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Switch to: References
Citations of:
Well-Being. Its Meaning, Measurement and Moral Importance
Tijdschrift Voor Filosofie 52 (1):171-171 (1988)
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Life is so wretched that it would be impossible to endure were it not for the luminous beams of illusion that guide us through its darkest moments. Many argue, perhaps not to this degree, that were it not for some modest illusions about the world and ourselves we would experience a serious decline in quality of life. On those not-so-good days, this claim strikes me as irresistible. How would I endure life and maintain my sanity if I had to embrace (...) |
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This article argues that a person’s well-being at a time and the goodness of her life are two distinct values. It is commonly accepted as platitudinous that well-being is what makes a life good for the person who lives it. Even philosophers who distinguish between well-being at a time and the goodness of a life still typically assume that increasing a person’s well-being at some particular moment, all else equal, necessarily improves her life on the whole. I develop a precise (...) |
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This introduction to the special issue on well-being and health explores the ways that philosophical inquiry into well-being can play a productive role in understanding health and medicine. We offer an explanation of the concept of well-being, central theories of well-being, and how these key topics, along with other cutting-edge issues such as disability and cross-cultural reflections, can contribute to the discourse on the nature of health and medicine. We also provide brief overviews of the essays in this special issue (...) |
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Accelerated COVID-19 vaccine development represents an important accomplishment and a milestone in the history of vaccine evolution. However, the vaccine’s scarcity made its equitable global allocation and distribution ambiguous. Despite the initial pledges from wealthy countries for fairness and inclusivity towards the poorer ones, the policies followed diverged significantly. Wealthy countries have vastly superior access to vaccines in a reality likened to an ethical disaster. This paper calls for the need for fair global vaccine allocation and distribution and examines the (...) |
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What challenges must a principle of need for prioritisations in health care meet in order to be plausible and practically useful? Some progress in answering this question has recently been made by Hope, Østerdal and Hasman. This article continue their work by suggesting that the characteristic feature of principles of needs is that they are sufficientarian, saying that we have a right to a minimally acceptable or good life or health, but nothing more. Accordingly, principles of needs must answer two (...) |
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Although anxiety is frequently seen as a predominantly negative phenomenon, some recent researchers have argued that it plays an important positive function, serving as an alert to warn agents of possible problems or threats. I argue that not only can one’s own, first-personal anxiety perform this function; because it is possible for others—in particular, one’s friends—to feel anxious on one’s behalf, their anxious feelings can sometimes play the same role in our functioning, and make similar contributions to our well-being. I (...) |
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Orthodox Humeans about normative reasons for action believe that there are no rational principles governing the substantive content of desire. But they also believe that desires with misinformed content should be rejected and cannot be the proper subjective sources of normative reasons for action. These two ideas, I argue, in fact stand in tension with each other: The Humean rejection of misinformed desire actually has to invoke a feasibility principle for desire, a semi-substantive rational principle that is already built into (...) |
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That death is not a welfare issue appears to be a widespread view among animal welfare researchers. This paper demonstrates that this view is based on a mistaken assumption about harm, which is coupled to ‘welfare’ being conceived as ‘welfare at a time’. Assessments of welfare at a time ignore issues of longevity. In order to assess the welfare issue of death, it is necessary to structure welfare assessment as comparisons of possible lives of the animals. The paper also demonstrates (...) |
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Relational conceptions of autonomy attempt to take into account the social aspects of autonomous agency. Those views that incorporate not merely causally, but constitutively necessary relational conditions, incorporate a condition that has the form: A necessary condition for autonomous agency is that the agent stands in social relations S. I argue that any account that incorporates such a condition cannot play one of autonomy’s key normative roles: identifying those agents who ought to be protected from paternalistic intervention. I argue, against (...) |
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Robert Nozick's experience machine thought experiment is often considered a decisive refutation of hedonism. I argue that the conclusions we draw from Nozick's thought experiment ought to be informed by considerations concerning the operation of our intuitions about value. First, I argue that, in order to show that practical hedonistic reasons are not causing our negative reaction to the experience machine, we must not merely stipulate their irrelevance (since our intuitions are not always responsive to stipulation) but fill in the (...) |
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Generating an account that can sidestep the disagreement among substantive theories of well-being, while at the same time still providing useful guidance for well-being public policy, would be a significant achievement. Unfortunately, the various attempts to remain agnostic regarding what constitutes well-being fail to either be an account of well-being, provide useful guidance for well-being policy, or avoid relying on a substantive well-being theory. There are no theory-free lunches in well-being policy. Instead, I propose an intermediate account, according to which (...) |
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Pareto principles are at the core of ethics and decision theory. The Strong Pareto principle says that if one thing is better than another for someone and at least as good for everyone else, then the one is overall better than the other. But a host of famous figures express it differently, with ‘not worse’ in place of ‘at least as good.’ In the presence of parity (or incommensurability), this results in a strictly stronger Pareto principle, which I call Super‐Strong (...) |
