The aim of the present paper is to describe three different attempts, which have been made by philosophers, to define what quality of life is; and to spell out some of the difficulties that faces each definition. One, Perfectionism, focuses on the capacities that human beings possess: capacities for friendship, knowledge and creative activity, for instance. It says that the good life consists in the development and use of these capacities. Another account, the Preference Theory, urges that satisfying one's preferences, (...) or desires, is what improves one's quality of life. And a third account, Hedonism, sees life-quality as consisting in the enjoyment of pleasure and the avoidance of pain. The paper describes and evaluates objections to each of these views, thereby displaying their weaknesses and strengths. Since no view comes out as the right one there is a choice to be made. At the end of the paper it is being discussed how well each of the views cohere with different methodologies used in quality of life research. Also it is suggested that considerations about what the research is to be used for are relevant. (shrink)

I defend the theory that one's life is meaningful to the extent that one promotes the good. Call this the good cause account (GCA) of the meaning of life. It holds that the good effects that count towards the meaning of one's life need not be intentional. Nor must one be aware of the effects. Nor does it matter whether the same good would have resulted if one had not existed. What matters is that one is causally responsible for the (...) good. I argue that the best theory of the meaning of life should clearly distinguish between subjective fulfillment and objective meaningfulness. The GCA respects the distinction. And it is superior to its leading rivals in the recent literature, most notably those of Erik Wielenberg and Susan Wolf. (shrink)

How should we assess the burden of moral demands? A predominant assessment is provided by what Murphy calls the baseline of factual status-quo (FSQ): A moral theory is demanding if the level of agents’ well-being is reduced from the time they begin to comply perfectly with the theory. The aims of my paper are threefold. I will first discuss the limits of the FSQ baseline. Second, I suggest a different assessment, which examines moral demands from a whole-life perspective. My view (...) is that even if agents’ compliance with a moral theory will not cause a substantial reduction to their existing level of well-being, the total quality of life that they may obtain from complying with this theory may still be lower than what they could have obtained by following some other moral theories. The third aim of this paper is that, through this investigation, I hope to explicate the relation between agents’ acceptance of a moral theory and the burden of demands that is created by it. I believe that we can achieve a more comprehensive understanding of the nature of moral demands by paying attention to the psychological development of agents as they accept and internalize a moral theory. (shrink)

Recently, some of the leading proponents of the view that there is widespread incommensurability among goods have suggested that the incommensurability of some goods is a constitutive feature of the goods themselves. So, for example, a friendship and a million dollars are incommensurable because it is part of what it is to be a friendship that it be incommensurable with money. According to these ‘constitutive incommensurabilists’ incommensurability follows from the very nature of certain goods. In this paper, I examine this (...) idea and argue that constitutive incommensurabilists have mistaken for constitutive incommensurability a particular emphatic kind of comparability. This examination involves an account of ‘higher’ and ‘lower’ goods and an explanation of how goods of different ‘types’ figure in practical conflict. (shrink)

What, if anything, directly detracts from well-being? Objective list theorists affirm basic goods such as knowledge, friendship, and achievement, but it is less clear what they should say about opposing bads. In this paper, I argue that false beliefs, unhealthy relationships, and failed projects are not basic bads and do not directly detract from well-being. They can have bad effects or elements, or block the realization of basic goods, but do not themselves carry negative weight with respect to well-being. This (...) is shown by comparing cases where these bads are present and absent, examining their relation to negative overall well-being, and considering the role of these bads in the pursuit of positive goods. (shrink)

Two practical measures that have been introduced in an effort to stop sports parents from behaving badly will be critically discussed. The first measure is known under the slogan quiet weekends'. These prohibit parents from attending games in which their child is participating. Although this strategy calls attention to an important issue, it is unfair. The second, and far more elaborate, measure is to have a set of ethical guidelines informing parents how they should behave towards their child and others (...) in the context of sport. Two central values tend to run through these guidelines: namely parental concern for the child's autonomy and parental concern for the child's well-being. These values are discussed as I apply them to cases in what can be called a grey area, where it is not obvious what is morally right or wrong. In the concluding discussion a tentative checklist will be presented which good sports parents can use when they are confronted with ethical issues. (shrink)

