This dissertation examines the viability of a feminist ethic of flourishing. The possibility of a eudaimonist, or flourishing-based, ethic adapted for the needs of feminist ethics and politics has recently been raised by a number of feminist moral philosophers. However, in these discussions, the degree to which an ethic of flourishing requires a substantive conception of human nature has not been adequately addressed. Flourishing-based ethical theories appear to require a substantive account of the kind of thing whose flourishing is to (...) be promoted, while contemporary academic feminism is characterized by a strong suspicion toward claims about human nature. Chapter one situates this problem in the current literature and reframes feminist anti-essentialist objections to nature claims. Chapter two analyzes three historically influential exemplars of the ethics of flourishing: Aristotle, Hume, and Marx. Employing the analytic categories developed in chapter two, chapters three through five assess the work of Rosalind Hursthouse, Martha Nussbaum, and Lisa Tessman for their adequacy to serve as the basis of a feminist ethic of flourishing. I argue that each has something of value to offer and yet each is problematic when it comes to how they appeal (or fail to appeal) to human nature. The central argument of this dissertation is that, properly understood, a theory of human nature can be a critical resource for a feminist ethic of flourishing. As such, feminist moral philosophers who would condemn oppression, gender-based subordination, and other injustices by appealing to an ideal of flourishing that is being denied or cut off, would benefit from greater attention to the assumptions about human nature that such theories of flourishing entail. On the view defended here, a normative conception of human nature is a necessary methodological element of a flourishing-based ethical theory that illuminates the reasons one has in support of a particular vision of flourishing. While I leave open the question of how such a conception of human nature could be objectively justified, this dissertation argues that a theory of human nature can serve as a normative resource for feminist moral criticism within a flourishing-based ethical framework. (shrink)

The capability approach, originated by Amartya Sen is among the most comprehensive and influential accounts of justice that applies to issues of health and health care. However, although health is always presumed as an important capability in Sen’s works, he never manages to fully explain why health is distinctively valuable. This paper provides an explanation. It does this by firstly laying out the general capability-based argument for health justice. It then discusses two recent attempts to justify why health is distinctively (...) valuable from within a capability framework – these are Sridhar Venkatapuram’s conception of health as the central human meta-capability and, respectively, Norman Daniels’ embrace of the capability metric in his use of Rawls’ principle of fair equality of opportunity. The paper argues that none of these accounts succeed in providing a plausible justification of the value of health. Finally, the paper suggests an alternative more complex justification, closely tied to different but central element of the capability view, that captures the core intuitions of both Venkatapuram and Daniels’ accounts but without being vulnerable to the objections raised against each of them. This, the paper concludes, provides a promising ground on which the capability view on health justice should be founded. (shrink)

The concept of dignity plays a foundational role in the more recent versions of Martha Nussbaum’s capabilities theory. However, despite its centrality to her theory, Nussbaum’s conception of dignity remains under-theorised. In this paper we critically examine the role that dignity plays in Nussbaum’s theory by, first, developing an account of the concept of dignity and introducing a distinction between two types of dignity, status dignity and achievement dignity. Next, drawing on this account, we analyse Nussbaum’s conception of dignity and (...) contrast it with Kant’s conception of dignity. On the basis of this comparison between Nussbaum and Kant, we highlight tensions between Nussbaum’s Aristotelianism, which is central to her conception of dignity, and her commitment to political liberalism. This leads us to conclude that Nussbaum’s claim that her conception of dignity is only a partial political conception is implausible and that her conception of dignity seems to commit her to a satisficing form of perfectionist liberalism. (shrink)

The capabilities approach is the theory according to which, in order to assess people's quality of life and reflect on the basic political entitlements, we should consider what people are capable of doing and being. Focusing mostly on Nussbaum's account, a number of scholars analysed the metaethical structure underlying the approach, showing her Aristotelian and Kantian sources. This article explores another aspect of Nussbaum's theory which has so far been somewhat overlooked: the role of emotions in the justification and motivational (...) support of the approach. After showing the importance Nussbaum places on compassion (and other benevolent emotions) to warrant her moral theory, I argue that – assuming her own cognitive account of compassion – her argument begs the question. I will then contend that Nussbaum's case does not have the inner tools to overcome such a circularity, trying to suggest, in conclusion, a possible way out which is consistent with it. (shrink)

