According to HealthCare.gov, by improving access to quality health for all Americans, the Affordable Care Act (ACA) will reduce disparities in health insurance coverage. One way this will happen under the provisions of the ACA is by creating a new health insurance marketplace (a health insurance exchange) by 2014 in which “all people will have a choice for quality, affordable health insurance even if a job loss, job switch, move or illness occurs”. This does not mean that everyone will have (...) whatever insurance coverage he or she wants. The provisions of the ACA require that each of the four benefit categories of plans (known as bronze, silver, gold and platinum) provides no less than the benefits available in an “essential health benefits package”. However, without a clear understanding of what criteria must be satisfied for health care to be essential, the ACA’s requirement is much too vague and open to multiple, potentially conflicting interpretations. Indeed, without such understanding, in the rush to provide health insurance coverage to as many people as is economically feasible, we may replace one kind of disparity (lack of health insurance) with another kind of disparity (lack of adequate health insurance). Thus, this paper explores the concept of “essential benefits”, arguing that the “essential health benefits package” in the ACA should be one that optimally satisfies the basic needs of the people covered. (shrink)

Facts about need play some role in our causal understanding of the world. We understand, for example, that people have basic needs for food, water and shelter, and that people come to be harmed because those needs go unmet. But what are needs? How do explanations in terms of need fit into our broader causal understanding of the world? This paper provides an account of need attribution, their contribution to causal explanations, and their relation to disposition attribution.

Some normative theorists appeal to the concept of basic needs. They argue that when it comes to issues such as global justice, intergenerational justice, human rights or sustainable development our first priority should be that everybody is able to meet these needs. But what are basic needs? We attempt to inform discussions about this question by gathering evidence of ordinary English speakers’ intuitions on the concept of basic needs. First, we defend our empirical approach to analyzing this concept and identify (...) a number of its potential features. Then we present three preregistered empirical studies that were conducted to investigate the extent to which ordinary speakers endorse these features. The studies yield convergent evidence for the following three claims: (1) ordinary speakers sometimes apply the concept of basic needs to necessities for a flourishing (not just a minimally decent) life, (2) most ordinary speakers attribute at least some degree of subjectivity to the concept, and (3) most ordinary speakers attribute at least some degree of relativity to the concept. We discuss the implications of these findings for philosophical analyses of _basic needs_. (shrink)

Philosophy strives to give us a firmer hold on our concepts. But what about their hold on us? Why place ourselves under the sway of a concept and grant it the authority to shape our thought and conduct? Another conceptualization would carry different implications. What makes one way of thinking better than another? This book develops a framework for concept appraisal. Its guiding idea is that to question the authority of concepts is to ask for reasons of a special kind: (...) reasons for concept use, which tell us which concepts to adopt, adhere to, or abandon, thereby shoring up—or undercutting—the reasons for action and belief that guide our deliberations. Traditionally, reasons for concept use have been sought either in timeless rational foundations or in concepts’ inherent virtues, such as precision and consistency. Against this, the book advances two main claims: that we find reasons for concept use in the conceptual needs we discover when we critically distance ourselves from a concept by viewing it from the autoethnographic stance; and that sometimes, concepts that conflict, or exhibit other vices such as vagueness or superficiality, are just what we need. By considering not what concepts are absolutely best, but what concepts we now need, we can reconcile ourselves to the contingency of our concepts, determine the proper place of efforts to tidy up thought, and adjudicate between competing conceptions of things—even things as contested as liberty or free will. A needs-based approach separates helpful clarification from hobbling tidy-mindedness, and authoritative definition from conceptual gerrymandering. (shrink)

