Intelligent neurotechnology is an emerging field that combines neurotechnologies like brain-computer interface (BCI) with artificial intelligence. This paper introduces a capability framework to assess the responsible use of intelligent BCI systems and provide practical ethical guidance. It proposes two tests, the threshold and flourishing tests, that BCI applications must meet, and illustrates them in a series of cases. After a brief introduction (Section 1), Section 2 sets forth the capability view and the two tests. It illustrates the threshold test using (...) examples from clinical medicine of BCI applications that enable patients with profound disabilities to function at a threshold level through computer mediation. Section 3 illustrates the flourishing test by exploring possible future applications of BCI involving neuroenhancements for healthy people, using examples adapted from research currently underway in the US military. Section 3 applies a capability lens to a complex case involving dual effects, both therapeutic and non-therapeutic, showing how the threshold and flourishing tests resolve the case. Section 4 replies to three objections: neurorights are the best tool for assessing BCI; the two tests are moving targets; and the analysis utilizes a capability view to do work it is not designed for. The paper concludes that a capability view offers unique advantages and gives practical guidance for evaluating the responsible use of present and future BCI applications. Extrapolating from our analysis may help guide other emerging technologies, such as germline gene editing, expected to impact central human capabilities. (shrink)

Freedom and security are often portrayed as things that have to be traded off against one another, but this view does not capture the full complexity of the freedom-security relationship. Rather, there seem to be four different ways in which freedom and security connect to each other: freedom can come at the cost of security, security can come at the cost of freedom, freedom can work to the benefit of security, and security can work to the benefit of freedom. This (...) paper analyses each of these connections in turn. It shows that particular understandings of freedom can help us to see particular connections between freedom and security. The practical examples used to illustrate these connections are drawn from the context of the COVID-19 pandemic. It will be suggested that, in the face of challenges such as this one, taking into account all four connections between freedom and security can ultimately help decision-makers in upholding both. (shrink)

People are increasingly subject to algorithmic decisions, and it is generally agreed that end-users should be provided an explanation or rationale for these decisions. There are different purposes that explanations can have, such as increasing user trust in the system or allowing users to contest the decision. One specific purpose that is gaining more traction is algorithmic recourse. We first pro- pose that recourse should be viewed as a recommendation problem, not an explanation problem. Then, we argue that the capability (...) approach provides plausible and fruitful ethical standards for re- course. We illustrate by considering the case of diversity constraints on algorithmic recourse. Finally, we discuss the significance and implications of adopting the capability approach for algorithmic recourse research. (shrink)

Emerging reprogenetic technologies may radically change how humans reproduce in the not-so-distant future. One foreseeable consequence of disruptive innovations in the procreative domain is an increase in the reproductive autonomy of intended parents. Regarding the prospective parental liberty of enhancing non-health–related traits of the offspring, one controversy has particularly dominated the literature. Does parents' choice of genetically enhancing the traits of their descendants compromise children's future personal autonomy? In this article, I will analyse the main arguments which posit that reprogenetic (...) enhancement could be at odds with the child's future autonomy. I will argue that these objections are ill-founded. Moreover, I will present other arguments that show that reprogenetic technologies can enhance the autonomy of future children. Autonomy enhancement is a plausible and pro tanto desirable application of emerging reprogenetic technologies. (shrink)

The Sustainable Development Goal of the United Nations related to reduced inequalities calls for greater economic inclusion of the poor. Yet, how business leaders grant economic opportunities and development to the poor is significantly under-researched. Extending burgeoning responsible leadership theory that promotes paradox-savvy leadership for building inclusive ventures through various actors, this study introduces new concepts of inclusive leadership that foster the economic inclusion of the poor from Amartya Sen’s capability approach perspective. By studying how leaders include the poor in (...) social businesses, we provide a fresh perspective of inclusive leadership as a personalized empowering cycle of economic–social–economic inclusion to close the gaps between the rich and poor in business and society. This perspective provides new territories of diversity and inclusion research for reduced inequality. (shrink)

The main goal of this thesis is to provide a clear basis for the analysis of alternative currencies, such as Bitcoin, LETS, Local currencies, the WIR or Carbon currencies. It attempts to determine whether alternative currencies might constitute just and workable alternatives, either in the form of small-scale experiments or in the form of more radical reforms. The first chapter proposes a new way to classify currencies. The second examines the case in favour of monetary plurality. The third analyses the (...) claims in favour of restricting the use of money locally, within a community, or to certain goods. The fourth studies the link between money and the market. Finally, a post-scriptum focuses on Bitcoin and cryptocurrencies. This thesis highlights that these currencies are drivers of several potential conflicts. Their widespread use might conflict with the adequate management of monetary policy, with social justice, and with liberal values. These conflicts are potential, for they would come into existence only if alternative currencies increased in scope. However, there is no reason to disregard potential conflicts when the case in their favour relies mostly on their potential benefits. (shrink)

The books’ goal is to answer the question: Do the weaknesses of value-free economics imply the need for a paradigm shift? The author synthesizes criticisms from different perspectives (descriptive and methodological). Special attention is paid to choices over time, because in this area value-free economics has the most problems. In that context, the enriched concept of multiple self is proposed and investigated. However, it is not enough to present the criticisms towards value-free economics. For scientists, a bad paradigm is better (...) than no paradigm. Therefore, the author considers whether value-based economics with normative approaches such as economics of happiness, capability approach, libertarian paternalism, and the concept of multiple self can be the alternative paradigm for value-free economics. This book is essential reading to everyone interested in the current state of economics as a discipline. (shrink)