Transmission views of testimony hold that a speaker's knowledge or justification can become the audience's knowledge or justification. We argue that transmission views are incompatible with the hypothesis that one's epistemic state, together with one's practical circumstances, determines what actions are rationally permissible for an agent. We argue that there are cases where, if the speaker's epistemic state were transmitted to the audience, then the audience would be warranted in acting in particular ways. Yet, the audience in these cases is (...) not so warranted, as their strength of justification does not come close to the speaker's. (shrink)

The perspectives of the dominant Western ethical theories, have dominated the concepts of autonomy and informed consent for many years. Recently this dominant understanding has been challenged by ethics of care which, although, also emanates from the West presents a more nuanced concept: relational autonomy, which is more faithful to our human experience. By paying particular attention to relational autonomy, particularity and Process approach to ethical deliberations in ethics of care, this paper seeks to construct a concept of informed consent (...) from the perspective of ethics of care which is here called relational autonomy-in-informed consent. Thus, providing a broader theoretical basis for informed consent beyond the usual theoretical perspectives that are particularly Western. Care ethics provides such a broader basis because it appeals to a global perspective that encompasses lessons from other cultures, and this will help to enrich the current ideas of bioethics principles of autonomy and informed consent. This objective will be achieved by exploring the ethics of care emphasis on relationships based on a universal experience of caring; and by contrasting its concept of autonomy as relational with the understanding of autonomy in the approaches of the dominant moral theories that reflect rational, individualistic, and rights-oriented autonomy of the American liberalism. (shrink)

Scholars of religion and science have generated remarkable scholarship in recent years in their explorations of love. Exactly how scholars involved in this budding field believe that love and science should relate and/or be integrated varies greatly. What they share in common is the belief that issues of love are of paramount importance and that the various scientific disciplines—whether natural, social, or religious—must be brought to bear upon how best to understand love. I briefly introduce the emergence of the love‐and‐science (...) research program and note that scholars have not done well defining what they mean by love. I suggest that the present surge in love scholarship will fail to produce the positive results that it otherwise might if love is not defined well. I provide and defend a definition of love adequate for those doing love‐and‐science research: To love is to act intentionally, in sympathetic response to others (including God), to promote well‐being. To explain better what this simple definition entails, I explore its three main phrases. Love is said to have many forms, but agape is the form to which the love‐and‐science literature most commonly refers. I comment briefly on the debates about how to best understand agape, noting sixteen different definitions proposed by major scholars. I identify weaknesses in many of them and then offer what I argue is a more adequate definition of agape as intentional response to promote well‐being when confronted by that which generates ill‐being. In short, agape repays evil with good. While research on love and science requires much more than adequate definitions, I believe that the definitions I proffer can prove useful in furthering the love‐and‐science research program. (shrink)

I argue that all rights exist by convention. According to my definition, a right exists by convention just in case its justification appeals to the rules of a socially shared pattern of acting. I show that our usual justifications for rights are circular, that a right fulfills my criterion if all possible justifications for it are circular, and that all existing philosophical justifications for rights are circular or fail. We find three non-circular alternatives in the literature, viz. justifications of rights (...) by consequences, by autonomy or by divine commands. I show that all three alternatives fail, and I conclude that all rights exist by convention. This ontological result has a surprising and beneficial consequence. A common argument against conventionalism is that it implies cultural relativism. I finish by showing that the suggested conventionalism is incompatible with cultural relativism. (shrink)

In this paper, I criticize the view that non-conscious entities—such as plants and bacteria—have well-being. Plausible sources of well-being include pleasure, the satisfaction of consciously held desires, and achievement. Since nonconscious entities cannot obtain well-being from these sources, the most plausible source of well-being for them is the exercise of natural capacities. Plants and bacteria, for example, certainly do exercise natural capacities. But I argue that exercising natural capacities does not in fact contribute (in a non-instrumental way) to well-being. I (...) do so by presenting cases in which human beings exercise natural capacities that they do not enjoy exercising and that they do not desire (non-instrumentally) to exercise. I also argue that plausible views about fortune—how one’s well-being ranks on an appropriate scale—do not support the claim that exercising natural capacities contributes to well-being. (shrink)

This article outlines an objective list theory of animal and alien well-being. Responding to three sorts of perfectionist criticism of such OLT, it argues that OLT is actually superior on each count. This is significant, because perfectionism is much discussed yet OLT is little discussed in philosophy of animal well-being, and because perfectionism can reasonably be expected to do comparatively well on the points where it is criticizing OLT.