The intersection between virtue and care ethics is underexplored in contemporary moral philosophy. This thesis approaches care ethics from a neo-Aristotelian virtue ethical perspective, comparing the two frameworks and drawing on recent work on care to develop a theory thereof. It is split into seven substantive chapters serving three major argumentative purposes, namely the establishment of significant intertheoretical agreement, the compilation and analysis of extant and new distinctions between the two theories, and the synthesis of care ethical insights with neo-Aristotelianism (...) to generate a virtue ethical theory of care. In the first two chapters, I outline virtue ethics and care ethics, and argue for considerable agreement over central premises. Chapter 2 summarises the foundational commitments of care ethics, focusing particularly on their relational ontology and its links to the other ethical claims care ethicists universally ascribe to, namely particularism, partialism, the moral salience of emotions, and the rejection of hard public/private distinctions. Chapter 3 lays out the central concepts in neo-Aristotelian virtue ethics, including eudaimonism, virtue, and character traits, and drawing a number of comparisons between virtue and care ethics specifically with regard to relational ontology and the meta-ethical commitments it underpins. In addition to doing the necessary expository work for the remainder of the thesis, Chapters 2 and 3 also argue that care ethics and virtue ethics have much more in common than is typically acknowledged – the first major contribution of this thesis to the literature. Chapters 2 and 3 to provide at least a prima facie justification for pursuit of the questions I confront in the remainder of the thesis. In Chapter 4, I ask what differentiates these two ethical theories. I survey some of the differences which philosophers in either camp have identified and offer some of my own. I suggest that several of those differences either rest on misunderstandings of one ethic or the other, or that in erecting a divide between virtue and care ethics they also disunify ethics of care. I do, however, identify two differences which seem defensible. Specifically, they are that virtue ethics seems to lack an account of care, which I define minimally as a response or responsiveness to need, and that virtue and care ethics organise their meta-ethical and normative concepts differently. This chapter thus presents a second contribution to the literature: a study of the differences between virtue ethics and care ethics. It also serves to set the trajectory for the remaining chapters, where I respond to the claim that virtue ethics lack an account of care. I spend the remainder of the thesis constructing what I take to be a satisfying foundation for a virtue ethical theory of care. In Chapter 5, I offer three initially viable means of incorporating care into virtue ethics, all of which treat care as a virtue. These are the analogical approach, according to which care is analogous to an existing virtue; the additive approach, according to which care is a novel virtue; and the bundling approach, according to which care is a bundle of virtues. I also offer and evaluate reasons to reject the claim that care is a virtue, concluding that the claim is indeed a viable one so long as the concept of care is sufficiently thick, and I contend that analogical approaches, and particularly analogies with charity, outperform the others. Chapter 5 therefore serves two ends. First, it proffers a novel meta-analysis of concepts of care as a virtue, and thus makes a third contribution to the literature. In doing so, it makes an inroad into the second: the development of a neo-Aristotelian theory of care. Chapter 6 continues this project. I attempt to show how care can be construed as an act-type and a practice. I argue in this chapter that practices are a subcategory of actions, and that care qualifies as an Anscombean act-type which aims at the meeting of needs relating to the care-recipient’s flourishing. I go on to consider the implications of this account for ethics which deploy care as a moral concept, maintaining that it not only offers a better account of consequences than theories of care which include success criteria, but also that it affords us interesting insights into the distinction between ‘caring about’ and ‘caring for’ which allow us to make sense of certain tenets of neo-Aristotelianism. This represents a contribution to both discourses, since neither care nor virtue ethicists working at the intersection of their respective normative theories have delved very deeply into the philosophy of action. Chapter 7 discusses caring relations, suggesting that a virtue ethical theory of caring relations can lean on the work care ethicists have done, and adding some necessary refinements, such as a distinction between ideal and non-ideal caring relations, and a theory of caring relations as reasons for action. This final chapter also draws these three concepts of care together by arguing that virtuous caregivers who are invested in the flourishing of those for whom they care are also sensitive to the relations those care-recipients bear to their institutional environment. I argue that because they are caring participants in caring relations, virtuous agents are characteristically motivated by states of need and dependency to engage in certain sorts of conventionally political practices. In other words, the virtue or virtues of caring characteristically manifest in certain sorts of political or social practices, relating specifically to those areas of moral life. This allows us to build upon recent work in feminist virtue ethics of the sort offered by Tessman and Friedman. I also offer a novel analysis of migration, suggesting that the account of care presenting here is analytically useful both when it comes to historical cases of migration such as the underground railroads and escapes from Nazi-occupied Europe, but also for contemporary issues such as the migrations occurring in the Southern United States and in much of Europe. I thus conclude not only that virtue ethicists ought to incorporate care into their normative framework, and that the theory of care presented here is a coherent one, but that this leads us naturally into applied topics such as virtue politics. I conclude the thesis by considering some its implications and by identifying some further avenues for research. (shrink)