Non-human animal chimeras, containing human neurological cells, have been created in the laboratory. Despite a great deal of debate, the status of such beings has not been resolved. Under normal definitions, such a being could either be unconventionally human or abnormally animal. Practical investigations in animal sentience, artificial intelligence, and now chimera research, suggest that such beings may be assumed to have no legal rights, so philosophy could provide a different answer. In this vein, therefore, we can ask: What would (...) a chimera, if it could think, think about? Thinking is used to capture the phenomena of a novel, chimeric being perceiving its terrible predicament as no more than a laboratory experiment. The creation of a thinking chimera therefore forces us to reconsider our assumptions about what makes human beings (potentially) unique (and other sentient animals different), because, as such, a chimera’s existence bridges our social and legal expectations about definitions of human and animal. Society has often evolved new social norms based on different kinds of (ir)rational contrivances; the imperative of non-contradiction, which is defended here, therefore requires a specific philosophical response to the rights of a thinking chimeric being. (shrink)

Political practices often aim to reach valuable outcomes through democratic processes. However, philosophical considerations and democratic deliberations sometimes support different conclusions about what a valuable outcome would be. This paper contributes to a research agenda that aims to reconcile recommendations that follow from these different bases. The setting for this research agenda is capabilitarian. It affirms the idea that what we should distribute are substantive freedoms to be and do things that people have reason to value. Disagreements about these valuable (...) outcomes become particularly problematic in urgent situations such as pandemics, floods, and wildfires. These situations are urgent since they are time-sensitive and involve an impending loss of well-being. A method of compromise would help mitigate losses of well-being while respecting the aim of reaching valuable outcomes through democratic processes. I thus offer an equitable and decisive method of compromise that helps integrate philosophical considerations with democratic deliberations. (shrink)

Much research has studied the importance of play for children’s development. However, questions of its political importance and our public institutions’ duties to protect it have been largely neglected. This article argues that childhood play is politically important due to having both intrinsic and instrumental value, and it suggests that the duty to protect the capability for play in childhood falls especially on the public health system. If this argument succeeds, it follows that we have stronger duties toward our children (...) than we currently believe. (shrink)

The capability approach is one of the main contenders in the field of theorizing social justice. Each citizen is entitled to a set of basic capabilities. But which are these? Martha Nussbaum formulated a set of ten central capabilities. Amartya Sen argued they should be selected in a process of public reasoning. Critics object that the Nussbaum‐approach is too perfectionist and the Sen‐approach is too proceduralist. This paper presents a third alternative: a substantive but non‐perfectionist capability theory of justice. It (...) presents a two‐level concept of individual agency as connected to social practices. It then argues basic capabilities are those necessary to for the agency necessary to navigate freely and autonomously between different social practices. (shrink)

Dignity may just be the most promiscuous normative abstraction. This article, informed by dignity’s historical variability, political theoretic multipurpose, and conflicting jurisprudence, focuses on a particular but influential invocation of the term: dignity as the normative ground for the ‘capabilities approach’ model of social justice. We ask whether or not the CA, in particular the influential version propounded by philosopher Martha Nussbaum, requires dignity as its foundational premise, and whether or not dignity may be more costly than beneficial for the (...) CA’s vision of a minimally just society. The first section of this article rehearses the warrants of and criticisms against the dignity-basis of Nussbaum’s CA. We canvass the relatively sparse scholarship on dignity within the CA to situate our contribution. The next two sections are case studies, demonstrating dignity’s shortcomings for assessing and regulating sex and abortion, respectively. The fourth section rebuts two possible objections to our criticisms of dignity. The fifth and final section gestures toward another normative abstraction, ‘minimum conditions of individuation’, less polysemic than dignity, which might alternatively ground the CA. (shrink)

Many consider play a natural part of childhood, and although there is disagreement in the literature on what essentially defines “play” in childhood, philosophical theories of play tend to support this initial consideration. But is childhood play also something we owe each other within a framework of educational justice? This is a question yet to be addressed. In this paper, I answer this question affirmatively. I take off from a generic account of educational justice and argue that childhood play should (...) be considered a central entitlement of this account. I then argue in line with the capability approach that if we ought to protect childhood play, it should be children’s capability for play rather than the functioning of play that needs protection. I end by offering an account of the capability for childhood play. (shrink)

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)

Despite the exceptional growth of interest in the Capability Approach in specific fields of application, the approach has yet to clarify certain basic concepts, such as freedom, functioning, and, in particular, its key concept of capability. Taking two basic tenets of CA as my starting point, I would first of all like to contribute to the clarification of these central concepts. It thereby becomes apparent that “capability” is, on the one hand, an essentially hybrid concept with both an internal and (...) external aspect. On the other hand, it addresses the freedom of choice between various lifestyles as a second-order competency. Against this background, this paper offers a suggestion to correct the terminology used by Martha C. Nussbaum in her concept of capability, and subsequently it will outline a basic model of the transformation of resources into forms of being and activities with reference to Ingrid Robeyns. In conclusion I will couple this rather static perspective with two critical points: First of all, a more dynamic view reveals hitherto barely considered aspects of freedom in everyday human lives. Secondly, the idea of capabilities opposes the attempt at a separation of capabilities from functions in order to avoid paternalism, as suggested by Nussbaum. (shrink)