Psychopharmacological cognitive enhancements could lead to a higher quality of life of healthy individuals with lower cognitive capacities, but the current regulatory framework does not seem to enable access to this group. This article discusses why Sen’s Capability Approach could open up such access, while two other modern social justice theories – utilitarianism and Rawls’ Justice as Fairness – could not. In short, the utilitarian approach is proven to be inadequate, due to practical reasons and having a low chance of (...) real-world success. Rawls’ Justice as Fairness seems to be problematic because of conflicting stances that follow from his First Principle of Justice. The Capability Approach has the greatest chance of success in the context of these substances, because of arguments that can be identified under the banners of agency/self-respect and the way the public views those who take the capability path out of their poor situation. The article also discusses general and practical problems with psychopharmacological cognitive enhancement that should be addressed when writing new policy on this topic. (shrink)

There are increasing calls for rejecting the ‘dead donor’ rule and permitting ‘organ donation euthanasia’ in organ transplantation. I argue that the fundamental problem with this proposal is that it would bestow more worth on the organs than the donor who has them. What is at stake is the basis of human equality, which, I argue, should be based on an ineliminable dignity that each of us has in virtue of having a rational nature. To allow mortal harvesting would be (...) to make our worth contingent upon variable quality of life of judgments that can only be based on properties that come in degrees. Thus, rejecting the ‘dead donor’ rule comes at the expense of our egalitarian principles with respect to the value each individual human life has in relation to the protections against killing. (shrink)

Social media companies commonly design their platforms in a way that renders them addictive. Some governments have declared internet addiction a major public health concern, and the World Health Organization has characterized excessive internet use as a growing problem. Our article shows why scholars, policy makers, and the managers of social media companies should treat social media addiction as a serious moral problem. While the benefits of social media are not negligible, we argue that social media addiction raises unique ethical (...) concerns not raised by other, more familiar addictive products, such as alcohol and cigarettes. In particular, we argue that addicting users to social media is impermissible because it unjustifiably harms users in a way that is both demeaning and objectionably exploitative. Importantly, the attention-economy business model of social media companies strongly incentivizes them to perpetrate this wrongdoing. (shrink)

This transdisciplinary doctoral thesis presents various theoretical, methodological and empirical approaches that together form an ecological approach to the study of social sciences. The key argument follows: to understand how sustainable behaviours and cultures may emerge, and how their development can be facilitated, we must further learn how behaviours emerge as a function of the person and the material and social environment. Furthermore, in this thesis the sustainability crises are framed as sustain-ability crises. We must better equip our cultures with (...) abilities to deal with the complexity and uncertainty of socio-ecological systems, and use these cultural skillsets to survive in and adapt to an increasingly unpredictable world. This thesis employs a plurality of ecological social sciences and related methodologies—such as ecological psychology, ecological rationality and agent-based modelling—to enlighten the question of how the collective adoption of sustainable behaviours can be leveraged, particularly by changing the affordances in the material environment. What is common to these ecological approaches is the appreciation of ‘processes’ over ‘products’: we must understand the various processes through which sustainable forms of behaviour or decision-making emerge to truly locate leverage points in social systems. Finally, this thesis deals extensively with uncertainty in complex systems. It proposes that we can look to local and traditional knowledge in learning how to deal adaptively with uncertainty. (shrink)

This thesis justifies the need for and develops a new integrated model of practical reasoning and argumentation. After framing the work in terms of what is reasonable rather than what is rational (chapter 1), I apply the model for practical argumentation analysis and evaluation provided by Fairclough and Fairclough (2012) to a paradigm case of unreasonable individual practical argumentation provided by mass murderer Anders Behring Breivik (chapter 2). The application shows that by following the model, Breivik is relatively easily able (...) to conclude that his reasoning to mass murder is reasonable – which is understood to be an unacceptable result. Causes for the model to allow such a conclusion are identified as conceptual confusions ingrained in the model, a tension in how values function within the model, and a lack of creativity from Breivik. Distinguishing between dialectical and dialogical, reasoning and argumentation, for individual and multiple participants, chapter 3 addresses these conceptual confusions and helps lay the foundation for the design of a new integrated model for practical reasoning and argumentation (chapter 4). After laying out the theoretical aspects of the new model, it is then used to re-test Breivik’s reasoning in light of a developed discussion regarding the motivation for the new place and role of moral considerations (chapter 5). The application of the new model shows ways that Breivik could have been able to conclude that his practical argumentation was unreasonable and is thus argued to have improved upon the Fairclough and Fairclough model. It is acknowledged, however, that since the model cannot guarantee a reasonable conclusion, improving the critical creative capacity of the individual using it is also of paramount importance (chapter 6). The thesis concludes by discussing the contemporary importance of improving practical reasoning and by pointing to areas for further research (chapter 7). (shrink)

Inclusive design prescribes addressing the needs of the widest possible audience in order to consider human differences. Taking differences seriously, however, may imply severely restricting “the widest possible audience”. In confronting this paradox, we investigate to what extent Rawls’ theory of justice as fairness applies to design. By converting the paradox into the question of how design can be fair, we show that the demand for equitability shifts from the design output to the design process. We conclude that the two (...) main questions about justice find application in design: the question about the standards of justice and the question about its metrics. We endorse a Rawlsian approach to the former, while some revision may be due regarding the latter. (shrink)

Extreme inequality of opportunity leads to a number of social tensions, inefficiencies and injustices. One issue of increasing concern is the effect inequality is having on people’s fair chances of attaining meaningful work, thus limiting opportunities to make a significant positive contribution to society and reducing the chances of living a flourishing life and developing their potential. On a global scale we can observe an increasingly uneven provision of meaningful work, raising a series of ethical concerns that need detailed examination. (...) The aim of this article is to explore the potential of a normative framework based upon the idea of contributive justice to defend a fairer provision of meaningful work. (shrink)