According to the so-called Classical Theory, concepts are mentally represented by individually necessary and jointly sufficient application conditions. One of the principal empirical objections against this view stems from evidence that people judge some instances of a concept to be more typical than others. In this paper we present and discuss four empirical studies that investigate the extent to which this ‘typicality effect’ holds for the concept of basic needs. Through multiple operationalizations of typicality, our studies yielded evidence for a (...) strong effect of this kind: Participants tended to recall the same core examples of the concept in a free-listing task. They judged some basic needs to be more typical than others. The items that were judged to be more typical were listed more frequently in the free-listing task. These items were listed earlier on in the free-listing task. Typical basic needs, as well as non needs, were classified faster than atypical basic needs in a reaction time study. These findings suggest that the concept of basic needs may have a non-classical structure. If so, the quest for a simple and robust intensional analysis of the concept may be futile. (shrink)

This paper presents a new analysis of the concept of non-instrumental need, and, using it, demonstrates how a need-satisfaction theory of well-being is much more plausible than might otherwise be supposed. Its thesis is that in at least some contexts of evaluation a central part of some persons’ well-being consists in their satisfying certain “personal needs”. Unlike common conceptions of other non-instrumental needs, which make those out to be moralised, universal, and minimal, personal needs are expansive and particular to particular (...) persons, generated rather by persons’ non-moral personal commitments. Against objections to the contrary, I show how these are genuine necessities, since unlike mere desires and freely escapable aims, personal needs constitute objective, inescapable, and non-compensable practical requirements. The personal-need-satisfaction theory of well-being combines objectivity with subject-dependence in novel ways, and motivates well-being pluralism at the level of individual agency. Implicating necessity as it does in the structure of individual well-being, this account presents a robust challenge to ethical and political theories that rely on the intrapersonal aggregation of well-being to be unproblematic. (shrink)

Are there limits to what it is morally okay to imagine? More particularly, is imaginatively inhabiting morally suspect perspectives something that is off-limits for truly virtuous people? In this paper, I investigate the surprisingly fraught relation between virtue and a familiar form of imaginative perspective taking I call empathy. I draw out a puzzle about the relation between empathy and virtuousness. First, I present an argument to the effect that empathy with vicious attitudes is not, in fact, something that the (...) fully virtuous person can indulge in. At least one prominent way of thinking about the psychology of the virtuous person excludes the possibility that the virtuous could emotionally apprehend the world in a less than virtuous way, and empathizing with vicious outlooks does seem to run afoul of that restriction. Then, I develop an argument that runs in the contrary direction: virtue in fact requires empathy with vicious outlooks, at least in some situations. There is reason to think that a crucial part of being virtuous is ministering effectively to others’ needs, and there is also reason to think that other people may need to be empathized with, even if their emotional outlooks are at least minorly vicious. Finally, I outline two different solutions to this puzzle. Both solutions hold some promise, but they also bring new challenges in their train. (shrink)

From the day on which humans are born they need things. Some of these needs seem “basic,” such as our needs for food, water or shelter. Everybody has these needs. We cannot escape them. We also cannot escape the serious harm that arises when these needs remain unsatisfied. It is thus no wonder that in thinking about what we ought to do some researchers have suggested to first and foremost focus on people's basic needs. Such need‐based theories must answer three (...) main questions: What are basic needs? What are their implications for normative questions? And how can these needs and their satisfaction be measured? Proponents must also defend these theories against objections, such as against the objections that the theories are paternalistic, materialistic, and passivity‐promoting. Depending on their goals and contexts (distributive justice, sustainable development, human rights, etc.), appeals to basic needs may take various different forms. (shrink)

European Journal of Philosophy, EarlyView.

