While aging research and policy aim to promote ‘health’ at all ages, there remains no convincing explanation of what this ‘health’ is. In this paper, I investigate whether we can find, implicit within the sciences of aging, a way to know what health is and how to measure it, i.e. a theory of health. To answer this, I start from scientific descriptions of aging and its modulators and then try to develop some generalizations about ‘health’ implicit within this research. After (...) discussing some of the core aspects of aging and the ways in which certain models describe spatial and temporal features specific to both aging and healthy phenotypes, I then extract, explicate, and evaluate one potential construct of health in these models. This suggests a theory of health based on the landscape of optimized phenotypic trajectories. I conclude by considering why it matters for more candidate theories to be proposed and evaluated by philosophers and scientists alike. (shrink)

There are long-standing doubts about whether data from subjective scales—for instance, self-reports of happiness—are cardinally comparable. It is unclear how to assess whether these doubts are justified without first addressing two unresolved theoretical questions: how do people interpret subjective scales? Which assumptions are required for cardinal comparability? This paper offers answers to both. It proposes an explanation for scale interpretation derived from philosophy of language and game theory. In short: conversation is a cooperative endeavour governed by various maxims (Grice 1989); (...) because subjective scales are vague and individuals want to make themselves understood, scale interpretation is a search for a focal point (Schelling 1960). A specific focal point it hypothesised; if this hypothesis is correct, subjective data will be cardinally comparable. Four individually necessary and jointly sufficient conditions for cardinal comparability are specified. The paper then argues this hypothesis can be empirically be tested, makes an initial attempt to do so using subjective well-being data, and concludes it is supported. Numerous areas for further research are identified including, at the end of the paper, how certain tests could be used to ‘correct’ subjective data if they are not cardinal. (shrink)

Suppose you want to do as much good as possible. What should you do? According to members of the effective altruism movement—which has produced much of the thinking on this issue and counts several moral philosophers as its key protagonists—we should prioritise among the world’s problems by assessing their scale, solvability, and neglectedness. Once we’ve done this, the three top priorities, not necessarily in this order, are (1) aiding the world’s poorest people by providing life-saving medical treatments or alleviating poverty (...) itself, (2) preventing global catastrophic risks, such as those posed by nuclear war or rogue artificial intelligence, and (3) ending factory farming. These claims are both plausible and striking. If correct, they should prompt a stark revision of how we approach our altruistic activities. However, the project of determining how to do the most good—as opposed to say, whether we should do the most good—has only recently, within the last ten years, become the subject of serious academic attention. Many key claims have not yet been carefully scrutinised. This is a cause for concern: are effective altruists doing good badly? In this thesis, I critique and develop some of the latest claims about how individuals can do the most good. I do this in three areas: the value of saving lives (preventing premature deaths), how best to improve lives (making people happier during their lives), and cause prioritisation methodology (frameworks for determining which problems are the highest priorities). In each case, I raise novel theoretical considerations that, when incorporated, change the analysis. Roughly speaking, my main conclusions are (1) saving lives is not as straightforwardly good we tend to suppose, may not be good at all, and is not clearly a priority; (2) happiness can be measured through self-reports and, based on the self-reported evidence, treating mental health stands out as an overlooked problem that may be an even more cost-effective way to improve lives than alleviating poverty; (3) the cause prioritisation methodology proposed by effective altruists needs to be moderately reconceptualised and, when it is, it turns out it is not as illuminating a tool as we might have thought and hoped. (shrink)

Psychometrics is one of the main approaches to social scientific measurement. It is relied upon in drug testing, economic policymaking, recruitment, and other decision-making contexts. The first aim of this article is to introduce philosophers to key aspects of psychometrics, namely, classical test theory, item response theory, and construct validity. The second aim is to show how a debate on the nature of psychological attributes manifests in psychometrics. In this debate, realists claim that psychometric measures are indicators of independently existing (...) qualities, while operationalists argue that a measure defines its target attribute. The third and final aim is to argue that despite its poor reputation among philosophers, operationalism is a viable approach to psychometrics. (shrink)

Essentially everyone agrees that the outlawing of slavery, or the beginning of women’s suffrage, or the defeat of Nazism constitute paradigmatic examples of moral progress in human history. But this consensus belies a deep division about the nature of moral progress more generally, a consequence of the foundational differences among and within normative traditions regarding the nature and scope of the ‘moral’ in moral progress. This essay proposes that philosophers might nonetheless converge on a working definition of moral progress by (...) identifying a proxy property that reliably tracks moral progress, but which does not purport to be coextensive with the philosophically-relevant property. The aim of this essay is to identify this proxy property with emerging empirical measures of population welfare, and to show why this indicator of moral progress can garner overlapping consensus from a variety of normative traditions. (shrink)