This paper offers a critique of Martha Nussbaum’s description of the capability approach, and offers an alternative. I will argue that Nussbaum’s characterization of the capability approach is flawed, in two ways. First, she unduly limits the capability to two strands of work, thereby ignoring important other capabilitarian scholarship. Second, she argues that there are five essential elements that all capability theories meet; yet upon closer analysis three of them are not really essential to the capability approach. I also offer (...) an alternative description of the capability approach, which is called the cartwheel view of the capability approach. This view is at the same time radically multidisciplinary yet also contains a foundationally robust core among its various usages, and is therefore much better able to make the case that the capability approach can be developed in a very wide range of more specific normative theories. Finally, the cartwheel view is used to argue against Nussbaum's claim that all capabilitarian political theory needs to be politically liberal. (shrink)

I explore the usefulness of Martha Nussbaum's capabilities approach in regard to the UN Convention on the Rights of Persons with Disabilities (CRPD). The CRPD aims at empowering people with disabilities by granting them a number of civil and political, but also economic, social and cultural rights. Implementing the CRPD will clearly be politically challenging and also very expensive for states. Thus, questions might arise as to whether the requirements set in the CRPD can be justified from an ethical perspective. (...) I will first investigate if Nussbaum's capabilities approach provides support for the rights claimed in the CRPD. Second, I will investigate to what extent Nussbaum's capabilities approach is a useful tool to set priorities among rights in the course of the implementation of the convention. This is an urgent question because seen realistically, it will not be possible to realize all rights at once and thus some rights need to receive greater priority than others. I will argue that the capabilities approach can be regarded as supporting the rights specified in the CRPD, but that it proves unable to guide the implementation process due to an insufficient grounding of the capabilities. Employing the capabilities approach thus leads to only limited results. (shrink)

A capability approach prescribes paternalist government actions to the extent that it requires the promotion of specific functionings, instead of the corresponding capabilities. Capability theorists have argued that their theories do not have much of these paternalist implications, since promoting capabilities will be the rule, promoting functionings the exception. This paper critically surveys that claim. From a close investigation of Nussbaum's statements about these exceptions, it derives a framework of five categories of functionings promotion that are more or less unavoidable (...) in a capability theory. It argues that some of these categories may have an expansionary dynamic; they may give rise to widespread functionings promotion, which would defeat the capabilitarian promise that paternalist interventions will be exceptions to the rule of a focus on capabilities. Finally, the paper discusses three further theoretical issues that will be decisive in holding this paternalist tendency in check: how high one sets threshold levels of capability protection, how lengthy one's list of basic capabilities is, and how one deals with individual responsibility for choices resulting in a loss of one's capabilities. (shrink)

Poverty is more than a ‘welfare status’ among others. In this paper I want to show that poverty is not only a failure of distribution of income but that it is a state of humiliation. In the first section I will examine poverty knowledge, how poverty is conceptualised and what norms are inherent in the measures of the poor. In the second section I will show that poverty is humiliating because it is bound to failure and deficiency. To be poor (...) means to be unable to take care for oneself. In the third and final section I will turn to social critique and its relation to the subjects of poverty. There are good reasons to be sceptical of the poor and their judgements and to seek for objective criteria, but this cannot replace the subject and their experience. (shrink)

The capability approach, which is closely connected to the works of Amartya Sen and Martha Nussbaum, is one possible theoretical framework that could be used to answer the question as to why poverty is a problem from a moral point of view. In this paper we will focus on the normative philosophical capability approach rather than the social scientific and descriptive perspective. We will show that the approach characterizes poverty mainly as a limitation of freedom and that it is precisely (...) this aspect, from its point of view, that makes poverty morally significant. This insight shifts the discussion away from questions regarding specific capabilities or lists of them-questions treated extensively in the literature-to the more general level of what constitutes the normative core of the capability approach. But as we will also discuss and argue, the role of freedom alone does not give us a complete picture of poverty but only presents us with one aspect relevant to evaluating it. A further aspect which we consider has not been adequately recognized and taken into account by most capability theorists is the experience of disrespect and humiliation, or to put it differently, a lack of recognition. (shrink)

Health services internationally struggle to ensure health care is “person-centered” (or similar). In part, this is because there are many interpretations of “person-centered care” (and near synonyms), some of which seem unrealistic for some patients or situations and obscure the intrinsic value of patients’ experiences of health care delivery. The general concern behind calls for person-centered care is an ethical one: Patients should be “treated as persons.” We made novel use of insights from the capabilities approach to characterize person-centered care (...) as care that recognizes and cultivates the capabilities associated with the concept of persons. This characterization unifies key features from previous characterisations and can render person-centered care applicable to diverse patients and situations. By tying person-centered care to intrinsically valuable capability outcomes, it incorporates a requirement for responsiveness to individuals and explains why person-centered care is required independently of any contribution it may make to health gain. (shrink)

This paper provides a critical exploration of the capability approach to human rights (CAHR) with the specific aim of developing its potential for achieving a synthesis between “humanist” or “naturalistic” and “political” or “practical” perspectives in the philosophy of human rights. Section II presents a general strategy for achieving such a synthesis. Section III provides an articulation of the key insights of CAHR (its focus on actual realizations given diverse circumstances, its pluralism of grounds, its emphasis on freedom of choice, (...) its demand for public reasoning, its context-sensitive universalism, and its broad view of obligations). These insights go some way toward the achievement of the desired synthesis. But, as explained in IV.1, in its current form CAHR faces two serious objections by the defenders of the political perspective: the Gap Between Capabilities-Interests and Rights Objection and the Disconnect From Practice Objection. Answering these criticisms requires some amendments to CAHR. Section IV.2 suggests a response to the first objection based on the introduction of a contractualist framework of justification. Sections IV.3 and IV.4 tackle the second objection by introducing a re-characterization of the cosmopolitan standard underlying the humanist perspective and by identifying the differences and relations between various dimensions of a conception of human rights and their significance for actual political practice. The paper illustrates the practical implications of CAHR, in its modified form, for the pursuit of some important rights. (shrink)