People who are involuntarily childless need to use assisted reproductive technologies if they want to have a genetically related child. Yet, from an ethical point of view it is unclear to what extent assistance to satisfy this specific desire should be warranted. We first show that the subjectively felt harm due to the inability to satisfy this reproductive desire does not in itself entail the normative conclusion that it has to be met. In response, we evaluate the alternative view according (...) to which the satisfaction of this desire is regarded as a way to meet one’s presumed intermediate need for parenthood. This view presupposes that parenthood is one of those general categories of experiences and activities that contribute an irreplaceable value to people’s lives, but the central difficulty is to find those characteristics that mark out parenthood as an irreplaceable constituent of a valuable life. We go on to argue, however, that even if one assumes that parenthood is such an irreplaceable constituent that makes life more valuable, this does not necessarily entail a moral duty to satisfy the desire for genetic parenthood. We conclude that there is a pro tanto obligation to help people conceive a genetically related child (if this is what they prefer), but that this can be outweighed by other moral considerations, such as safety and justice concerns. (shrink)

The article presents an original needs-based partial theory of human injustice and shows its relationship to existing theories of human need and human liberation. The theory is based on an original typology of three social structural sources of human injustice, a partial theorization of the mechanisms of human injustice, and a needs-based theorization of the nature of human injustice, as experienced by individuals. The article makes a sociological contribution to normative social theory by clarifying the relationship of human injustice to (...) human needs, human rights, and human liberation. The theory contends that human injustice is produced when oppression, mechanistic dehumanization, and exploitation create systematic inequality in opportunities to address human needs, leading to wrongful need deprivation and the resulting serious harm. In one longer sentence, this needs-based partial theory of the sources, mechanisms, and nature of human injustice contends that three distinct social systemic sources—oppression, mechanistic dehumanization, and exploitation—produce unique and/or overlapping social mechanisms, which create systematic inequality in opportunities to address universal human needs in culturally specific ways, thus producing the nature of the human injustice theorized here: wrongfully unmet needs and serious harm. (shrink)

This paper explores early Australasian philosophy in some detail. Two approaches have dominated Western philosophy in Australia: idealism and materialism. Idealism was prevalent between the 1880s and the 1930s, but dissipated thereafter. Idealism in Australia often reflected Kantian themes, but it also reflected the revival of interest in Hegel through the work of ‘absolute idealists’ such as T. H. Green, F. H. Bradley, and Henry Jones. A number of the early New Zealand philosophers were also educated in the idealist tradition (...) and were influential in their communities, but produced relatively little. In Australia, materialism gained prominence through the work of John Anderson, who arrived in Australia in 1927, and continues to be influential. John Anderson had been a student of Henry Jones, who might therefore be said to have influenced both main strands of Australian philosophical thought. (shrink)

