This paper presents the interpersonal variability of harm challenge to Jerome Wakefield’s harmful-dysfunction account (HDA) of disorder. This challenge stems from the seeming fact that what promotes well-being or is harmful to someone varies much more across individuals than what is intuitively healthy or disordered. This makes it at least prima facie difficult to see how judgments about health and disorder could, as harm-requiring accounts of disorder like the HDA maintain, be based on, or closely linked to, judgments about well-being (...) and harm. This interpersonal variability of harm challenge is made salient by the difficulty faced by harm-requiring accounts of disorder in dealing satisfactorily with cases of intuitively disordered conditions that seem harmless because they do not deprive the individuals that they affect of anything that they value (e.g., desired infertility). I argue that this challenge is made more serious for the HDA by some clarifications Wakefield has recently made on harm. In recent publications, Wakefield dissociates himself from the sheer cultural-relativist view of harm attributed to him by some critics based on his linkage of harm to social values, and adopts a more qualified social-values-based view of harm that leaves room for criticism of the values endorsed by members of a cultural group at a given time. I show how Wakefield’s qualified view makes it more difficult for the HDA to deal with the interpersonal variability of harm challenge, at least when applied to a Western cultural context where a high value is placed on autonomy and individual choice. (shrink)

In a recent article, McClennen (2012) defends an alternative bargaining theory in response to his criticisms of the standard Nash bargaining solution as a principle of distributive justice in the context of the social contract. McClennen rejects the orthodox concept of expected individual utility maximizing behavior that underlies the Nash bargaining model in favor of what he calls full rationality, and McClennen’s full cooperation bargaining theory demands that agents select the most egalitarian strictly Pareto-optimal distributional outcome that is strictly Pareto-superior (...) to the state of nature. I argue that McClennen’s full cooperators are best described as reasonable agents whose rationality is constrained by moral considerations and that McClennen’s bargaining theory is moralized in this regard. If, by contrast, the orthodox concept of rationality is assumed and plausible assumptions are made about human nature and social cooperation, then a modified version of the standard Nash bargaining solution, which I call the stabilized Nash bargaining solution (Moehler 2010), is justified. From the perspective of rational agents, the stabilized Nash bargaining solution can accommodate McClennen’s criticisms of the standard Nash bargaining solution in the context of the social contract and, for such agents, it can serve as a principle of distributive justice in deeply morally pluralistic societies. (shrink)