A lively topic of debate in decision theory over recent years concerns our understanding of the different risk attitudes exhibited by decision makers. There is ample evidence that risk-averse and risk-seeking behaviours are widespread, and a growing consensus that such behaviour is rationally permissible. In the context of clinical medicine, this matter is complicated by the fact that healthcare professionals must often make choices for the benefit of their patients, but the norms of rational choice are conventionally grounded in a (...) decision maker’s own desires, beliefs and actions. The presence of both doctor and patient raises the question of whose risk attitude matters for the choice at hand and what to do when these diverge. Must doctors make risky choices when treating risk-seeking patients? Ought they to be risk averse in general when choosing on behalf of others? In this paper, I will argue that healthcare professionals ought to adopt a deferential approach, whereby it is the risk attitude of the patient that matters in medical decision making. I will show how familiar arguments for widely held anti-paternalistic views about medicine can be straightforwardly extended to include not only patients’ evaluations of possible health states, but also their attitudes to risk. However, I will also show that this deferential view needs further refinement: patients’ higher-order attitudes towards their risk attitudes must be considered in order to avoid some counterexamples and to accommodate different views about what sort of attitudes risk attitudes actually are. (shrink)

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

The concept of well-being is increasingly gaining acceptance as an object of science, and many different types of well-being measures have been developed. A debate has emerged about which measures are able to capture well-being successfully. An important underlying problem is that there is no unified conceptual framework about the nature of well-being—a hotly debated topic of philosophical discussion. I argue that while there is little agreement about the nature of well-being in philosophy, there is an important agreement on some (...) important principles relevant for its measurement. I argue that well-being science has good reasons to accommodate these principles, but currently fails to do so. (shrink)

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

In criticizing communitarian views of justice, Amartya Sen argues that identity is not merely a matter of discovery but an object of reasoned choice subject to constraints. Distinguishing three notions of identity – self-perception, perceived identity and social affiliation – I claim that the relevant constraints implied by this argument are minimal. Some of Sen's arguments about perceived identity and social context do not establish any further constraints. Sen also argues that a model of multiculturalism and some forms of education (...) can restrict, or fail to promote, reasoned and informed identity choice. This argument is better understood in the light of Sen's work on capability and justice, notably his concern with ways in which underdogs can adapt and his emphasis on public reasoning. It highlights limitations on information and opportunities for reasoning. I suggest that these lead to genuine constraints on (reasoned and informed) identity choice. The paper focuses on Sen's work, though its claims are also relevant to George Akerlof and Rachel Kranton's analysis of identity. (shrink)

For more than three decades, business ethics has suggested and evaluated strategies for multinationals to address abject deprivations and weak regulatory institutions in developing countries. Critical appraisals, internal and external, have observed these concerns being severely constrained by the overwhelming prioritization of economic values, i.e., economism. Recent contributions to business ethics stress a re-imagination of the field wherein economic goals are downgraded and more attention given to redistribution of wealth and well-being of the weaker individuals and groups. Development ethics, a (...) lesser known field of normative enquiry, already offers nuanced justifications against economism which business ethicists can use in their current attempts to wean the field from old habits. (shrink)

Philosophical accounts of human well-being face a number of significant challenges. In this paper, I shall be primarily concerned with one of these. It relates to the possibility, noted by Martha Nussbaum and Amartya Sen amongst others, that people’s desires and attitudes are malleable and can ‘adapt’ in various ways to the straitened circumstances in which they live. If attitudes or desires adapt in this way it can be argued that the relevant desires or attitudes fail to provide a reliable (...) basis for evaluating well-being. This is, what I shall call the ‘adaptation problem’. Nussbaum and Sen have—in different ways used this argument to motivate their versions of the ‘capability approach’. However, questions remain about the implications of adaptation for philosophical accounts of well-being. (shrink)