This dissertation is a contribution to the debate about ‘climate justice’, i.e. a call for a just and feasible distribution of responsibility for addressing climate change. The main argument is a proposal for a cautious, practicable, and necessary step in the right direction: given the set of theoretical and practical obstacles to climate justice, we must begin by making contemporary development practices sustainable. In times of climate change, this is done by recognising and responding to the fact that emissions of (...) greenhouse gases, with climate change as their result, are an immanent threat to any reflectively embraced development project. In the universal pursuit of progress, basic needs of both present and future people are put at risk. Even so, a political stalemate and business-as-usual prevail. The situation is locked up by an uncertainty about the exact impacts of choices made and by the reasonable disagreement of modern societies. The result is passiveness, and the passing on of a slowly and indiscernibly growing problem to future generations. This dissertation brings out a crucial message about the need to make our development sustainable. Instead of delaying action through trying to resolve the intractable epistemic and normative uncertainty fully, the focus should be on vindicating already shared points of practical convergence. On the constructivist method here adopted, the task is to characterise the agent and the situation faced from a practical and first-person point of view. More specifically, to specify the practical problem climate change gives rise to; the moral importance of needs (chapter three); how a principled priority of basic needs can be defended (chapter four), intergenerationally (chapter five) and internationally (chapter six); and what natural and social limits there are to development (chapter seven). These conceptions narrows the practice of development in the present context: it can be concluded that development must not risk the basic needs of anyone implicated. This common ground brackets off disagreement irrelevant to the urgent need to act, and so brings together otherwise deeply divided agents. A sufficientarian basic needs-principle, as the focus of an overlapping consensus, is practicable and anticipatory in the disuniting moral conundrum of climate change. (shrink)

This paper argues that those who emphasise that designers and engineers need to plan for obsolescence are too conservative. Rather, in addition to planning for obsolescence, designers and engineers should also think carefully about what they could do in order delay obsolescence. They should so this by thinking about the design itself, thinking of ways in which products could be useful and appealing for longer before becoming obsolete, as well thinking about the wider context in terms of the marketing of (...) products, and also the social and legal. The paper also considers objections that these suggestions are unrealistically idealistic, failing to recognise the economic realities. I respond to these objections appealing to research in advertising, psychology, cognitive linguistics, philosophy, history, and economics, as well as drawing on the Statement of Ethical Principles developed by the Royal Academy of Engineering and the Engineering Council. (shrink)

ZusammenfassungAdipositas ist eine weltweite Herausforderung für die Gesundheitssysteme. In Zeiten des demografischen Wandels sind auch immer mehr ältere Menschen davon betroffen, was sowohl die Akut- als auch die Langzeitpflege vor erhebliche Herausforderungen stellt. Bislang fehlt eine detaillierte Analyse der vielfältigen Gruppe der über 65-Jährigen in diesem Bereich. Weder die Bedürfnisse der Pflegebedürftigen noch der Pflegekräfte und Einrichtungen werden beobachtet, analysiert oder systematisch bewertet. Darüber hinaus sind die ethischen Implikationen der professionellen Pflege von älteren Menschen mit Adipositas in Forschung und Politik (...) noch nicht diskutiert worden. Wir argumentieren, dass ein bedürfnisorientierter Ansatz angemessen ist, um diese ethische Komplexität anzugehen. Dafür sollte eine breite und umfassende Analyse der ethischen Aspekte aus einer interdisziplinären Perspektive erfolgen. Daher führen wir ein systematische Literaturrecherche (Scoping Review) und eine thematische Fallanalyse durch, um den aktuellen Stand der Forschung aus professionellen Pflegeeinrichtungen in europäischen und nordamerikanischen Institutionen zusammenzufassen. So gewinnen wir Einblicke in die direkten Erfahrungen von Leistungserbringern und adipösen Patient*innen im Pflegebereich. Wir kommen zu dem Schluss, dass auch in Deutschland ein erheblicher Forschungsbedarf an der Schnittstelle ethischer Herausforderungen von Langzeitpflege, Alter und Adipositas besteht. Aus der begrenzten Anzahl von (Fall‑)Studien, die sich finden lassen, geht eine Reihe von ethischen Bedenken hervor, die direkte Auswirkungen auf den Zugang, die Inanspruchnahme und die Qualität der Versorgung haben. Ein empirisch-ethischer Ansatz kann die künftige Forschung und Pflegepraxis im Bereich der Adipositas und der Altenpflege leiten. Schwerpunkte der zukünftigen Mixed-methods-Forschung sollten sein: die Bedürfnisse adipöser älterer Menschen und ihrer Pfleger*innen, Kriterien für die Abwägung von Bedürfnissen und Ressourcenallokation sowie praktische Lösungen für mehrfach stigmatisierte Menschen. (shrink)