This article presents the most important strands of the philosophical debate about markets. It offers some distinctions between the concept of markets and related concepts, as well as a brief outline of historical positions vis-à-vis markets. The main focus is on presenting the most common arguments for and against markets, and on analyzing the ways in which markets are related to other social institutions. In the concluding section questions about markets are connected to two related themes, methodological questions in economics (...) and the topics of business ethics and corporate social responsibility. (shrink)

The development of the science of poverty has largely been driven by the need to define more precisely what poverty is, as well as to provide theoretical and empirical criteria for identifying those who suffer from it. This thesis focuses on a notable response to these and related questions: the conception and measure of poverty by the British sociologist Peter Townsend. Townsend defines poverty as relative deprivation caused by lack of resources. This conception, along with his corresponding cut-off measure, constitutes (...) some of the key components of his theory of poverty. The theory discusses what poverty is, its causes, and how it can be eradicated, and is detailed in Poverty in the United Kingdom: A Survey of Household Resources and Standards of Living (1979), his magnum opus. The primary aim of this thesis is to interpret the theory from Townsend’s adherence to the value-free ideal. He pursued this ideal in response to what he perceived as the pervasive and deleterious influence of moral and political values on measures, theories, and policies on poverty throughout its scientific and political history. I argue that to be free from such influence, Townsend aimed to be as guided by epistemic values as possible, which resulted in a systematic theory of poverty. -/- The thesis is structured as follows: In Chapter 1, I situate Townsend’s conception and measurement of poverty within the context of both the recent history of scientific poverty lines and the most important approaches to measuring the phenomenon. Chapter 2 discusses the systematic nature of the theory, including its role as a middle-range theory that bridges broad-range theories with empirical data. This connection is achieved through several elements: a conception of poverty; hypotheses and anthropological observations related to the elements of the conception; measures to test these hypotheses; an explanation of poverty; and reports on how the research was conducted. Furthermore, Townsend’s theory aligns with Bradburn et al.’s (2017) measurement theory, which asserts that a good measure must include a conception of the relevant phenomenon, a representation, and procedures to gather data. Additionally, all three components must be supported by arguments showing that they fit together properly. -/- In the remaining chapters, I present and discuss the main elements of the theory: his conception of poverty as relative deprivation caused by lack of resources, along with the related hypotheses and observations (Chapter 3); the representations of this conception and the procedures for data collection, processing, as well as ensuring their reliability (Chapter 4); and the explanation of poverty (Chapter 5). I conclude by presenting what Townsend considered the “policy prescriptions” of his theory. Despite its potential shortcomings, I also argue that Townsend’s theory fulfills an important epistemic value: fruitfulness. (shrink)

Capability approach pioneers Amartya Sen and Martha Nussbaum both recognize empowerment as an important aspect of human development. They seem to disagree, however, about how empowerment should be represented within the capability approach (CA). This essay is concerned with the analysis of the foundational concepts at work within Sen and Nussbaum’s CAs. Part One concerns the key concepts of empowerment at work in Sen’s CA and has three goals. 1) Clarify Sen’s various empowerment concepts. 2) Argue that Sen’s concept of (...) Realize Agency Success is flawed. 3) Make clear that empowerment in Sen’s approach can be helpfully understood in terms of agency and capability set expansion. Part Two considers Nussbaum’s CA and the debate over whether it can account for empowerment. I conclude that not only can Nussbaum’s CA account for empowerment, but that the role of empowerment in both Sen’s and Nussbaum’s CAs can be understood in terms of agency and capability set expansion. In other words, Sen and Nussbaum actually agree about empowerment at the foundational level. (shrink)

The 2004-5 essay competition set by the Federal Reserve Bank of Minneapolis asks, “Why are some countries rich and some countries poor?” It has information which strangely does not feature the name Amartya Sen. But I have conceived of a defence against the charge that this is bad practice, which resembles appealing to the descriptivist theory of names.

This paper demonstrates how ubuntu relational philosophy may be used to ground beneficial coercive care without necessarily violating a patient’s dignity. Specifically, it argues that ubuntu philosophy is a useful theory for developing necessary conditions for determining a patient’s potential dangerousness; setting reasonable limits to the duty to protect; balancing the long-term good of providing unimpeded therapy for patients who need it with the short-term good of protecting at-risk parties; and advancing a framework for future case law and appropriate regulations (...) in the care of psychotherapy patients. Issues regarding the decision to breach medical confidentiality in psychotherapeutic care are ultimately reserved for the courts. Professional assessment might be an important first step in this process, and court rulings govern most aspects of this assessment. However, current case law, especially in the United States, places an unreasonable expectation on psychotherapists to protect all at-risk parties or foresee that a patient intends to follow through on said threats. It has largely failed to guarantee psychotherapy patients unlimited access to care, while potentially inhibiting future honest communication between patients and health professionals and endangering the safety of others. Of these decisions, the two most prominent are the 1976 Tarasoff decision and the 2016 Volk decision. This paper argues for the possibility of grounding good laws in ubuntu African philosophy in a way that protects others from harm and ensures unimpeded access to care without necessarily breaching medical confidentiality. (shrink)