This essay responds to the helpful criticisms of Valuing Health: Well-Being, Freedom, and Suffering, which have been offered by Elselijn Kingma, Adam Oliver, Anna Alexandrova, Alex Voorhoeve, Erik Nord and James Wilson. I am extremely grateful to Jonathan Wolf and especially James Wilson for arranging a one-day conference on my book, Valuing Health: Well-Being, Freedom, and Suffering [Hausman, D.. Valuing Health: Well-Being, Freedom, and Suffering. Oxford: Oxford University Press.], and for publishing this symposium. I am also grateful to the wonderful (...) six scholars who took the time to study my work and to offer perceptive and helpful criticisms. Without unduly trying the patience of readers, I cannot respond to all their remarks, but I hope that in what follows I have replied to the most important of their comments on the arguments and conclusions of Valuing Health. Before I begin these replies, a brief synopsis of Valuing Health may be helpful to the reader. (shrink)

Wellbeing describes how good life is for the person living it. Wellbeing comes in degrees. Subjective theories of wellbeing maintain that for objects or states of affairs to benefit us, we need to have a positive attitude towards these objects or states of affairs: the Resonance Constraint. In this article, we investigate to what extent subjectivism can plausibly account for degrees of wellbeing. There is a vast literature on whether preference-satisfaction theory – one particular subjective theory – can account for (...) degrees of wellbeing. This is generally taken to be problematic. However, other subjective theories – namely, desire-satisfaction, judgment- and value-fulfillment theories – do not suffer from the same difficulties. We introduce two models of degrees of wellbeing a subjectivist can employ: the Relative and the Absolute Model, and defend the claim that both models face difficulties. In particular, we argue that a subjectivist theory should describe instances of depression as instances of low degrees of wellbeing. We also argue that a reduction of desires may sometimes improve one’s degree of wellbeing, an idea we call the Epicurean Intuition. We then argue that the Relative Model fails to account for the disbenefit of certain types of depression, while the Absolute Model fails to meet a central commitment of subjectivism – the Resonance Constraint – and is unable to accommodate the Epicurean Intuition. The upshot of the paper is that subjectivist theories cannot account for degrees of well-being in a plausible way. (shrink)

This paper provides a philosophical assessment of leading theory-based, evidence-based and coherentist approaches to the definition and the measurement of well-being. It then builds on this assessment to articulate a reformed division of labor for the science of well-being and argues that this reformed division of labor can improve on the proffered approaches by combining the most plausible tenets of theory-based approaches with the most plausible tenets of coherentist approaches. This result does not per se exclude the possibility that theory-based (...) and coherentist approaches may be independently improved or amended in the years to come. Still, together with the challenges that affect these approaches, it strengthens the case for combining the most plausible tenets of those approaches. (shrink)

Psychotherapy research is known for its pursuit of evidence-based treatment. Psychotherapeutic efficacy is assessed by calculation of aggregated differences between pre treatment- and post treatment symptom levels. As this ‘gold standard methodology’ is regarded as ‘procedurally objective’, the efficacy number that results from the procedure is taken as a valid indicator of treatment efficacy. However, I argue that the assumption of procedural objectivity is not justified, as the methodology is build upon a problematic numerical basis. I use an empirical case (...) study to show how measurement problems practically occur in the first step of data collection, i.e. in individual symptom measurement. These problems have been discussed and acknowledged for decades, but still measurement is regarded as the best epistemic means to gain evidence on psychotherapeutic efficacy. Therefore, I show how initial measurement problems are overlooked in the remainder of the methodological procedure, which harms the ‘evidence-base’ of psychotherapeutic EBT. Via this applied analysis, I exhibit concerns that are increasingly raised in the literature in an empirical way, to emphasize the need for a non-idealized consideration of the ‘gold standard methodology’ as a means towards its clinical end. (shrink)

This article introduces a symposium on Daniel Hausman’s Valuing Health: Well-Being, Suffering and Freedom. The symposium contains papers by Elselijn Kingma, Adam Oliver, Anna Alexandrova, Erik Nord, Alex Voorhoeve and James Wilson, with replies by Daniel Hausman. In Valuing Health, Hausman argues that, despite apparently measuring health, projects such as the Global Burden of Disease Study in fact measure judgments about the value of health. Once this has been clarified, the key question is how the value of health should be (...) measured. Hausman argues that existing instruments measure the private value of health, that is, health’s ‘contribution to whatever the individual cares about or should care about’, whereas what should be measured for resource allocation purposes is the public value of health, that is, the value health should be accorded from the perspective of the liberal state. Hausman argues that the public value of health should be measured by the extent to which suffering and activity limitations are relieved. Each commentator engages with a different aspect of Hausman’s argument. (shrink)