Some considerations are urgent and others are not. Sometimes we invite criticism if we neglect the urgency of our situation, even if our action seems adequate to respond to it. Despite this significance, the literature does not offer a satisfactory analysis of the normative structure of urgency. I examine three views of urgency, drawn from philosophical and adjacent literature, which fail to explain the distinctive criticism we face when we neglect the urgency of our reasons. Instead I argue that urgent (...) considerations pre-empt our deliberation about less urgent considerations. Urgency, then, is a meta-normative phenomenon, setting standards for how we handle and respond to first-order considerations, requiring that we close deliberation. In the face of urgency, appropriate action is not enough: commitment is called for. This is how we enact appreciation of our practical reasons, independently of our carrying out the action they call for. (shrink)

Philosophers often identify needing something with requiring it to avoid harm. This view of need is roughly accurate, but no adequate analysis of the relevant sort of requirement has been given, and the relevant notion of harm has not been clarified. Further, the harm-avoidance picture must be broadened, because we also need what is required to reduce danger. I offer two analyses of need (one probabilistic) to address these shortcomings. The analyses are at a high level of generality and accommodate (...) our ordinary notion of need as well as narrower conceptions. I also explain why the only extant, detailed modal account of need, David Wiggins’s (1987/1998), is inadequate. My analyses imply that to have a need for something is to have the (expected) quality of one’s life depend counterfactually on it in a certain way. The analyses shed some light on need’s distinctive normative significance. (shrink)

Care ethics takes as central the discerning of needs in those being cared for and attempts to meet those needs. Perceptive caring agents are more likely to be able to identify needs in those for whom they are caring. The identification of needs is no small matter, not least in teaching encounters. This paper modestly proposes that at least some of the needs a caring agent should attempt to meet are a function of the identity of the patient of caring (...) action. Taking Nel Noddings’ account of care ethics as representative, I present it in outline. This leads to the needs-identification problematic. Following this I turn to Soran Reader’s account of needs. I interpret this to offer what I designate as identity as ‘what-ness’. Such an understanding of identity-based needs is a starting point for the caring agent but a more nuanced account, of identity as ‘who-ness’, is argued to be preferable. Identity as ‘who-ness’, as expressed in Paul Ricoeur’s work, advances the discussion, culminating in his concept of the ‘capable human being’. Having brought this aspect of Ricoeur’s thought into conversation with care ethics, I offer an account of identity-based needs conducive to the broader aims of the care ethical project. Finally, I consider what this bolstered account of care ethics might say about a brief and illustrative teaching encounter. (shrink)

In answering normative questions, researchers sometimes appeal to the concept of basic needs. Their guiding idea is that our first priority should be to ensure that everybody is able to meet these needs—to have enough in terms of food, water, shelter, and so on. This article provides an opinionated overview of basic needs in normative contexts. Any basic needs theory must answer three questions: (1) What are basic needs? (2) To what extent do basic needs generate reasons for action and (...) how are these reasons to be understood? (3) How are basic needs and their satisfaction to be measured? I address these questions in turn. Then I also briefly discuss the theoretical potential of appealing to basic needs in normative contexts. It turns out that future research in this area could benefit from a higher degree of interdisciplinarity and methodological reflection, and that, generally speaking, basic needs theories are more promising than they have often been claimed to be. (shrink)