Biomedical innovations are making possible the enhancement of human capabilities. There are two philosophical stances on the role that medicine should play in this respect. On the one hand, naturalism rejects every medical intervention that goes beyond preventing and treating disease. On the other hand, welfarism advocates enhancements that foster subjective well-being. We will show that both positions have considerable shortcomings. Consequently, we will introduce a third characterization in which therapies and enhancements can be reconciled with the legitimate objectives of (...) medicine inasmuch as they improve the capabilities that enable the freedom to pursue personal well-being. (shrink)

In this paper, two central questions will be addressed: ought we to implement medical AI technology in the medical domain? If yes, how ought we to implement this technology? I will critically engage with three options that exist with respect to these central questions: the Neo-Luddite option, the Assistive option, and the Substitutive option. I will first address key objections on behalf of the Neo-Luddite option: the Objection from Bias, the Objection from Artificial Autonomy, the Objection from Status Quo, and (...) the Objection from Inscrutability. I will thereafter present the Demographic Trends Argument and the Human Enhancement Argument in support of alternatives to the Neo-Luddite option. In the second half of the paper, I will argue against the Substitutive option and in favour of the Assistive option, given the existence of two chief formal deficits in medical AI technology: the causality deficit and the care deficit. (shrink)

The strong correlation between people’s socioeconomic position and health within high income countries is a well-documented fact. A person’s occupation, income and education level tell us a lot about that person’s prospects on a long and healthy life, such that we can speak of a ‘social gradient in health’, or a ‘socioeconomic health gap’. This association is often perceived to be unjust. Therefore, it is generally thought that governments should aim to reduce socioeconomic health inequalities. However, this idea needs ethical (...) justification, for it is not evident if and why exactly these inequalities are unjust. For instance, are inequalities in health unjust per se? Or because the underlying socioeconomic inequalities are unjust? And does justice require equal health levels, or a minimum level of health? What complicates the issue, is that the width of the health gap, or the steepness of the social gradient, depends on what health measures are used. Overall, the more subjective the measure, the greater the inequalities appear to be. But are all these measures equally morally relevant? This dissertation aims to give a better understanding of these philosophical questions. It does so by investigating the question of what we should understand by health in the first part, after which it addresses the question of how to evaluate socioeconomic health inequalities in the light of justice. The introduction begins with a description of the phenomenon of socioeconomic health inequalities, and how it has been addressed by politicians, epidemiologists and philosophers in the past and today. The chapter continues by formulating the central question of the dissertation – that of which health inequalities should be focused in the light of a concern with social justice. It explicates how this dissertation contributes to answering that question, by discussing the potential relation between the conceptualisation of health and justice evaluations, and by discussing which questions are addressed in each of the following chapters. The chapter 2 addresses the question of how health is conceptualised in the philosophical and public heath literature, and how theoretical concepts of health differ. It proposes to approach health concepts as a Wittgensteinian family of thick concepts and argues that while theories on health generally argue in favour of one specific concept, a comparison of concepts shows that we may need different concepts of health given the variety of health practices. By explicating the differences between five concepts of health, this chapter argues that each captures aspects of health that all seem relevant when we talk and think about health. Classifying these concepts based on their distinctions reveals them as members of a conceptual family: each of the discussed concepts differs from the others in at least one respect and resembles the others in several respects. Moreover, the discussion of the concepts shows that ‘health’ always both describes a condition and values that condition at the same time. Having both descriptive and evaluative dimensions, we can see health concepts as ‘thick concepts’. Given this evaluative dimension, it is important to reflect on the question of what understanding of health guides specific practices. Moreover, the distinctions revealed by the classification can serve as a conceptual toolbox for reflection on the assumptions and purposes of health practices. How such reflection could work is illustrated by a brief exploration of what health aspects are focused upon in three specific health practices. Chapter 3 presents a study into the question of how health is conceptualised by ordinary citizens and to what extent conceptualisations of health differ between socioeconomic groups. By making use of the method of concept mapping, this study analyses how different socioeconomic groups formulate their own answers regarding the question ‘what does health mean to you?’. It presents concept maps of health for three different socioeconomic groups living in the city of Utrecht that reveal that all groups have a multidimensional understanding of health. An interpretation of the concept maps reveals nuanced differences between groups. The multiple aspects of health were also ranked by importance. It appears that each group assigned most importance to mental health. All in all, the study shows that people in lower socioeconomic groups are more likely to show a conceptualisation of health that refers to 1) the absence of health threats, 2) a person within his/her circumstances, 3) the value of functional notions, and 4) an accepting attitude towards life. Chapter 4 addresses the question of what the theoretical and empirical study to concepts of health could imply for health equity practices. It does so by exploring further the suggestions made in chapters 2 and 3. Regarding the question of which health aspects should guide health equity policies, this chapter discusses the question of whether we should primarily look at subjective or objective health measures, and whether a universal or relative standard of health should be central. While justice-related concerns of impartiality and equal treatment may seem to favour an objective perspective and a universal health standard, it appears that we have good reason to account for the subjective perspective as well. It is also argued that a concern for recognition and participatory parity gives room for relative health standards. Th room for relative health standards confronts us with the question of how to deal with mechanisms like adaptive preferences that the concept maps reveal. It proposes a way out, by arguing for society-relative health standards. Chapter 5 examines the question of whether inequalities in health should be evaluated ‘directly’, thus independently of a distribution of their social determinants. It proposes a sufficientarian perspective, such that the central question of evaluation is that of whether everyone is – or can be – healthy enough. By discussing two sufficientarian approaches to health and social justice – by Powers & Faden and by Nussbaum – this chapter distinguishes two ways of setting a threshold level for health. Both approaches appear to provide an unsatisfactory basis for justice evaluations and lead us away from direct evaluation if we try to settle health minima that are less arbitrary. In anticipation to chapters 6 and 7, it is argued that the perspective of sufficient health for relational equality escapes this arbitrariness: compared to that of a decent human life, it better helps to answer both the question of what socioeconomic health inequalities a society is due to avoid, and the question of when socioeconomic health inequalities are unjust considering their consequences. Chapter 6 discusses to what extent Daniels’s theory of health justice provides a satisfactory answer to the question of what health inequalities a society is due to avoid. Daniels proposes an indirect evaluative approach by arguing that we should evaluate socioeconomic health inequalities in the light of Rawls’s principles of justice as fairness. That is, if socioeconomic inequalities are in accordance with fair equality of opportunity and with the difference principle, the corresponding health inequalities would be just. It is shown that the suggestion that Rawls’s principles regulate the social determinants of health neglects that not all social determinants of health belong to society’s basic structure as conceived of by Rawls and are thereby not subjected to the principles of justice. To acknowledge the social mechanisms leading to socioeconomic health inequalities in their full complexity, it is argued that we should broaden our understanding of society’s structure in accordance with Young’s notion of social structural processes. This renders the question of what health inequalities a society is due to avoid into a question of what we can expect from the side of the various actors that uphold the social structures that produce socioeconomic health inequalities. Lastly, it is discussed how a shift to Young’s theory completes the shift to non-ideal theorising that seem already initiated by Daniels, and that with this, the distinction between direct and indirect evaluation dissolves. Chapter 7 discusses to what extent equality in health is of instrumental value for a society of free and equals. It thus takes up the idea proposed in chapter 5, that an evaluation of the consequences of health inequalities is also due. Taking relational equality as an evaluative framework reveals three ways in which inequalities in life expectancy threaten this ideal. That is, via unequal risks to stigmatisation, unequal risks to unemployment and the risk of unequal pension enjoyments. It is thereby shown that these risks are especially great for those lower down the socioeconomic strata. It thus concludes that equality in health is of instrumental value to relational equality. The chapter continues to argue that our instrumental approach opens a new perspective: to mitigate the identified injustices by changing society, rather than by reducing inequalities in health. This is argued to be an advantage in the light of the realistic assumption that of the socioeconomic health inequalities will persist. The paper thus offers a complementary approach to both the evaluation and the mitigation of the injustice of socioeconomic inequalities in health. The discussion chapter summarises the central findings of the analyses of health concepts and discusses questions regarding the philosophical and practical merits of comparing theoretical health concepts, the need for developing new health measures or concepts and the importance or nonsense of studying citizen’s views on health. Repeating this for the dissertation’s second part, the central findings of the chapters on justice evaluation are summarised and followed by a discussion of questions and issues that have remained unaddressed so far. Here, central points of discussion are my take on rules of distribution, the distinction of direct and indirect evaluation, the role of ideal and non-ideal theory, the idea of relational equality, and personal responsibility for health. The chapter concludes by noting that also in the light of justice evaluations, all commonly used health measures are relevant for justice. Therefore, my recommendations for policy and further research entail that inequalities in each of these measures deserve attention by both policymakers and researchers. Specifically, policymakers and researchers should give attention to how exactly each of these health inequalities come about, in such a way that a discussion about the question of who can be assigned responsibility to alleviate them is well-informed; and both should give attention to the effects of health inequalities on the opportunities for people to live on equal standing, in such a way that when these opportunities are diminished, actions can be considered to aim to restore relational equality. (shrink)