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Value pluralists believe in multiple dimensions of value. What does betterness along a dimension have to do with being better overall? Any systematic answer begins with the Strong Pareto principle: one thing is overall better than another if it is better along one dimension and at least as good along all others. We defend Strong Pareto from recent counterexamples and use our discussion to develop a novel view of dimensions of value, one which puts Strong Pareto on firmer footing. We (...) |
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Medical ethics would be better if people were taught to think more clearly about well-being or the concept of what is good for a person. Yet for a variety of reasons, bioethicists have generally paid little attention to this concept. Here, I argue, first, that focusing on general theories of welfare is not useful for practical medical ethics. I argue, second, for what I call the “theory-without-theories approach” to welfare in practical contexts. The first element of this approach is a (...) |
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Theories of well-being are typically divided into subjective and objective. Subjective theories are those which make facts about a person’s welfare depend on facts about her actual or hypothetical mental states. I am interested in what motivates this approach to the theory of welfare. The contemporary view is that subjectivism is devoted to honoring the evaluative perspective of the individual, but this is both a misleading account of the motivations behind subjectivism, and a vision that dooms subjective theories to failure. (...) |
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The principle of beneficence directs healthcare practitioners to promote patients’ well-being, ensuring that the patients’ best interests guide treatment decisions. Because there are a number of distinct theories of well-being that could lead to different conclusions about the patient’s good, a careful consideration of which account is best suited for use in the medical context is needed. While there has been some discussion of the differences between subjective and objective theories of well-being within the bioethics literature, less attention has been (...) |
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In this paper we explore the relation between health-care needs and patients’ desires within shared decision-making in a context of priority setting in health care. We begin by outlining some general characteristics of the concept of health-care need as well as the notions of SDM and desire. Secondly we will discuss how to distinguish between needs and desires for health care. Thirdly we present three cases which all aim to bring out and discuss a number of queries which seem to (...) |
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An important objection to preference-satisfaction theories of well-being is that these theories cannot make sense of interpersonal comparisons of well-being. A tradition dating back to Harsanyi () attempts to respond to this objection by appeal to so-called extended preferences: very roughly, preferences over situations whose description includes agents’ preferences. This paper examines the prospects for defending the preference-satisfaction theory via this extended preferences program. We argue that making conceptual sense of extended preferences is less problematic than others have supposed, but (...) |
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An important objection to preference-satisfaction theories of well-being is that they cannot make sense of interpersonal comparisons. A tradition dating back to Harsanyi :434, 1953) attempts to solve this problem by appeal to people’s so-called extended preferences. This paper presents a new problem for the extended preferences program, related to Arrow’s celebrated impossibility theorem. We consider three ways in which the extended-preference theorist might avoid this problem, and recommend that she pursue one: developing aggregation rules that violate Arrow’s Independence of (...) |
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An increasingly popular view in the philosophy of art is that some artworks are good artworks at least partly because they are achievements. This view was introduced to explain why two works that look the same, such as an original painting and a perfect copy, can differ in artistic merit. An achievement theory can say that the original is better because it is a greater achievement. Achievement theories have since been used to answer other questions, and they are now a (...) |
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Deep-brain stimulation has been used to treat advanced Parkinson disease and other neurological and psychiatric disorders that have not responded to other treatments. While deep-brain stimulation can modulate overactive or underactive regions of the brain and thereby improve motor function, it can also cause changes in a patient’s thought and personality. This paper discusses the trade-offs between the physiological benefit of this technique and the potential psychological harm. |
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Most agree that, in some special scenarios, prudence can speak against feeling a fitting emotion. Some go further, arguing that the tension between fittingness and prudence afflicts some emotions in a fairly general way. This paper goes even further: it argues that, when it comes to anxiety, the tension between fittingness and prudence is nearly inescapable. On any plausible theory, an enormous array of possible outcomes are both bad and epistemically uncertain in the right way to ground fitting anxiety. What’s (...) |
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Abstract: The topic for this paper is the phenomenon of apparent value incommensurability—two goods are apparently incommensurable when it appears that neither is better than the other nor are they equally good. I shall consider three theories of this phenomenon. Indeterminists like Broome (1997) hold that the phenomenon is due to vagueness: when two goods appear to be incommensurable, this owes to the fact that “better than” is vague. Incommensurabilists like Chang (2002) hold that some goods appear to be incommensurable (...) |
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We engage with the nature and the value of achievement through a critical examination of an argument according to which biomedical “enhancement” of our capacities is impermissible because enhancing ourselves in this way would threaten our achievements. We call this the argument against enhancement from achievement. We assess three versions of it, each admitting to a strong or a weak reading. We argue that strong readings fail, and that weak readings, while in some cases successful in showing that enhancement interferes (...) |