This paper explores what is meant by ‘loss and damage’ within the area of climate policy focused on loss and damage. I present two possible understandings of loss and damage, one of which connects it to harm and one of which connects it to value. In both cases, I argue that the best contemporary philosophical understandings of these concepts suggest a much broader range of losses and damages than is currently being considered within the usual discussions in this area. I (...) argue that a broader understanding of loss and damage would allow a more complete assessment of potential climate impacts. I conclude by offering recommendations for evaluating loss and damage according to this broader understanding. (shrink)

This paper considers a new problem for desire theories of well-being. The problem claims that these theories are implausible because they misvalue the effects of fleeting desires, long-standing desires, and fluctuations in desire strength on well-being. I begin by investigating a version of the desire theory of well-being, simple concurrentism, that fails to capture intuitions in these cases. I then argue that desire theories of well-being that are suitably stability-adjusted can avoid this problem. These theories claim that the average strength (...) of a desire, and the length of time that it is held, both influence the extent to which its fulfilment or frustration affects well-being. I end by considering whether value-fulfilment theories of well-being have a more attractive response to this problem. I find that these theories have significant downsides that make them unappealing alternatives. (shrink)

Schools often aim at creating opportunities for good life and at promoting a good society. Liberal theorization on schooling is premised on a functioning liberal democracy with a capitalist economy. However, postcolonial societies are characterized by poverty and inequality, cultural diversity, and an ongoing project of state and nation building. This challenges some of the foundational assumptions of liberal conceptions of schooling aimed at promoting good life and good society in postcolonial societies. Realization of good life through schools is shaped (...) both by shaping of ‘consciousness, identities, and desires’ [Bernstein ] and through imparting knowledge and skills that help realize these desires in particular contexts. These schooling practices have different influences on opportunities for good life in short, medium, and long terms in these societies. A conceptual model of schooling that addresses these complexities is key to understanding the processes that influence the opportunities for a pursuit of good life through schooling in postcolonial societies. Such a model could draw upon the existing theories of liberal schooling but would have to adapt them to respond to the contexts of postcolonial societies. (shrink)

This article explores the possibility that there is a parental duty to use preimplantation genetic diagnosis (PGD) for the medical benefit of future children. Using one genetic disorder as a paradigmatic example, we find that such a duty can be supported in some situations on both ethical and legal grounds. Our analysis shows that an ethical case in favor of this position can be made when potential parents are aware that a possible future child is at substantial risk of inheriting (...) a serious genetic condition. We further argue that a legal case for a duty to use PGD for medical benefit can be made in situations in which potential parents have chosen to conceive through in vitro fertilization and know that any children conceived are at substantial risk of having a serious genetic condition. (shrink)

It may seem paradoxical to speak of the ‘goodlife’ for demented elderly. Many people consider dementia to be a life-wrecking disease and nursing homes to be terrible places. Still, it is relevant to ask how we can make life as good as possible for demented nursing home residents. This paper explores what three standard philosophical accounts of well-being — subjective preference theory, objectivist theories, and hedonism — have to say about the good life for demented people. It is concluded that (...) the relevant differences between the various philosophical theories manifest themselves not so much in their general account of the substantial content of ‘the good life’ but in a number of specific controversies. These concern the nature of well-being, the necessity of endorsement by the patient, the value of experience and the need for experiences to be rooted in reality. Moreover, it is argued that further research should pay detailed attention to the process of dementia and to the effects of this process on patients' identities, self-conceptions, capacities, preferences, values and the like, and that a narrative approach which incorporates the factor time may offer a more comprehensive account of the good life for demented elderly. (shrink)

This essay examines the classical Confucian perspective on the topic of happiness through the lens of three Western theories: hedonism, desire satisfaction theory, and objective list theory. My analysis of the two classical texts—the Analects and the Mencius —reveals that three salient aspects of the Confucian conception of happiness, namely ethical pleasure, ethical desire, and moral innocence, play the fundamental role in the guidance and evaluation of an individual’s life. According to Confucius and Mencius, happiness consists primarily not in pleasure, (...) but in ethical pleasure; the good life is not a life in which all or most of one’s desires are fulfilled, but a life in which the satisfaction of prudential desires is subject to the constraint of ethical desire; the source of the greatest happiness lies not in the attainment of the greatest political power, but rather in the cognizance of one’s moral innocence. For classical Confucian thinkers, the relationship between happiness and the good life is that happiness is a critically important constituent of the good life. However, happiness—defined in terms of pleasure, desire satisfaction, or a list of goods—needs to be tempered by moral constraints. In light of their views on happiness and the good life, I conclude that Confucius and Mencius each lived a good life that exemplified the three salient features of happiness, and to that extent they were happy. (shrink)