Claims about needs are a ubiquitous feature of everyday practical discourse. It is therefore unsurprising that needs have long been a topic of interest in moral philosophy, applied ethics, and political philosophy. Philosophers have devoted much time and energy to developing theories of the nature of human needs and the like. -/- Philosophers working on needs are typically committed to the idea that there are different kinds of needs and that within the different kinds of needs is a privileged class (...) of needs that is especially normatively significant. -/- Some philosophers go further and make rather grand claims about needs. They claim that needs are central or fundamental to moral thinking and that we must have a needs-centred moral theory or a general reorientation of moral philosophy around needs. -/- In this paper I aim to do two things. First, to show how applying recent work on modal terms can help us to understand thought and talk about needs. This is the positive part. I then use these ideas to cast doubt on the more ambitious claims about needs. Put briefly, a proper understanding of claims about needs undermines the idea that the concept of needs is fundamental in moral thought or in moral philosophy. Ambitious needs theory fails. (shrink)

This book offers an original account of a distinctly republican theory of social and global justice. The book starts by exploring the nature and value of Hegelian recognition theory. It shows the importance of that theory for grounding a normative account of free and autonomous agency. It is this normative account of free agency which provides the groundwork for a republican conception of social and global justice, based on the core-ideas of freedom as non-domination and autonomy as non-alienation. As the (...) author argues, republicans should endorse a sufficientarian account of social justice, which focuses on the nature of social relationships and their effects on people's ability to act freely and realize their fundamental interests. On the global level, the book argues for the cosmopolitan extension of the republican principles of non-domination and non-alienation within a multi-level democratic system. In so doing, the book addresses a major gap in the existing literature, presenting an original theory of justice, which combines Hegelian recognition theory and republican ideas of freedom, and applying this hybrid theory to the global domain. Fabian Schuppert creates a grand synthesis uniting neo-republican insights on freedom with Hegelian recognition theory. The result is an account of agency that arises from the idea of non-domination whose aim it is to safeguard individual freedom. When combined with Hegelian recognition theory a social focus also emerges. This amalgam comments on many of the major disputes concerning global justice from a cosmopolitan perspective. Because of the broad scope and the many contemporary discussions engaged this book will be of keen interest to scholars as well as a welcome addition to the classroom. (shrink)

People have various desires, but it is a contested moral issue when a desire becomes of such importance that it legitimizes a moral claim on others. This paper explores how the normative significance of desire satisfaction can be assessed and argues that a normatively significant desire can constitute a pro tanto obligation to help satisfy it. The paper presents a framework that relates the normative significance of a given desire to the general goal of living a reasonably valuable life and (...) inquires how the latter can be given determinate content without excluding a heterogeneity of the personal good. The paper contends that the set of possibly normatively significant desires is thus restricted by considerations about intelligibility, adequacy, and replaceability, which are mediated by societal background theories. (shrink)

Sufficientarians face a problem of arbitrariness: why place a sufficiency threshold at any particular point? One response is to seek universal goods to justify a threshold. However, this faces difficulties (despite sincere efforts) by either being too low, or failing to accommodate individuals with significant cognitive disabilities. Some sufficientarians have appealed to individuals’ subjective evaluations of their lives. I build on this idea, considering another individualized threshold: ‘tolerability’. I respond to some traditional challenges to individualistic approaches to justice: ‘expensive’ tastes, (...) and adaptive preferences. Finally, I end by offering some suggestions about how this relates to policymaking. (shrink)

In the presence of anthropogenic climate change, gross environmental degradation, and mass abject poverty, many political theorists currently debate issues such as people's right to water, the right to food, and the distribution of rights to natural resources more generally. However, thus far many theorists either focus (somewhat arbitrarily) only on one particular resource (e.g. water) or they treat all natural resources alike, meaning that many relevant distinctions within the group of natural resources are overlooked. Hence, the paper will start (...) with an analysis of the various forms which natural resources can take and how this might influence one's conception of resource rights. In so doing, the paper argues that we have to carefully distinguish between the actual physical resources people might control and how we distribute these, and the life-sustaining benefits each and every person draws from sustainable and functioning ecosystems. Based on this distinction, the paper will argue for a right to the benefits of life-sustaining ecosystem services as a universal basic right every person has. Further distributive claims with respect to particular physical resources would thus be limited by the requirements of such a basic right. (shrink)

