There are various reasons why efforts to promote “support for self-management” have rarely delivered the kinds of sustainable improvements in healthcare experiences, health and wellbeing that policy leaders internationally have hoped for. This paper explains how the basis of failure is in some respects built into the ideas that underpin many of these efforts. When support for self-management is narrowly oriented towards educating and motivating patients to adopt the behaviours recommended for disease control, it implicitly reflects and perpetuates limited and (...) somewhat instrumental views of patients. It tends to: restrict the pursuit of respectful and enabling ‘partnership working’; run the risk of undermining patients’ self-evaluative attitudes ; limit recognition of the supportive value of clinician-patient relationships; and obscure the practical and ethical tensions that clinicians face in the delivery of support for self-management. We suggest that a focus on enabling people to live well with their long-term conditions is a promising starting point for a more adequate conception of support for self-management. We then outline the theoretical advantages that a capabilities approach to thinking about living well can bring to the development of an account of support for self-management, explaining, for example, how it can accommodate the range of what matters to people for living well, help keep the importance of disease control in perspective, recognize social influences on people’s values, behaviours and wellbeing, and illuminate more of the rich potential and practical and ethical challenges of supporting self-management in practice. (shrink)

The aim of this article is twofold. First is to demonstrate that most values that underpin public health policy are a source of reasonable disagreement amongst citizens to whom said policy applies....

The capabilities approach is the theory according to which, in order to assess people's quality of life and reflect on the basic political entitlements, we should consider what people are capable of doing and being. Focusing mostly on Nussbaum's account, a number of scholars analysed the metaethical structure underlying the approach, showing her Aristotelian and Kantian sources. This article explores another aspect of Nussbaum's theory which has so far been somewhat overlooked: the role of emotions in the justification and motivational (...) support of the approach. After showing the importance Nussbaum places on compassion (and other benevolent emotions) to warrant her moral theory, I argue that – assuming her own cognitive account of compassion – her argument begs the question. I will then contend that Nussbaum's case does not have the inner tools to overcome such a circularity, trying to suggest, in conclusion, a possible way out which is consistent with it. (shrink)

Volume 20, Issue 3, March 2020, Page 85-87.

In this article, I apply the environmental or expanded capabilities approach to species and examine whether species as wholes can have capabilities and what are the implications if they can. The examination provides support for the claim that species as evolutionary groups can possess capabilities. They have integrity, which refers to the functionings that enable the self-making and development of species, and it is conceptually possible to identify capabilities that essentially enable or contribute to species integrity. One central capability for (...) species can be identified from conservation literature: adaptive capacity, the ability of species to react to environmental changes by self-regulative evolution. After constructing the main argument that species can have capabilities and that they possess the capability to adaptive capacity, I shortly expound on the implications of these claims. It turns out that there are at least three different ways to apply the notion, and that the claim ‘species have capabilities’ does not entail that species are necessarily recipients of justice. (shrink)

One major objection to social rights is a failure of determining which precise social and economic claims should be granted rights status. The social rights debate has grappled with this ‘indeterminacy problem’ for quite some time, and a number of proposals have emerged aimed at fixing the content of these rights. In what follows I examine three distinct approaches to fleshing out the idea of a minimum threshold: social rights as the fulfilment of basic needs, social rights as the securing (...) of a minimally decent life and social rights as a requirement of citizenship. Each of these proposals progressively expands on what the minimum threshold of social rights requires and, conversely, what obligations they generate on part of the state. I will show that none of these approaches is entirely satisfactory and suggest that the social rights debate look elsewhere to determine its content. (shrink)

Political practices often aim to reach valuable outcomes through democratic processes. However, philosophical considerations and democratic deliberations sometimes support different conclusions about what a valuable outcome would be. This paper contributes to a research agenda that aims to reconcile recommendations that follow from these different bases. The setting for this research agenda is capabilitarian. It affirms the idea that what we should distribute are substantive freedoms to be and do things that people have reason to value. Disagreements about these valuable (...) outcomes become particularly problematic in urgent situations such as pandemics, floods, and wildfires. These situations are urgent since they are time-sensitive and involve an impending loss of well-being. A method of compromise would help mitigate losses of well-being while respecting the aim of reaching valuable outcomes through democratic processes. I thus offer an equitable and decisive method of compromise that helps integrate philosophical considerations with democratic deliberations. (shrink)