Clients may feel trapped into sharing their private digital data with insurance companies to get a desired insurance product or premium. However, private insurance must collect some data to offer products and premiums appropriate to the client’s level of risk. This situation creates tension between the value of privacy and common insurance business practice. We argue for three main claims: first, coercion to share private data with insurers is pro tanto wrong because it violates the autonomous choice of a privacy-valuing (...) client. Second, we maintain that irrespective of being coerced, the choice of accepting digital surveillance by insurers makes it harder for the client to protect his or her autonomy. The violation of autonomy also makes coercing customers into digital surveillance pro tanto morally wrong. Third, having identified an economically plausible process involving no direct coercion by insurers, leading to the adoption of digital surveillance, we argue that such an outcome generates further threats against autonomy. This threat provides individuals with a pro tanto reason to prevent this process. We highlight the freedom dilemma faced by regulators who aim to prevent this outcome by constraining market freedoms and argue for the need for further moral and empirical research on this question. (shrink)

Retributive approaches to the justification of legal punishment are often thought to place exacting and unattractive demands on state officials, requiring them to expend scarce public resources on apprehending and punishing all offenders strictly in accordance with their criminal ill deserts. Against this caricature of the theory, I argue that retributivists can urge parsimony in the use of punishment. After clarifying what parsimony consists in, I show how retributivists can urge reductions in the use of punishment in order to conserve (...) scarce resources for other valuable social purposes, minimize the foreseeable and adverse effects of legal punishment on the innocent, and accommodate the fact that existing societies fail in numerous ways to satisfy the conditions that make retributive punishment fully justified. (shrink)

1. Brian Hedden, in this impressively learned and ingenious, if somewhat maddening book,1 1 defends a view he calls Time-slice Rationality, a view comprising two central claims. They are: Synchronicity : All requirements of rationality are synchronic. Impartiality : In determining how you rationally ought to be at a time, your beliefs about what attitudes you have at other times play the same role as your beliefs about what attitudes other people have.

This paper provides a philosophical critique of social choice theory insofar as it deals with the normative evaluation of voting and voting rules. I will argue that the very method of evaluating voting rules in terms of whether they satisfy various conditions is deeply problematic because introducing strategic behaviour leads to a violation of any condition that makes a difference between voting rules. I also argue that it is legitimate to make interpersonal comparisons of utilities in voting theory. Combining a (...) realistic account of voters’ behaviour with a utilitarian evaluation of the outcomes then leads to the judgment that strategic voting is beneficial. If it is, then Arrow's theorem does not have far-reaching consequences for democracy because one of its conditions is not normatively acceptable. (shrink)

In this paper, I ask how – and whether – the rectification of injury at which corrective justice aims is possible, and by whom it must be performed. I split the injury up into components of harm and wrong, and consider their rectification separately. First, I show that pecuniary compensation for the harm is practically plausible, because money acts as a mediator between the damaged interest and other interests. I then argue that this is also a morally plausible approach, because (...) it does not claim too much for compensation: neither can all harms be compensated, nor can it be said when compensation is paid that the status quo ante has been restored. I argue that there is no conceptual reason for any particular agent paying this compensation. I then turn to the wrong, and reject three proposed methods of rectification. The first aims to rectify the wrong by rectifying the harm; the second deploys punitive damages; the third, punishment. After undermining each proposal, I argue that the wrong can only be rectified by a full apology, which I disaggregate into the admission of causal and moral responsibility, repudiation of the act, reform, and, in some cases, disgorgement and reparations, which I define as a good faith effort to share the burden of the victim’s harm. I argue, further, that only the injurer herself can make a full apology, and it is not something that can be coerced by other members of society. As such, whether rectification of the wrong can be a matter of corrective justice is left an open question. (shrink)