In this chapter, I propose the mechanism of cognitive enhancement based on studies of cognitive-enhancing drugs and behavioral training. I argue that there are mechanistic differences between cognitive-enhancing drugs and behavioral training due to their different enhancing effects. I also suggest possible mechanisms for cognitive-enhancing drugs and behavioral training and for the synergistic effects of their simultaneous application.

For the last 25 years, human development has become part of official development discourses. It takes the normative position that the success of policies depends on whether they have expanded human flourishing, or expanded the 'freedoms' or 'capabilities' people have 'reason to value', as Amartya Sen would put it. It emphasises the importance of institutions to facilitate such expansion, and the agency of people to create such institutions. The ability of institutions to be conducive to human flourishing depends on the (...) nature of human interaction. When human interaction no longer has the flourishing of other persons as its aim, it can create structures which then constrain human agency. The article argues that the human development perspective could be enriched by theological insights such as structural sin and the contribution of religious narratives to public reasoning. It concentrates on the idea of justice of one biblical parable, and illustrates its argument with examples from the Argentine labour context. (shrink)

The intellectual property regimes we have currently in place are heavily under attack. One of the points of criticism is the interaction between two elements of article 27 of the Universal Declaration of Human Rights, the widely discussed issue of being able to benefit from scientific progress and the less argued for position of having a right to take part in scientific enterprises. To shine light on the question if we should balance the two elements or prioritize one of them, (...) an exploration will be offered on how benefiting from scientific progress and the ability to participate in the advancement of science relate to securing human capabilities. A different perspective to the question will be gained by identifying the problem as an issue of misrecognition, especially the failure to recognize many willing collaboration partners in scientific research as peers. Lastly, I will argue that cooperative justice requires that if we have an innovation incentive system that disproportionally benefits one particular group, a certain duty to counterbalance this advantage exists when we are relying on mutual cooperation for the recognition of intellectual property rights. (shrink)

