pension enjoyments. It is thereby shown that these risks are especially great for those lower down the socioeconomic strata. It thus concludes that equality in health is of instrumental value to relational equality. The chapter continues to argue that our instrumental approach opens a new perspective: to mitigate the identified injustices by changing society, rather than by reducing inequalities in health. This is argued to be an advantage in the light of the realistic assumption that of the socioeconomic health inequalities will persist. The paper thus offers a complementary approach to both the evaluation and the mitigation of the injustice of socioeconomic inequalities in health. The discussion chapter summarises the central findings of the analyses of health concepts and discusses questions regarding the philosophical and practical merits of comparing theoretical health concepts, the need for developing new health measures or concepts and the importance or nonsense of studying citizen’s views on health. Repeating this for the dissertation’s second part, the central findings of the chapters on justice evaluation are summarised and followed by a discussion of questions and issues that have remained unaddressed so far. Here, central points of discussion are my take on rules of distribution, the distinction of direct and indirect evaluation, the role of ideal and non-ideal theory, the idea of relational equality, and personal responsibility for health. The chapter concludes by noting that also in the light of justice evaluations, all commonly used health measures are relevant for justice. Therefore, my recommendations for policy and further research entail that inequalities in each of these measures deserve attention by both policymakers and researchers. Specifically, policymakers and researchers should give attention to how exactly each of these health inequalities come about, in such a way that a discussion about the question of who can be assigned responsibility to alleviate them is well-informed; and both should give attention to the effects of health inequalities on the opportunities for people to live on equal standing, in such a way that when these opportunities are diminished, actions can be considered to aim to restore relational equality. (shrink)

Examining the health of the population of the industrial world, the authors conclude that it is no healthier than it used to be, rather that diseases have been substituted, not eliminated. They suggest an alternative approach to health care which derives from a philosophy of nature.

How do people understand the concepts of mental health and disorder? The objective of this paper is to examine the impact of several factors on people’s judgments about whether a condition constitutes a mental disorder or a healthy state. Specifically, this study examines the impact of the source of the condition, its outcome, individual valuation (i.e., the value the individual attaches to the condition), and group valuation (i.e., the value the relevant group attaches to the condition). While we find (...) that people’s health and disorder judgments are driven by perceived dysfunction, we also find that health and disorder judgments are impacted differently by these factors. Health judgements are impacted by outcome and individual valuation, and disorder judgments are impacted by condition source. These results suggest that the folk concept of mental health is positive (i.e., mental health is more than the absence of mental disorder) and normativist (i.e., value judgments play a significant role in determining whether a condition counts as healthy), while the concept of mental disorder aligns with a naturalist perspective, at least to the extent that dysfunction plays an important role in categorizing a condition as a disorder. However, our finding that people’s dysfunction judgments are influenced by individual valuation and outcomes poses a strong challenge to naturalist accounts. To provide access to our supplementary data, an appendix has been included. (shrink)

Abstract This paper explores gender and mental health with particular reference to the emerging philosophical field of critical realism. This philosophy suggests a shared ontology and epistemology for the natural and social sciences. Until recently, most of the debate surrounding gender and mental health has been guided either implicitly or explicitly within a positivist or constructivist philosophy. With this in mind, key areas of critical realism are explored in relation to gender and mental health, and contrasted (...) with the positions of positivism and constructivism. It is argued that critical realism offers an alternative philosophical framework for the exploration of gender issues within mental health care. (shrink)

This book is a scholarly treatise on the nature of health presented in the form of a dialogue between an inquirer and a philosopher. It elaborates a holistic theory of health, according to which people are completely healthy if, and only if, they are able to realize all their vital goals, given reasonable circumstances. health is applied t practices, on particular areas of interest.

The studies of health care systems are conducted intensively on various levels. They are important because the systems suffer from numerous pathologies. The health care is analyzed, first of all, in economic aspects but their functionality in the framework of systems theory is studied, as well. There are also attempts to work out some general values on which health care systems should be based. Nevertheless, the aforementioned studies, however, are fragmentary ones. In this paper holistic approach to (...) the philosophical basis of health care is presented. The levels on which the problem can be considered are specified explicitly and relations between them are analyzed, as well. The philosophical basis on which the national health care systems could be based is proposed. Personalism is the basis for the proposal. First of all, the values, that are derived from the personalistic philosophy, are specified as the basic ones for health care systems. Then, general organizational and functional properties of the system are derived from the assumed values. The possibility of adaptation of solutions from other fields of social experiences are also mentioned. The existing health care systems are analyzed within the frame of the introduced proposal. (shrink)

Filozoficko-antropologické dědictví Viktora E. Frankla zůstává dosud nedoceněnou oblastí v jeho široké tvůrčí činnosti, která zahrnuje také neurologické, psychiatrické, psychoterapeutické a axiologicko-etické bádání. Franklovým dílem však prolíná svébytná multidimenzionální koncepce člověka, která je v následujícím příspěvku úzce spojena s Franklovou primární profesní orientací - péčí o zdraví a snahou o uzdravení nemocných - a s jednou z dominant Franklovy tragické triády - utrpením.