Many philosophers with hedonistic sympathies (e.g., Mill, Sidgwick, Sumner, Feldman, Crisp, Heathwood, and Bradley) have claimed that well-being is necessarily experiential. Kagan once claimed something slightly different, saying that, although unexperienced bodily events can directly impact a person’s well-being, it is nonetheless true that any change in a person’s well-being must involve a change in her (i.e., either in her mind or in her body). Kagan elaborated by saying that a person’s well-being cannot float freely of her such that it (...) is affected by events that do not affect her (Kagan 1992, 169–189). These two claims—that well-being is necessarily experiential and that changes in well-being must involve changes in the person—are two different ways of specifying the general intuition that a person’s well-being must be strongly tied to her. This general intuition imposes an adequacy constraint on welfare theorizing: To be adequate, a welfare theory cannot allow that someone can be directly benefited by events that are not strongly tied to her. Call this the strong-tie requirement. The strong-tie requirement is easily satisfied by welfare hedonism, but it poses problems for desire-fulfillment welfare theories and objective-list welfare theories. Though a great deal has been written about desire-fulfillment welfare theories in relation to the strong-tie requirement, not as much has been written about objective-list welfare theories in relation to the strong-tie requirement. This paper argues that objective-list welfare theories can satisfy the strong-tie requirement, though probably only if they take a perfectionist form, as opposed to a brute-list form. (shrink)

In this article, we present a contextually embedded choice theory. Using concepts and tools of poset mathematics, we show how to include in rational choice theory cultural and social effects. Specifically, we define some choice superstructures, seen as choice set transformations imposed by cultural and social norms. As we shall argue, these transformations can be of help to explain choice behavior within different contexts. Moreover, we show that, once choice superstructures are taken into account, some well-known results about maximizing and (...) optimizing behavior are easily confirmed and some insights on intransitive choices may be phased out. (shrink)

Several prominent ethical philosophers have attempted to demonstrate that there exist instances or types of value that are of crucial moral significance but which cannot legitimately be compared with one another. Bernard Williams and Michael Stocker, for example, argue that it can sometimes be rational to regret having chosen the all-things-considered better of two alternatives, and that this sense of regret entails that the goodness of the worse option is not made up for by and is therefore incommensurable with that (...) of the better. Joseph Raz and others have made similar points. In this paper, I propose a theory of value that is monistic in that it countenances just one sort of morally crucial value, but pluralistic in that several distinct properties bearer this value. I then explain how this view avoids incommensurable values without doing violence to the core intuitions that seemed to necessitate them, and how it fits into a larger conception of morality, right conduct, and moral psychology. (shrink)

According to a standard picture, for any two comparable objects and a basis for comparison, either one is greater than the other or they are equal with respect to the basis. This picture has been called the Trichotomy Thesis, and although it is intuitive and plausible, it has been called into question by such philosophers as Derek Parfit, James Griffin, Joseph Raz, and Ruth Chang. Chang’s discussion is particularly rich, for she proposes and provides a detailed account of a possible (...) fourth relation that, she argues, provides a satisfying explanation of hard cases of comparison. In this paper, I will examine a version of the main argument against the Trichotomy Thesis and attempt to show that it is unsound. (shrink)

Although the thesis that the moral better than relation is transitive seems obviously true, there is a growing literature according to which Parfit’s repugnant conclusion and related puzzles reveal that this thesis is false or problematic. This paper begins by presenting several such puzzles and explaining how they can be used in arguments for the intransitivity of better than. It then proposes and defends a plausible alternative picture of the behavior of better than that both resolves the repugnant conclusion and (...) preserves transitivity. On the threshold-based model of lexicality defended here, hedonic episodes whose intensity is above a certain point are lexically greater than those whose intensity is below it. The final sections argue that this model is independently plausible and can be defended from several important objections. (shrink)

This paper raises an objection to two important arguments for reductive ethical naturalism. Reductive ethical naturalism is the view that ethical properties reduce to the properties countenanced by the natural and social sciences. The main arguments for reductionism in the literature hold that ethical properties reduce to natural properties by supervening on them, either because supervenience is alleged to guarantee identity via mutual entailment, or because non-reductive supervenience relations render the supervenient properties superfluous. After carefully characterizing naturalism and reductionism, we (...) will present, explain, and raise objections against each of the main reductionist arguments: that supervenience does not support the claim that ethical properties and their subvenient natural properties are mutually entailing; that reductive views undermine the claim that ethical properties yield resemblance; and that supervenience does not entail that non-descriptive ethical properties are superfluous in the most fundamental sense. (shrink)