Robots as social companions in close proximity to humans have a strong potential of becoming more and more prevalent in the coming years, especially in the realms of elder day care, child rearing, and education. As human beings, we have the fascinating ability to emotionally bond with various counterparts, not exclusively with other human beings, but also with animals, plants, and sometimes even objects. Therefore, we need to answer the fundamental ethical questions that concern human-robot-interactions per se, and we need (...) to address how we conceive of »good lives«, as more and more of the aspects of our daily lives will be interwoven with social robots. (shrink)

In projects concerning big data, ethical questions need to be answered during the design process. In this paper the Value Sensitive Design method is applied in the context of data-driven health services aimed at disease prevention. It shows how Value Sensitive Design, with the use of a moral dialogue and an ethical matrix, can support the identification and operationalization of moral values that are at stake in the design of such services. It also shows that using this method can support (...) meeting the requirements of the General Data Protection Regulation. (shrink)

Some proponents of the Anthropocene argue that it is time adopt a future-oriented outlook: natural baselines no longer matter, and humans should remake the planet for the better. This raises questions about whose vision should guide such remaking, and whether the past deserves any consideration in adapting for the future. I argue that the past remains relevant, because the natural, cultural, and social worlds people enter into – shaped by those who came before us – matter. On this view, there (...) are reasons to value ‘nature’, even in a human-altered world, and climate adaptation should take that into account. (shrink)

This thesis contextualises academic writing in EAP (English for Academic Purposes) and subjects it to an interdisciplinary (educational and philosophical) analysis in order to argue that what makes writing academic are its socio-academic practices and values, not its conventional forms. In rejecting dominant discourses that frame academic writing as a transferable skill which can be reduced to conventional forms, I show that academic writings are varied and evolve alongside changing writer agencies and textual environments. This accounts for the emergence of (...) a diverse academic writing landscape that enacts diverse socio-academic practices and that does not reduce writing to predictable static surface features. My methodology resists traditional disciplinary classifications and is in line with the reflective and interpretative approaches associated with the humanities. Rather than ‘filling a gap’ in academic writing research, I challenge writing conventions in EAP by questioning assumptions. This is because EAP is influential in shaping discourses about academic writing and, as such, it must not mislead students and practitioners about the evolving purposes, forms and possibilities for academic expression. The thesis is divided into three parts, each containing two chapters. Part 1 is concerned with explaining what academic writing is in EAP and how EAP can misrepresent it. Part 2 delves into the history of writing and literacy to tease out the ideologies shaping writing practices. Part 3 proposes a model based on philosophical theories of mind and sociology that lays the foundation for a macro theory of academic writing and a future writing pedagogy. The model re-imagines academic writing as an affordance within a non-linear, emergent and complex social open system. This system can be referred to as an organic unity and requires a shift from conceiving writing as a ‘transferable skill’. When re-imagined as an affordance, change and diversity in academic writing practices become possible. (shrink)

In philosophical debates on human rights between the East and the West, scholars argue whether rights in the Universal Declaration of Human Rights (UDHR) and other international documents (in short, “international human rights”) are universal or culturally relative. Some scholars who emphasize the importance of East Asian cultures (such as the Confucian tradition) have different attitudes toward civil and political rights (CP rights) than toward economic, social, and cultural rights (ESC Rights). They argue that at least some international human rights (...) on the list of CP rights are not universal and believe that East Asian cultures can contribute to the moral justification of ESC rights. This chapter introduces a philosophical argument to support a normative account of human rights. This normative account, called “the minimal account of human rights,” is based on the ideas of minimal values, especially essential necessities of dignity. Based on this account, we can explain why international human rights are both universal and justified by East Asian cultures, especially the Confucian tradition. To explain this minimal account and illustrate how it can be applied to debates on international human rights, this chapter focuses on debates on the international human rights to liberty on the list of CP rights and the human rights to health on the list of ESC rights. (shrink)

There are two leading accounts of the principles of educational adequacy by Elizabeth Anderson and Debra Satz. Anderson’s and Satz’s accounts have been criticized for being insufficiently value-pluralist, and both lack a metric of justice. In this paper, I revise the principle of educational adequacy in order to address these problems. I argue that although the principle of educational adequacy cannot be the only principle in a complete theory of educational justice, it can tell us what basic justice in education (...) requires in measurable terms. I highlight two core commitments that Anderson and Satz share: a commitment to 1) democratic egalitarianism and 2) sufficientarian equal citizenship. Then, I reformulate these commitments in a way that accounts for the role that other egalitarian values have to play in a complete theory of justice in education. Finally, I claim that progress towards educational adequacy can be measured using the capabilities approach. (shrink)

Agroecology has been criticized for being more labor-intensive than other more industrialized forms of agriculture. We challenge the assertion that labor input in agriculture has to be generally minimized and argue that besides quantity of work one should also consider the quality of work involved in farming. Early assessments on work quality condemned the deskilling of the rural workforce, whereas later criticisms have concentrated around issues related to fair trade and food sovereignty. We bring into the discussion the concept of (...) contributive justice to welcome the added labor-intensity of agroecological farming. Contributive justice demands a work environment where people are stimulated to develop skills and learn to be productive. It also suggests a fairer distribution of meaningful work and tedious tasks. Building on the notion of contributive justice we explore which capabilities and types of social relationships are sustainably promoted and reinforced by agroecological farming practices. We argue that agroecological principles encourage a reconceptualization of farm work. Farmers are continuously stimulated to develop skills and acquire valuable experiential knowledge on local ecosystems and agricultural techniques. Further, generalized ecological studies recognize the significance of the farmer’s observations on natural resources management. This contributes to the development of a number of capabilities and leads to more bargaining power, facilitating self-determination. Hereby farm work is made more attractive to a younger generation, which is an essential factor for safeguarding the continuity of family farms. (shrink)