Este artículo presenta un análisis entre el activismo ambiental encabezado por niños, niñas y adolescentes y la democracia deliberativa. Sostengo que ya no basta solo con reconocer la importancia de las voces de los menores de edad, sino que es necesario un reconocimiento político. De este modo, se pone en primer plano la naturaleza transformadora de la democracia deliberativa entre adultos y los niños, niñas y adolescentes. Para comprender el impacto del activismo ambiental en la democracia deliberativa, es necesaria una (...) comprehensión no solo de los derechos, sino también de las capacidades y la agencia de los niños, las niñas y adolescentes. Para ello propongo abordar este asunto desde el enfoque del children’s capabilitarianism y el childism. El primero enfatiza la importancia de las capacidades de los niños, las niñas y adolescentes para participar activamente en los procesos de toma de decisiones mientras que el segundo hace hincapié en modificar la comprensión tradicional de las estructuras sociales adultocéntricas, abogando por un enfoque que incluya las experiencias vividas de los niños, las niñas y adolescentes. (shrink)

The author of the paper investigates Martha C. Nussbaum’s philosophical concept of education in which education is considered key to all human development. In the first part, the author focuses on some of the more interesting ideas in Nussbaum’s philosophy of education regarding the growth, development and improvement of the individual, community, society, nation, country and humankind. The second part is a critical exploration of the individual in education, looking specifically at the general development of humankind and the shaping of (...) abstract cosmopolitan world citizens, which are the main political goals of Nussbaum’s philosophy of education. (shrink)

Energy production and consumption give rise to issues of justice for future humans. By analysing a specific case – Swedish energy politics – this article contributes to the discussion of how consideration for future humans should affect energy policy making. It outlines three different energy scenarios for the period 2035-2065 – the nuclear-renewables, the renewables-low and the renewables-high scenarios – and assesses them from the point of view of justice for future individuals by using the capabilities approach as a normative (...) framework. We cannot make a definitive assessment of the different scenarios due to the great uncertainties involved in determining the impacts on individuals living between 2035 and 2065 and individuals born thereafter, but we still conclude that we have certain reasons to prefer the renewables-low scenario since it avoids certain risks connected with the other scenarios. The economic growth in this scenario is lower than in the others, but we question whether this is a disadvantage from the point of view of the capabilities approach. _Keywords:_ energy scenarios, justice, future generations, capabilities approach. (shrink)

International guidelines recommend that prenatal screening for fetal abnormalities should only be offered within a non-directive framework aimed at enabling women in making meaningful reproductive choices. Whilst this position is widely endorsed, developments in cell-free fetal DNA based Non-Invasive Prenatal Testing are now raising questions about its continued suitability for guiding screening policy and practice. This issue is most apparent within debates on the scope of the screening offer. Implied by the aim of enabling meaningful reproductive choices is the idea (...) that screening services should support women in accessing prenatal tests that best enable them to realize the types of reproductive choice that they find important. However, beyond whatever options meet the quality standards required for facilitating an informed decision, the remaining criteria of facilitating autonomous choice is strictly non-directive. As a result, policy makers receive little indication prior to consultation with each individual woman, about what conditions should be prioritized during the offer of screening. In this paper we try to address this issue by using the capabilities approach to further specify the non-directive aim of enabling meaningful reproductive choice. The resulting framework is then used to assess the relative importance of offering prenatal screening where concerning different types of genetic condition. We conclude that greater priority may be ascribed to offering prenatal screening for conditions that more significantly diminish a woman’s central capabilities. It follows that serious congenital and earlier-onset conditions are more likely to fulfill these criteria. (shrink)