There is a tension between our need for associative control and our need for social connections. This tension creates ethical dilemmas that we can call each-we dilemmas of sociability. To resolve these dilemmas, we must prioritize either negative moral rights to dissociate or positive moral rights to social inclusion. This article shows that we must prioritize positive social rights. This has implications both for personal morality and for political theory. As persons, we must attend to each other's basic social needs. (...) As a society, we must adopt a sufficientarian approach to the regulation of social resources. (shrink)

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 (...) two very popular conceptions of fairness that contrast with his. One of these very popular conceptions identifies fairness with the equal and impartial application of rules. The other identifies fairness with all-things-considered moral rightness. (shrink)

Need-claims are ubiquitous within moral and political theory. However, need-based theories are often criticized for being too narrow in scope and too focused on the material preconditions for leading a decent life for grounding a substantial theory of social justice. The aim of this paper is threefold. Firstly, it will investigate the nature and scope of needs by analysing existing conceptualizations of the idea of needs. In so doing, we will get a better understanding of needs, which will help us (...) to carve out the importance and singularity of basic need claims. Secondly, on the basis of the analysis of needs, it will argue for the concept of a fundamental interest in free social agency, which is much better suited than the idea of basic needs actually to ground a theory of social justice, as it highlights the social and institutional conditions for free agency. Thirdly, using the distinction between basic needs and fundamental interests, it will clarify their respective role in and importance for grounding moral principles. Overall, the paper offers a friendly critique of need-based theories, while arguing for a shift of focus to the idea of fundamental interests. (shrink)

Recent medical innovations like ‘omics’ technologies, mobile health (mHealth) applications or telemedicine are perceived as part of a shift towards a more preventive, participatory and affordable healthcare model. These innovations are often regarded as ‘disruptive technologies’. It is a topic of debate to what extent these technologies may transform the medical enterprise, and relatedly, what this means for medical ethics. The question of whether these developments disrupt established ethical principles like respect for autonomy has indeed received increasing normative attention during (...) the past years. Yet, more fundamental ethical considerations of a possible disruption of the concept of ‘medical necessity’ (and the potential ensuing clinical ramifications) have been limited if not absent. It is our modest – though morally and practically relevant – aim to address this objective in this article, by exploring how the current wave of allegedly disruptive innovation is invoking a resurgence of this concept and related debates on ‘the’ goal(s) of medicine. (shrink)

Definition of the problem Obesity is a burgeoning challenge for healthcare systems worldwide. In times of demographic change, it also affects an increasing number of older persons, presenting substantial challenges to delivering health and nursing care in both acute and long-term care (LTC) settings. So far, a detailed analysis of the diverse group of 65+ in this field is missing, particularly in the area of LTC. The needs of neither care recipients, nor those of nurses and institutions are monitored, analyzed, (...) or systematically evaluated. Moreover, ethical implications of professional care for older persons with obesity have not yet been discussed in research and policy. Arguments We argue that a needs-based approach is appropriate to address these ethical complexities. We further argue that a comprehensive mapping of the ethical terrain is best from an interdisciplinary and mixed methods perspective. For this, we conduct a scoping review to synthesize the state-of-the-art in both the healthcare and LTC settings; and we focus on challenges reported in case studies from professional care settings in European and North American institutions. Conclusion Our findings point to a lack of research on ethical issues related to the LTC needs of older persons living with obesity and the challenges faced by their professional carers. From the limited number of (case) studies that can be found, however, a series of ethical concerns emerge that have direct import for access, utilization, and quality of care. Accordingly, a new research agenda is needed to inform an ethical approach for policy and practice. It must be rooted in a concern for both care recipients and caregivers in mixed methods studies. Future research should provide criteria for balancing needs, allocating resources and developing practical solutions for people who are confronted with multiple stigma. (shrink)