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 (...) each and every disgusting and disheartening fact about the world? Perceiving the world in a way that is neither clear-eyed nor complete may not be without its advantages. But even if being mistaken about the world or self-deceived causes one to be healthier or more comfortable, it is worth asking whether there is something to be said against a life of this kind. Might there not be some knowledge about ourselves or the world that we ought to have? Do not these ‘positive illusions,’ or flattering but inaccurate beliefs that people have about themselves and the world, interfere with their ability to live the good life? In the first part of this paper, I will briefly review the psychological literature which suggests that mild self-deception in the positive direction contributes to, rather than compromises, a person’s well-being. I will then, in the second part of the paper, examine what three thinkers, Joseph Butler, Immanuel Kant, and W.K. Clifford, have said about the wrongfulness of self-deception. While their arguments call attention to various reasons for thinking that some cases of self-deception might give rise on balance to negative consequences, they fail to show that all cases must have this effect. In the final part of the paper, I will consider whether our interest in autonomy might provide us with a better explanation of the supposed wrongfulness of self-deception. I will try to show that in virtue of being mistaken alone, the self-deceiver generally experiences some loss of a particular kind of autonomy. Nevertheless, my analysis will leave open the following two possibilities: that the loss of autonomy was autonomously brought about, and that the loss of autonomy in question may result on balance in an increase in the self-deceiver’s autonomy. (shrink)

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 (...) statement of this standard assumption, and then show that it is subject to counterexamples. The possibility of such counterexamples depends only on premises similar to those sometimes invoked to argue that a person’s well-being over a long period is not simply the aggregate well-being of the shorter periods that compose the long period. The refutation of the standard assumption linking well-being and life-goodness entails that these are distinct and sometimes divergent values. As an alternative to the standard assumption, it is proposed that well-being is best understood as an ingredient in a good life. (shrink)

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 (...) and highlight the significant philosophical implications they have for understanding both well-being and health. (shrink)

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 (...) barriers that were met along the way, originating from different points, such as the nationalistic approach on the matter that most wealthy countries have adopted or the inability of poor countries to purchase or manufacture vaccines. Further, a suggestion regarding the ethical principles and values that ought to guide global vaccine allocation and distribution is provided with a higher priority given to helping the worst-off, saving the most lives, protecting people in high risk, such as frontline healthcare professionals, and minimising social gaps, along with an ethical theoretical background for each prioritisation. It is not too late for wealthy countries to realise that vaccine inequity prolongs pandemics, so that they change their policies in favour of the global common good that will not only provide immediate universal benefits but will also serve as a guide for future pandemic crises. (shrink)

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 (...) distributive questions: when do we have sufficient and how should we prioritise among those who do not yet have a sufficiency? Furthermore, it is argued that Roger Crisp’s theory of need, which combines sufficientarianism with prioritarianism below the threshold of need, is better equipped than alternatives to answer these questions as well as meeting the challenges formulated by Hope, Østerdal and Hasman. However, Crisp’s theory faces two major challenges. First, it has to say something about the currency of distribution: a principle of need must be complemented either with a theory on the human good or a theory about the proper goals of health care. Second, it has to say something about where the threshold should be set. However, any attempt to set a threshold seems morally arbitrary in the light of the sufficientarian idea that those just above the threshold never should be given priority over those just below the threshold. (shrink)

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 (...) distinguish between a number of kinds of cases in which what I call proxy anxiety serves a positive function, including Anxiety Avoidance (where there is good reason for an agent to avoid becoming anxious herself, but can benefit from a friend’s anxiety on her behalf), Anxiety Omission (where an agent fails to become anxious due to a malfunctioning anxiety-generating system), long-term commitments involving dispositions to feel other-directed proxy anxiety, and cases in which proxy anxiety can help reduce or relieve excessive anxiety. A person’s friends, it is argued, are particularly well positioned to help regulate deficient and/or excessive anxieties, precisely because friends are close enough to care for and identify with the agent, but at the same time distant enough to maintain a relatively objective perspective. I conclude by examining connections between proxy anxiety and theories of well-being. (shrink)

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 (...) the very conceptions of rationality and desire that underlie orthodox Humeanism. This rational principle then provides a new account of the substantive rationality of desire, which in turn has some interesting implications in metaethics and first-order normative theories. (shrink)

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 (...) that excluding the welfare issues of being deprived of life from the ethical assessment of killing distorts the ethical considerations. (shrink)