International guidelines recommend that prenatal screening for fetal abnormalities should only be offered within a non-directive framework aimed at enabling women in making meaningful reproductive choices. Whilst this position is widely endorsed, developments in cell-free fetal DNA based Non-Invasive Prenatal Testing are now raising questions about its continued suitability for guiding screening policy and practice. This issue is most apparent within debates on the scope of the screening offer. Implied by the aim of enabling meaningful reproductive choices is the idea (...) that screening services should support women in accessing prenatal tests that best enable them to realize the types of reproductive choice that they find important. However, beyond whatever options meet the quality standards required for facilitating an informed decision, the remaining criteria of facilitating autonomous choice is strictly non-directive. As a result, policy makers receive little indication prior to consultation with each individual woman, about what conditions should be prioritized during the offer of screening. In this paper we try to address this issue by using the capabilities approach to further specify the non-directive aim of enabling meaningful reproductive choice. The resulting framework is then used to assess the relative importance of offering prenatal screening where concerning different types of genetic condition. We conclude that greater priority may be ascribed to offering prenatal screening for conditions that more significantly diminish a woman’s central capabilities. It follows that serious congenital and earlier-onset conditions are more likely to fulfill these criteria. (shrink)

Typically, philosophers analysing well-being’s nature maintain three claims. First, that well-being has essential properties. Second, that the concept of well-being circumscribes those properties. Third, that well-being theories should capture them exhaustively and exclusively. This predominant position is called well-being monism. In opposition, contextualists argue that no overarching concept of well-being referring to a universally applicable well-being standard exists. Such a standard would describe what is good, bad, and neutral, for us without qualification. Instead, well-being research is putatively about several central (...) phenomena. If several phenomena are central, a proliferation of concurrently acceptable well-being theories and operationalisations is expected. However, contextualists are challenged to explain how those analysing well-being are not systematically talking past each other. In this paper, I address that challenge. The upshot is that contextualist well-being theories can be justifiably context-sensitive and applied to tailor-made policy-making efforts. I illustrate the benefits by connecting contextualism to the capability approach. (shrink)

Despite the exceptional growth of interest in the Capability Approach in specific fields of application, the approach has yet to clarify certain basic concepts, such as freedom, functioning, and, in particular, its key concept of capability. Taking two basic tenets of CA as my starting point, I would first of all like to contribute to the clarification of these central concepts. It thereby becomes apparent that “capability” is, on the one hand, an essentially hybrid concept with both an internal and (...) external aspect. On the other hand, it addresses the freedom of choice between various lifestyles as a second-order competency. Against this background, this paper offers a suggestion to correct the terminology used by Martha C. Nussbaum in her concept of capability, and subsequently it will outline a basic model of the transformation of resources into forms of being and activities with reference to Ingrid Robeyns. In conclusion I will couple this rather static perspective with two critical points: First of all, a more dynamic view reveals hitherto barely considered aspects of freedom in everyday human lives. Secondly, the idea of capabilities opposes the attempt at a separation of capabilities from functions in order to avoid paternalism, as suggested by Nussbaum. (shrink)

El objetivo de este artículo es analizar las convergencias, complementariedades y diferencias entre la noción de desarrollo humano de Amartya Sen y el PNUD con el pensamiento de Benedicto XVI y Francisco. Las distintas nociones de desarrollo humano incluyen la integralidad o multidimensionalidad de las personas, así como la inclusión y la sustentabilidad. Cada noción de desarrollo supone una visión del ser humano, de la libertad, de la responsabilidad y de la agencia. Se discute acerca de la relevancia de las (...) instituciones, la eficiencia y la complejización de índices que consideren tanto lo social como lo ambiental. Finalmente, se postulan los aportes de la ética social cristiana a las políticas públicas en esta materia. (shrink)

Amartya Sen, the initiator of the Capability Approach, rejects perfectionism and the idea that theorists can, or ought to, predefine what capabilities we have reason to value. Instead he insists that the route to social justice stay true to the liberal ideal of value pluralism and human diversity and demands a content-neutral procedure of reflective scrutiny. This paper investigates the theoretical underpinnings assumed in such a procedural account. Can it avoid perfectionistic assumptions? I think it cannot for two reasons. First, (...) it is clear that a deliberative process is taken to be valuable without it being a product of such a process. It is thus taken to be a priori valuable. Consequently, the capabilities that enable citizens to successfully partake in such a process are taken to be what we have reason to value. Second, I argue, Sen’s procedural approach is primarily aimed at enhancing freedom understood as personal autonomy. I then ask if Sen successfully can deflect perfectionistic allegations by referring to a formal and content-neutral account of autonomy. Again, I conclude he cannot. This suggests that Sen’s rejection of perfectionism is untenable. (shrink)