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Switch to: References
Citations of:
Well-being: its meaning, measurement, and moral importance
Oxford [Oxfordshire]: Clarendon Press (1986)
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It has become somewhat a commonplace in recent political philosophy to remark that all plausible political theories must share at least one fundamental premise, ‘that all humans are one another's equals’. One single concept of ‘basic equality’, therefore, is cast as the common touchstone of all contemporary political thought. This paper argues that this claim is false. Virtually all do indeed say that all humans are ‘equals’ in some basic sense. However, this is not the same sense. There are not (...) |
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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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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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Hayek claimed that the idea of social justice is meaningless in a market economy because in that context, no identifiable agent intentionally brings about the distribution of wealth. But the assumption that the existence of injustice entails an identifiable agent of injustice is erroneous. Moreover, Hayek ignores the fact that in a market economy, the broad pattern of economic outcomes is foreseeable even if detailed, person‐by‐person outcomes are not. Hayek's rejection of the idea of social justice reveals a striking naïveté (...) |
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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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Ethics, Policy & Environment, Volume 14, Issue 3, Page 313-327, October 2011. |
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Policies and position statements regarding decision-making for extremely premature babies exist in many countries and are often directive, focusing on parental choice and expected outcomes. These recommendations often state survival and handicap as reasons for optional intervention. The fact that such outcome statistics would not justify such approaches in other populations suggests that some other powerful factors are at work. The value of neonatal intensive care has been scrutinized far more than intensive care for older patients and suggests that neonatal (...) |
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As behavioural economics reveals, human decision-making deviates from neoclassical assumptions about human behaviour and people (often) fail to make the ‘right’ welfare-enhancing choice. The purpose of Sunstein and Thaler’s concept of ‘nudge’ is to improve individual welfare. To provide normative justification, they argue that the only relevant normative criterion is whether the individual is ‘better off as judged by themselves’, so that the direction in which people are to be nudged is defined by their own preferences. In light of behavioural (...) |
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The main body of this paper assesses a leading recent theory of fairness, a theory put forward by John Broome. I discuss Broome's theory partly because of its prominence and partly because I think it points us in the right direction, even if it takes some missteps. In the course of discussing Broome's theory, I aim to cast light on the relation of fairness to consistency, equality, impartiality, desert, rights, and agreements. Indeed, before I start assessing Broome's theory, I discuss (...) |
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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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in recent years, policy makers have shown increasing interest in implementing policies aimed at promoting individual well-being. But how should policy makers choose their well-being policies? a seemingly reasonable first step is to settle on an agreed-upon definition of well-being. yet there currently is significant disagreement on how well-being ought to be characterized, and agreement on the correct view of well-being does not appear to be forthcoming. Nevertheless, i argue in this paper that there are several reasons to think that (...) |
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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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The harms of climate change are deeply uncertain. Though climate change will render most individuals more vulnerable to harm, many individuals will not actually suffer climate-related harms. In this paper, I argue that vulnerability to harms is itself a harm, because it undermines our enjoyment of the good of security. After some brief remarks on the concept of security, I give three reasons for thinking that depriving an individual of the security of basic goods harms them: it has a strong (...) |
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How should one understand comparisons in which neither of two alternatives is at least as good as the other? Much recent literature on comparability problems focuses on what the appropriate explanation of the phenomenon is. Is it due to vagueness or the possibility of non-conventional comparative relations such as parity? This paper argues that the discussions on how to best explain comparability problems has reached an impasse at which it is hard to make any progress. To advance the discussion we (...) |
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The desire-satisfaction theory of welfare says, roughly, that one's life goes well to the extent that one's desires are satisfied. On standard 'actualist' versions of the theory, it doesn't matter what you desire. So long as you are getting what you actually want – whatever it is – things are going well for you. There is widespread agreement that these standard versions are incorrect, because we can desire things that are bad for us -– in other words, because there are (...) |
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Hedonism and the desire-satisfaction theory of welfare are typically seen as archrivals in the contest over identifying what makes one's life go best. It is surprising, then, that the most plausible form of hedonism just is the most plausible form of desire satisfactionism. How can a single theory of welfare be a version of both hedonism and desire satisfactionism? The answer lies in what pleasure is: pleasure is, in my view, the subjective satisfaction of desire. This thesis about pleasure is (...) |
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I defend a methodology for theorizing about happiness. I reject three methods: conceptual analysis; scientific naturalism; and the “pure normative adequacy” approach, where the best conception of happiness is the one that best fills a role in moral theory. The concept of happiness is a folk notion employed by laypersons who have various practical interests in the matter, and theories of happiness should respect this fact. I identify four such interests in broad terms and then argue for a set of (...) |
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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 (...) |
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This paper argues against hedonistic theories of happiness. First, hedonism is too inclusive: many pleasures cannot plausibly be construed as constitutive of happiness. Second, any credible theory must count either attitudes of life satisfaction, affective states such as mood, or both as constituents of happiness; yet neither sort of state reduces to pleasure. Hedonism errs in its attempt to reduce happiness, which is at least partly dispositional, to purely episodic experiential states. The dispositionality of happiness also undermines weakened nonreductive forms (...) |
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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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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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This essay responds to the helpful criticisms of Valuing Health: Well-Being, Freedom, and Suffering, which have been offered by Elselijn Kingma, Adam Oliver, Anna Alexandrova, Alex Voorhoeve, Erik Nord and James Wilson. I am extremely grateful to Jonathan Wolf and especially James Wilson for arranging a one-day conference on my book, Valuing Health: Well-Being, Freedom, and Suffering [Hausman, D.. Valuing Health: Well-Being, Freedom, and Suffering. Oxford: Oxford University Press.], and for publishing this symposium. I am also grateful to the wonderful (...) |
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The tenuous claims of cost-benefit analysis to guide policy so as to promote welfare turn on measuring welfare by preference satisfaction and taking willingness-to-pay to indicate preferences. Yet it is obvious that people's preferences are not always self-interested and that false beliefs may lead people to prefer what is worse for them even when people are self-interested. So welfare is not preference satisfaction, and hence it appears that cost-benefit analysis and welfare economics in general rely on a mistaken theory of (...) |
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This essay criticizes the proposal recently defended by a number of prominent economists that welfare economics be redirected away from the satisfaction of people's preferences and toward making people happy instead. Although information about happiness may sometimes be of use, the notion of happiness is sufficiently ambiguous and the objections to identifying welfare with happiness are sufficiently serious that welfare economists are better off using preference satisfaction as a measure of welfare. The essay also examines and criticizes the position associated (...) |
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The health gradient among those who are by historical standards both remarkably healthy and well-off is of considerable moral importance with respect to benevolence, justice and the theory of welfare. Indeed it may help us to realize that for most people the good life lies in close and intricate social ties with others which can flourish only when inequalities are limited. The health gradient suggests that there is a story to be told in which egalitarian justice, solidarity, health and well-being (...) |
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Achievements have recently begun to attract increased attention from value theorists. One recurring idea in this budding literature is that one important factor determining the magnitude or value of an achievement is the amount of effort the achiever invested. The aim of this paper is to present the most plausible version of this idea. This advances the current state of debate where authors are invoking substantially different notions of effort and are thus talking past each other. While the concept of (...) |
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(No abstract is available for this citation). |
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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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Several critics have denied value incommensurability – or the claim, roughly, that there is no common measure in terms of which values can be weighed – on the basis of what we might call the argument from easy cases. Although the argument from easy cases is quite popular, what is much less often discussed is what exactly the argument entails – in other words, what sort of further commitments the argument generates. Suppose we grant that easy cases point to the (...) |
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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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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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