Amartya Sen, the initiator of the Capability Approach, rejects perfectionism and the idea that theorists can, or ought to, predefine what capabilities we have reason to value. Instead he insists that the route to social justice stay true to the liberal ideal of value pluralism and human diversity and demands a content-neutral procedure of reflective scrutiny. This paper investigates the theoretical underpinnings assumed in such a procedural account. Can it avoid perfectionistic assumptions? I think it cannot for two reasons. First, (...) it is clear that a deliberative process is taken to be valuable without it being a product of such a process. It is thus taken to be a priori valuable. Consequently, the capabilities that enable citizens to successfully partake in such a process are taken to be what we have reason to value. Second, I argue, Sen’s procedural approach is primarily aimed at enhancing freedom understood as personal autonomy. I then ask if Sen successfully can deflect perfectionistic allegations by referring to a formal and content-neutral account of autonomy. Again, I conclude he cannot. This suggests that Sen’s rejection of perfectionism is untenable. (shrink)

Martha C. Nussbaum, in the context of ancient philosophy, formulated ethics of human development based on 10 basic human capabilities as a precondition of meaningful human development, i.e. the ability to live a dignified human life. The paper, thus, deals with a capabilities approach with the aim of analysing the content of the idea of human dignity in Nussbaum’s understanding and its place in the conception of ethics of human development, since human dignity is the very core of the conception (...) in question. (shrink)

This article claims that the protection of children’s capability for play is a central social-political goal. It provides the following three-premise argument in defense of this claim: we have strong and wide-ranging normative reasons to be concerned with clusters of social deficiency; particular fertile functionings play a key role for tackling clusters of social deficiency; and finally the capability for childhood play is a crucial, ontogenetic prerequisite for the development of those particular fertile functionings. Thus, in so far as we (...) consider it a central political goal to tackle social deficiency, we should be concerned with protection of childhood play capability. This conclusion raises new insights on the importance – for global development policy as well as for welfare states’ aim to secure social justice – of protecting children’s capability to engage in playful activities. (shrink)

The capability approach is one of the main contenders in the field of theorizing social justice. Each citizen is entitled to a set of basic capabilities. But which are these? Martha Nussbaum formulated a set of ten central capabilities. Amartya Sen argued they should be selected in a process of public reasoning. Critics object that the Nussbaum-approach is too perfectionist and the Sen-approach is too proceduralist. This paper presents a third alternative: a substantive but non-perfectionist capability theory of justice. It (...) presents a two-level concept of individual agency as connected to social practices. It then argues basic capabilities are those necessary to for the agency necessary to navigate freely and autonomously between different social practices. (shrink)

I explore the usefulness of Martha Nussbaum's capabilities approach in regard to the UN Convention on the Rights of Persons with Disabilities (CRPD). The CRPD aims at empowering people with disabilities by granting them a number of civil and political, but also economic, social and cultural rights. Implementing the CRPD will clearly be politically challenging and also very expensive for states. Thus, questions might arise as to whether the requirements set in the CRPD can be justified from an ethical perspective. (...) I will first investigate if Nussbaum's capabilities approach provides support for the rights claimed in the CRPD. Second, I will investigate to what extent Nussbaum's capabilities approach is a useful tool to set priorities among rights in the course of the implementation of the convention. This is an urgent question because seen realistically, it will not be possible to realize all rights at once and thus some rights need to receive greater priority than others. I will argue that the capabilities approach can be regarded as supporting the rights specified in the CRPD, but that it proves unable to guide the implementation process due to an insufficient grounding of the capabilities. Employing the capabilities approach thus leads to only limited results. (shrink)

A capability approach prescribes paternalist government actions to the extent that it requires the promotion of specific functionings, instead of the corresponding capabilities. Capability theorists have argued that their theories do not have much of these paternalist implications, since promoting capabilities will be the rule, promoting functionings the exception. This paper critically surveys that claim. From a close investigation of Nussbaum's statements about these exceptions, it derives a framework of five categories of functionings promotion that are more or less unavoidable (...) in a capability theory. It argues that some of these categories may have an expansionary dynamic; they may give rise to widespread functionings promotion, which would defeat the capabilitarian promise that paternalist interventions will be exceptions to the rule of a focus on capabilities. Finally, the paper discusses three further theoretical issues that will be decisive in holding this paternalist tendency in check: how high one sets threshold levels of capability protection, how lengthy one's list of basic capabilities is, and how one deals with individual responsibility for choices resulting in a loss of one's capabilities. (shrink)