PEOPLE WITH MENTAL HEALTH conditions are often required to address the question of whether they should disclose information about their mental health. Should they inform their employers, colleagues, friends, family, neighbors, and so on, that they have a mental health condition? Should they be encouraged by others to do so? There has been a recent move to promote disclosure as a way to increase the empowerment and decrease the self-stigma of people with mental health conditions. For (...) instance, a three-week intervention, Coming Out Proud, has been devised to inform people about the costs and benefits of disclosure, forms of disclosure, and helpful ways to tell... (shrink)

The concept 'health' is ambiguous [18,9, 11]. The concept 'mental health' is even more so. 'Health' compasses senses of well-being, wholeness, and sound ness that mean more than the simple freedom from illness - a fact appreci ated in the World Health Organization's definition of health as more than the absence of disease or infirmity [7]. The wide range of viewpoints of the con tributors to this volume attests to the scope of issues placed under (...) the rubric 'mental health. ' These papers, presented at the Fourth Symposium on Philos ophy and Medicine, were written and discussed within a broad context of interests concerning mental health. Moreover, in their diversity these papers point to the many descriptive, evaluative, and, in fact, performative functions of statements concerning mental health. Before introducing the substance of these papers in any detail, I want to indicate the profound commerce between philosophical and psychological ideas in theories of mental health and disease. This will be done in part by a consideration of some conceptual developments in the history of psychiatry, as well as through an analysis of some of the functions of the notions of mental illness and health. 'Mental health' lays a special stress on the wholeness of human intuition, emotion, thought, and action. (shrink)

To date, of essential goals in psychiatry and establishment of future medical centers is creating therapeutic environments with the aim of improving clinical outcomes, preventing the progression of personality difficulties to serious psychiatric disorders, increasing self-satisfaction in society, facilitating personal growth and actualization, as well as reducing high medical costs. In this regard, the Personality Modulation Clinic in 2016 in Tabriz University of Medical Sciences was established, with the aim of providing appropriate mental health services for clients who do (...) not fulfill criteria for a specific mental disorder, in the traditional classifications; nevertheless, desiring to eliminate inner obstacles towards mental growth, self-actualization, spirituality and the proper well-being they lack. The services in this clinic provide clients with support in order to seek innovative growth opportunities within themselves, by removing inner obstacles towards personality development. These obstacles are roughly equivalent to the diagnosis of “personality difficulty” in the 11th edition of the International Classification of Diseases (ICD-11). Moreover, the therapeutic foundation of this clinic is an emerging medical paradigm known as Cosmetic Psychiatry. At the beginning of any new scientific establishment, as usually happens, and was true for this clinic as well, the bond of philosophical concepts are unveiled, and this is the irreversible and undeniable link between science and philosophy. Thereby, important questions appeared, which were approached philosophically. (shrink)

Efficiency and equity are central concepts for the normative assessment of health policy. Drawing on the work of academic philosophers and philosophically sophisticated economists, this article identifies important philosophical questions implicated by the notions of efficiency and equity and then summarizes influential answers to them. Promising avenues for further philosophical research are also highlighted, especially in the context of health equity and its elusive ethical foundations.

The political philosophy of health care has been characterized by considerable conceptual inflation in recent years. First, the concept of health that lies at its core has come to encompass ever-increasing aspects of individuals’ existences. And second, the emergence of the public health perspective has increased the range of resources relevant to health equity. This expansion has not been without cost. The decision to include more rather than less within the ambit of "health" is ultimately (...) a moral/political rather than an ontological or metaphysical one, and there are several ethical reasons to define the scope of theories of distributive justice in health narrowly. (shrink)

The central role of Health Care Analysis is to advance discourses between philosophy, health, and policy. Within that very wide-ranging agenda, perhaps the most complex challenges are in global health. In countries across the world, many, many populations are unable to enjoy conditions in which they can be healthy. The barriers to change are political, economic, social, regulatory, legal, and philosophical. Lawrence Gostin’s recent book on Global Health Law therefore marks a contribution of the highest (...) importance, marrying practical and philosophical agendas, and aiming at achieving global health with justice. -/- To progress the important work of Gostin’s book, the current journal issue draws together leading scholars in moral and political philosophy, economics, and law, with a shared interest in questions of global justice. In the first paper, Eric Friedman and Lawrence Gostin provide a clear overview of the practical and theoretical global health challenges and their response to these. Their analysis is followed by stimulating contributions from Norman Daniels, Jennifer Prah Ruger, Shawn Harmon, Attiya Waris and Laila Abdul Latif, Heather Widdows, and A.M. Viens, each engaging with questions raised by Global Health Law. The different papers underscore the significance of this area of inquiry, and the imperative to bring insights from scholarly work into global health practice. (shrink)

This article presents a serles of objections against having philosophers in the health care setting and rebuttals to these objections. These objections occur often enough to deal with them as characteristic criticisms. The rebuttals outline and advocate the positive — yet limited — function of the philosopher's presence in health care.