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Recently, Derek Parfit has offered a novel solution to the “Repugnant Conclusion” that compared with the existence of many people whose quality of life would be very high, there is some much larger number of people whose existence would be better but whose lives would be barely worth living. On this solution, qualitative differences between two populations will often entail that the populations are merely “imprecisely” comparable. According to Parfit, this fact allows us to avoid the Repugnant Conclusion without violating (...) |
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This paper seeks to identify a mid-level unifying ethical principle that may help clarify and articulate the ethical responsibilities of business firms in the field of marketing ethics. The paper examines critically the main principles which have been proposed to date in the literature, namely consumer sovereignty, preserving the conditions of an acceptable exchange, paternalism, and the perfect competition ideal, and concludes that all of them are vulnerable to damaging criticisms. The paper articulates and defends the mutuality principle as the (...) |
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It is sometimes suggested that victims of unjust harm should take priority over victims of other forms of harm. We explore four arguments for this view: that victims of unjust harm experience greater suffering; that prioritizing victims of unjust harm would help prevent unjust harm in the future; that it is good for perpetrators that their victims be prioritized; and that it is impersonally better that victims of unjust harm are prioritized. We argue that the first three arguments fail but (...) |
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An important constraint on the nature of intrinsic value---the “Supervenience Principle” (SP)---holds that some object, event, or state of affairs ϕ is intrinsically valuable only if the value of ϕ supervenes entirely on ϕ 's intrinsic properties. In this paper, I argue that SP should be rejected. SP is inordinately restrictive. In particular, I argue that no SP-respecting conception of intrinsic value can accept the importance of psychological resonance, or the positive endorsement of persons, in explaining value. |
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Welfare is at least occasionally a temporal phenomenon: welfare benefits befall me at certain times. But this fact seems to present a problem for a desire-satisfaction view. Assume that I desire, at 10am, January 12th, 2010, to climb Mount Everest sometime during 2012. Also assume, however, that during 2011, my desires undergo a shift: I no longer desire to climb Mount Everest during 2012. In fact, I develop an aversion to so doing. Imagine, however, that despite my aversion, I am (...) |
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This article brings together two debates in bioethics more substantively than has been the case until now. One is the methodological debate over "principlism," i.e., the theoretical framework for analyzing and solving ethical problems proposed by Beauchamp and Childress in Principles of Biomedical Ethics. The other is the normative debate about reproductive ethics, i.e., procreative rights and obligations in a time of pervasive opportunities for making detailed choices about the properties and capacities of future people. The obvious point of bringing (...) |
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Well-being is that which is non-instrumentally good for a person. It is identical to how well someone's life goes. There are three main theories of well-being: hedonism, desire-fulfillment, and objective list theories. Each of these theories is subject to criticism, which has led some philosophers to posit a hybrid theory in which well-being is defined as taking pleasure in objective goods. One problem that comes with such an account is the possibility of what I will call harmless pleasures; that is, (...) |
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Understanding is a valued trait in any epistemic practice, scientific or not. Yet, when it comes to characterizing its nature, the notion has not received the philosophical attention it deserves. We have set ourselves three tasks in this paper. First, we defend the importance of this endeavor. Second, we consider and criticize a number of proposals to this effect. Third, we defend an alternative account, focusing on abilities as the proper mark of understanding. |
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There are ethical guidelines that form the foundation of the traditional doctor–patient relationship in medicine. Health care providers are under special obligations to their patients. These include obligations to disclose information, to propose alternative treatments that allow patients to make decisions based on their own values, and to have special concern for patients’ best interests. Furthermore, patients know that these obligations exist and so come to their physicians with a significant level of trust. In this sense, therapeutic medicine significantly differs (...) |
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Might it be morally wrong to procreate? David Benatar answers affirmatively in Better Never to Have Been , arguing that coming into existence is always a great harm. I counter this view in several ways. First, I argue against Benatar’s asserted asymmetry between harm and benefit—which would support the claim that any amount of harm in a human life would make it not worth starting—while questioning the significance of his distinction between a life worth starting and one worth continuing. I (...) |
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Two competing accounts of value incomparability have been put forward in the recent literature. According to the standard account, developed most famously by Joseph Raz, ‘incomparability’ means determinate failure of the three classic value relations ( better than , worse than , and equally good ): two value-bearers are incomparable with respect to a value V if and only if (i) it is false that x is better than y with respect to V , (ii) it is false that x (...) |
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Jeremy Bentham provided a comprehensive list of the sources of pleasure and pain, rather in the manner of modern researchers into human well-being. He explicitly used the term well-being and made both qualitative and quantitative proposals for its measurement. Bentham insisted that the measurement of well-being should be firmly based on the concerns and subjective valuations of those directly concerned, in the context of a liberal society. Those who wished to superimpose other judgements were dismissed as "ipsedixitists." He also addressed, (...) |