This paper aims to provide autonomy-based reasons in favour of limitarianism. Limitarianism affirms it is of primary moral importance that no one gets too much. The paper challenges the standard assumption that having more material resources always increases autonomy. It expounds five mechanisms through which having too much material wealth might undermine autonomy. If these hypotheses are true, a theory of justice guided by a concern for autonomy will support a limitarian distribution of wealth. Finally, the paper discusses two issues (...) autonomy-based limitarianism would raise. First, insofar as coercion invades autonomy, do autonomy-based reasons legitimate coercive measures to secure a limitarian distribution of wealth? Second, is a limitarian ethos consistent with the incentive to produce enough wealth to secure distributive justice? (shrink)

In this paper I make a contribution to three distinct, but deeply interwoven subjects. Firstly, I argue that, at the level of ideal theory, the distribution of educational goods should follow a sufficientarian pattern and that the evaluative space of children’s advantage should be inspired by the capability approach. Secondly, the paper is delving into the more policy-oriented debates on the desirability of school choice. I argue that, given the non-ideal circumstances in which decision makers have to act, giving parents (...) the opportunity to choose the school for their children is a sine qua non condition for even approaching the ideals of sufficientarian justice. Lastly, I move the discussion on more empirical grounds, advancing a criticism of the Romanian educational legislation. I argue that the sufficiency-constrained school choice system that I envision could solve some of the problems that the Romanian educational system faces today. (shrink)

In this thesis I am going to explore the relationship between happiness and imprisonment. I will discuss three theories of happiness - hedonism, life satisfaction theories and emotional states theories. I will argue that the main problem of these theories is that they take happiness to consist only of psychological states. Because of this, I will turn my attention towards those theories that evaluate happiness in terms of how well life is going for the person who is living it. I (...) will argue that my Aristotelian account is the most plausible way to understand the relationship between happiness and imprisonment. This is because it takes into account both the external circumstances and the psychological and emotional life of pnsoners. Through this thesis, I will show that my account of happiness in prison accomplishes three tasks: i) it solves the problems encountered by the other theories of happiness in the evaluation of prisoners' happiness, ii) it does not suffer from two of the main objections to the other objectivist theories of happiness, and iii) it can help us to investigate the happiness of prisoners empirically more accurately. (shrink)

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 debate over the civilian use of nuclear power is highly polarised. We argue that a reasonable response to this deep disagreement is to maintain that advocates of both camps should modify their positions. According to the analysis we propose, nuclear power is neither entirely right nor entirely wrong, but rather right and wrong to some degree. We are aware that this non-binary analysis of nuclear power is controversial from a theoretical point of view. Utilitarians, Kantians, and other moral theorists (...) make sharp, binary distinctions between right and wrong acts. However, an important argument speaking in favour of our non-binary analysis is that it better reflects our considered intuitions about the ethical trade-offs we face in discussions of nuclear power. The aim of this article is to make this argument sharp by explaining how it can be rendered compatible with, and supported by, the Capability Approach, which is quickly becoming one of the most influential frameworks for thinking about human development. (shrink)

This paper explores the process of aging from a phenomenological perspective. Supplementing the model of becoming old found in Simone de Beauvoir’s work with a phenomenology of human suffering and flourishing, it asks whether it is possible to lead a good life in the process of becoming old. Is it possible to flourish while experiencing bodily waning? Is it possible to flourish while experiencing the shrinking of one’s everyday world and the passing away of close others? Aging, at least in (...) its protracted phases, appears to become full of suffering rather than flourishing. What are the prospects of finding meaningful life projects despite old age? By making use of insight found in Heidegger and other phenomenologists the paper tries to develop a slightly different view on aging than the one found in Beauvoir, stressing the importance of embodied experiences and life choices, which not only depend upon societal oppression and being objectified by others, but also upon processes of nature and the possibilities of an intergenerational intersubjectivity. Resources for this project is found in the philosophy of affectivity developed by Heidegger and other phenomenologists of facticity, such as Maurice Merleau-Ponty, Charles Taylor, Helmuth Plessner and Hannah Arendt. (shrink)

This article presents the framework Capability Sensitive Design (CSD), which consists of merging the design methodology Value Sensitive Design (VSD) with Martha Nussbaum's capability theory. CSD aims to normatively assess technology design in general, and technology design for health and wellbeing in particular. Unique to CSD is its ability to account for human diversity and to counter (structural) injustices that manifest in technology design. The basic framework of CSD is demonstrated by applying it to the hypothetical design case of a (...) therapy chatbot for mental health. By applying CSD to a design case, the merits of this new framework over the standard VSD approach become apparent. Also, the application demonstrates what a technology design would look like when attention is paid to capabilities right from the start of the design process. (shrink)

Este artículo pone en cuestión la adecuación de los enfoques convencionales de la Calidadde Vida e intenta realizar una contribución al debate existente acerca de la revisión, integración o mejora de las métricas del bienestar tal como son usadas tradicionalmente en la bibliografía de indicadores estadísticos. Como una alternativa, este estudio basa sus principales supuestos en el Enfoque de la Capacidad de Amartya Sen. La principal hipótesis es que los análisis del bienestar que se basan en mediciones puramente monetarias o (...) que olvidan la importancia del valor intrínseco de la libertad impiden adquirir imágenes adecuadas de las auténticas condiciones de vida de la gente en las complejas sociedades contemporáneas y, de ese modo, perjudican el diseño de la política pública. Esta hipótesis es verificada y comprobada tanto a través de una discusión teórica como también por medio de un análisis empírico de datos estadísticos de la OCDE. Lo que nuestras conclusiones indican es la gran importancia de incrementar la libertad para conseguir mejores resultados sociales e individuales. (shrink)