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 (...) objections from Oshana, that there are good reasons for maintaining the notion of autonomy in this role, and thus that such relational conceptions should not be accepted. This rejection goes beyond that from John Christman, which holds only for those relational conditions which are value-laden. (shrink)

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 (...) concrete details that would make them irrelevant. If we do this, we may see our feelings about the experience machine becoming less negative. Second, I argue that, even if our feelings about the experience machine do not perfectly track hedonistic reasons, there are various reasons to doubt the reliability of our anti-hedonistic intuitions. And finally, I argue that, since in the actual world seeing certain things besides pleasure as ends in themselves may best serve hedonistic ends, hedonism may justify our taking these other things to be intrinsically valuable, thus again making the existence of our seemingly anti-hedonistic intuitions far from straightforward evidence for the falsity of hedonism. (shrink)

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 (...) well-being is constituted by endorsed veridical experiences. This account refers back to theories of well-being but does so as agnostically as possible. An intermediate account of well-being is meant as a policy guiding compromise between the different theories of well-being that make claims regarding what constitutes well-being. An intermediate account does as well as can be hoped for in providing a basis for well-being policy. (shrink)

The psychological condition of being happy is best understood as a matter of a person's emotional condition. I elucidate the notion of an emotional condition by introducing two distinctions concerning affect, and argue that this “emotional state” view is probably superior on intuitive and substantive grounds to theories that identify happiness with pleasure or life satisfaction. Life satisfaction views, for example, appear to have deflationary consequences for happiness’ value. This would make happiness an unpromising candidate for the central element in (...) a theory of well-being, as it is in L. W. Sumner's work. Yet on an emotional state conception, happiness may prove to be a key constituent of well-being. the emotional state view also makes happiness less vulnerable to common doubts about the importance of happiness, and indicates that mood states are more important for well-being than is generally recognized.Happiness in intelligent people is the rarest thing I know.Ernest Hemingway. (shrink)

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. (...) I suggest that we need to revisit and reinstate certain features of traditional hedonism, in particular the idea that felt experience plays a role that no theory of welfare can afford to ignore. I then offer a sketch of a theory that is subjective in my preferred sense and avoids the worst sins of hedonism as well as the problems generated by the contemporary constraints of subjective theorists. (shrink)

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 (...) focus on examining important and relatively uncontroversial constituents of welfare as opposed to general theories. The second key element is a framework for thinking about choice in relation to welfare, a framework I refer to as “the mild objectivity framework.” I conclude with illustrations of the way in which the “theory without theories approach” can improve thinking in medicine. (shrink)

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 (...) given to the questions of what work a theory of well-being needs to do in bioethics and which standards of success ought to be used in selecting a theory of well-being for use in medicine. In this article, I argue that traditional theories of well-being developed in philosophy are not well suited to meet the needs of the medical context. For the principle of beneficence to be most useful, the underlying account of well-being should satisfy two conditions: first, it needs to lead to a concrete, action-guiding determination of the patient’s good; and, second, any recommendations it offers need to be justifiable to patients. Standard accounts of well-being have difficulty satisfying both conditions. Exploring the limitations of these theories when applied to treatment dilemmas helps point the way toward the development of an account of well-being better suited to healthcare. (shrink)

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 (...) arise due to the double focus on a patient’s need and what that patient desires. These queries regard the following themes: the objectivity and moral force of needs, the prediction about what kind of patients which will appear on a micro level, implications for ranking in priority setting, difficulties regarding assessing and comparing benefits, and implications for evidence-based medicine. (shrink)

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 (...) that even so extended preferences do not provide a promising way for the preference satisfaction theorist to make interpersonal well-being comparisons. Our main objection takes the form of a trilemma: depending on how the theory based on extended preferences is developed, either the result will be inconsistent with ordinary preference-satisfaction theory, or it will fail to recover sufficiently rich interpersonal well-being comparisons, or it will take on a number of other arguably odd and undesirable commitments. (shrink)

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 (...) Irrelevant Alternatives condition. (shrink)

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 (...) serious alternative to traditional theories of artistic merit. This paper has three aims. The first is to articulate the achievement theory more fully and explicitly than its advocates have. The second is to show that the achievement theory should be rejected, by raising five problems for it. The third is to show that appealing solely to the excellence, aptitude, and ineptitude a work manifests yields a better theory of artistic merit. (shrink)