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This paper argues that ethical reflection and dialogue can assist in understanding what animal welfare is. Questions about animal welfare’s nature are thorny and contested. Responding to an essay by Donald Bruckner, the paper acknowledges that animal welfare is a type of normative value distinct from ethical value and that the methodology for determining prudential value is not simply reducible to ethical thought. However, it contends that connections between ethics and understanding wellbeing are closer than we might expect. The paper (...) |
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Velleman, MacIntyre, and others have argued for the compositional view that lives can be other than equally good for the person who lives them even though they contain all and only the same moments, and that this is explained by their narrative structure. I argue instead for explanation by self-realization, partly by interpreting Siegfried Sassoon’s exemplary life-narrative. I decide between the two explanations by distinguishing the various features of the radial concept of narrative, and showing, for each, either that self-realization (...) |
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Policy-makers must allocate scarce resources to support constituents’ health needs. This requires policy-makers to be able to evaluate health states and allocate resources according to some principle of allocation. The most prominent approach to evaluating health states is to appeal to the strength of people’s preferences to avoid occupying them, which we refer to as decision utility metrics. Another approach, experienced utility metrics, evaluates health states based on their hedonic quality. In this article, we argue that although decision utility metrics (...) |
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The philosophical literature on well-being and the good life contains very little explicit discussion of what makes for a better or worse death. The purpose of this essay is to highlight some commonly held views about the good death and investigate whether these views are recognized by the leading theories of well-being. While the most widely discussed theories do have implications about what constitutes a good death, they seem unable to fully accommodate these popular good death views. I offer two (...) |
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The so-called Disability Paradox arises from the apparent tension between the popular view that disability leads to low well-being and the relatively high life-satisfaction reports of disabled people. Our aim in this essay is to make some progress toward dissolving this alleged paradox by exploring the relationship between disability and various “goods of life”—that is, components of a life that typically make a person’s life go better for her. We focus on four widely recognized goods of life (happiness, rewarding relationships, (...) |
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Many neo-Aristotelians argue that practical identities are normative, that is, they provide us with reasons for action and create binding obligations. Kantian constructivists agree with this insight but argue that contemporary Aristotelians fail to fully justify it. Practical identities are normative, Kantian constructivists contend, but their normativity necessarily derives from the normativity of humanity. In this paper, I shed light on this underexplored similarity between neo-Aristotelian and Kantian constructivist accounts of the normativity of practical identities, and argue that both ultimately (...) |
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The purpose of this article is to present a normative theory of the goals of medicine (a theory that tells us in what respects medicine should benefit the patient) that is both comprehensive and unified. A review of the relevant literature suggests that there are at least seven plausible goals that are irreducible to each other, namely to promote functioning, to maintain or restore normal structure and function, to promote quality of life, to save and prolong life, to help the (...) |
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The potential of physical activity to improve our health has been the subject of extensive research [38]. The relationship between physical activity and well-being has prompted substantial interest from exercise psychologists in particular [3], and it seems, is generating increasing interest outside the academic community in healthcare policy and practice inter alia through GP referrals for exercise. Researchers in the field have benefited from a rich tradition within psychology that investigates subjective well-being and its antecedents [7]. We argue that the (...) |
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This paper presents a new, third-personal account of empathy that characterizes empathy as being sensitive to others’ concerns as opposed to remaining stuck in one’s egocentric perspective on the world. The paper also demonstrates why this account is preferable to its two main rivals, namely the simulation theory of empathy, and the direct perception theory of empathy. |
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To protect children in research, procedures that are not administered in the medical interests of a child must be restricted. The risk threshold for these procedures is generally measured according to the concept of minimal risk. Minimal risk is often defined according to the risks of “daily life.” But it is not clear whose daily life should serve as the baseline; that is, it is not clear to whom minimal risk should refer. Commentators in research ethics often argue that “minimal (...) |
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The risk that direct-to-consumer advertising of prescription pharmaceuticals (DTCA) may increase inappropriate medicine use is well recognized. The U.S. Food and Drug Administration addresses this concern by subjecting DTCA content to strict scrutiny. Its strictures are, however, heavily focused on the explicit claims made in commercials, what we term their “propositional content.” Yet research in social psychology suggests advertising employs techniques to influence viewers via nonpropositional content, for example, images and music. We argue that one such technique, evaluative conditioning, is (...) |
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Most people have a clear sense of what they mean by disability, and have little trouble identifying conditions they consider disabling. Yet providing a clear and consistent definition of disability is far from straightforward. Standardly, disability is understood as the restriction in our abilities to perform tasks, as a result of an impairment of normal physical or cognitive human functioning. However, which inabilities matter? We are all restricted by our bodies, and are all incapable of performing some tasks, but most (...) |
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