This study investigates the reaction of high school students in an alternative urban secondary school to highly controlling, authoritarian practices. Premised on the published theories, we imagined that students would object to the regime and consider it unduly repressive. Student reactions were elicited through questionnaires and interviews. To our considerable surprise, most respondents approved of the authoritarian regime and disapproved of granting students more self-expression. Most have come to believe that they do not deserve freedom from pervasive rules, for they (...) will indeed abuse it. As one child said approvingly, ?This is a disciplinary school? ? you give up freedom and accept rules. We discuss the implications of such a strong identification with the school's norms and the consequent distrust of personal autonomy. (shrink)

The history of the documentation of health inequality is long. The way in which health inequality has customarily been documented is by comparing differences in the average health across groups, for example, by sex or gender, income, education, occupation, or geographic region. In the controversial World Health Report 2000, researchers at the World Health Organization criticized this traditional practice and proposed to measure health inequality across individuals irrespective of individuals’ group affiliation. They defended its proposal on the moral grounds without (...) clear explanation. In this paper I ask: is health inequality across individuals of moral concern, and, if so, why? Clarification of these questions is crucial for meaningful interpretation of health inequality measured across individuals. Only if there was something morally problematic in health inequality across individuals, its reduction would be good news. Specifically, in this paper I provide three arguments for the moral significance of health inequality across individuals: (a) health is special, (b) health equity plays an important and unique role in the general pursuit of justice, and (c) health inequality is an indicator of general injustice in society. I then discuss three key questions to examine the validity of these arguments: (i) how special is health?, (ii) how good is health as an indicator?, and (iii) what do we mean by injustice? I conclude that health inequality across individuals is of moral interest with the arguments (b) and (c). (shrink)

This article discusses the concepts of collective subjectivity and collective causality as an alternative to methodological individualism, structuralism and functionalism. It resumes Aristotelian issues in a realist framework and applies, by way of example, its main concepts to criticize and suggest a distinct view of capabilities"" and ""freedom"" in connection with collective subjectivity.".

Individuals who become ill as a result of personal lifestyle choices often shift the monetary costs of their healthcare needs to the taxpaying public or to fellow members of a private insurance pool. Some argue that policies permitting such cost shifting are unfair. Arguments for this view may seem to draw support from luck egalitarian accounts of distributive justice. This essay argues that the luck egalitarian framework provides no such support. To allocate healthcare costs on the basis of personal responsibility (...) would arbitrarily and publicly burden socially detectable risk-takers while undetectable risk-takers continue to get a free ride. That problem is unavoidable even on the assumption that distributive institutions outside the healthcare sector are fully just. In actual, farfrom-just societies, imposing personal liability for the costs of voluntary risk taking would be wrong for an additional reason. Doing so would tend to magnify existing distributive injustices. These conclusions draw attention to two common ‘moral fallacies of the second best’ that can arise when applying ideal normative theory to matters of institutional design and in real-world policy contexts. (shrink)

A decade ago, we reviewed the field of clinical ethics; assessed its progress in research, education, and ethics committees and consultation; and made predictions about the future of the field. In this article, we revisit clinical ethics to examine our earlier observations, highlight key developments, and discuss remaining challenges for clinical ethics, including the need to develop a global perspective on clinical ethics problems.

Here is a picture of a society that one might suppose to be ideally just in its distributive practices: All members of the society are equally free to live in any way that they might choose, and institutions are arranged so that the equal freedom available to all is at the highest feasible level. What, if anything, is wrong with this picture? One might object against the insistence on equal freedom for all and propose that freedom should instead be maximinned, (...) or leximinned, or maximized, or distributed according to some alternative norm. In this essay I wish to set aside the choice of distributive norm. The question for this essay is whether freedom in any sense is the aspect of people's condition that is the right basis of interpersonal comparison for a theory of distributive justice. I approach this question by analyzing some rival conceptions of freedom. (shrink)

Amartya Sen and Martha Nussbaum have argued that justice is concerned, at least in part, with the distribution of capabilities (opportunities to function). Richard Arneson, G.A. Cohen, and John Roemer have argued that justice is concerned with something like the distribution of opportunities for well-being. I argue that, although some versions of the capability view are incompatible with some versions of the opportunity for well-being view, the most plausible version of the capability view is identical to a slight generalization of (...) the opportunity for well-being view. (shrink)

"Ethical Leadership" in modern multicultural corporations is first the consideration of different personal and cultural value systems in decision-making processes. Second, it is the assignment of responsibility either to individual or organisational causalities. The task of this study is to set the stage for a distinction between rational entities and the arbitrary preferences of individuals in economic decision making processes.Defining rational aspects of behaviour in economics will lead to the formal structures of organisational systems, which are independent of concrete but (...) varying values. Luhmann''s Theory of systems of communication describes the internal dynamic forces of economic communication processes in terms of formal structures. On the other hand Habermas'' Theory of discourse integrates the previous relationship between individual subjectivity and rational behaviour. Habermas gives an indication of how to separate subjective values and meaning from rational arguments in rational communication processes. The translation of these theoretical structures into practical applications for decision making processes and decision taking acts links the ethical, or value-oriented, context precisely to both individual and organisational areas of responsibility. (shrink)

A liberal egalitarian theory of justice seeks to combine the values of equality, personal freedom, and personal responsibility. It is considered a much more promising position than strict egalitarianism, because it supposedly provides a fairness argument for inequalities reflecting differences in choice. However, we show that it is inherently difficult to fulfill this ambition. We present a liberal egalitarian paradox which shows that there does not exist any robust reward system that satisfies a minimal egalitarian and a minimal liberal requirement. (...) Moreover, we demonstrate how libertarianism may be justified in this framework if we drop the egalitarian condition. (shrink)

This article contributes to recent work on justice in resilience-based projects for climate adaptation. At present, the model commonly used for guiding normative reflection in this domain is the tripartite model of justice, whereby justice is seen as comprising distributive, procedural and recognitional aspects. After discussing some conceptual problems and practical shortcomings of this model, we propose an alternative model with six forms of justice or kinds of justice demands: distributive, procedural, intergenerational, restorative and retributive justice, and justice in system (...) outcomes. We also illustrate some advantages of this model with respect to representative accounts of the tripartite model. (shrink)

As it has historically been the case with many pandemics, the Covid-19 experience will induce many philosophers to reconsider the value of medical practice. This should be a good opportunity to critically scrutinize the way medical research and medical interventions are carried out. For much of its history, medicine has been very inefficient. But, even in its contemporary forms, a review of common protocols in medical research and medical interventions reveal many shortcomings, especially related to methodological flaws, and more importantly, (...) conflicts of interests due to profit incentives. In the face of these problems, we propose a program of “gentle medicine”. This term, originally formulated by philosopher Jacob Stegenga, describes a form of medicine in which physicians intervene less than they currently do. As part of this general program, we advance a series of reform recommendations that could be enacted both by medical staff in their everyday practice, but also by public health officials and policymakers. (shrink)

In this article, we apply deductive content analysis to the 100 most influential publications in the field of social entrepreneurship to identify the normative assumptions in SE scholarship. Using eight contemporary schools of thought in political philosophy as a template for analysis, we identify the philosophies underlying SE literature and the important consequences of their normative stances, such as: ambiguous concepts, justifications and critiques, and normative contradictions. Our study contributes to the SE literature by proposing that political philosophy can help (...) to identify what counts as the ‘social’ in SE. We are showing some of the field’s inherent normative tensions that could dampen its impact, and propose ways in which a normative awareness would help to establish a basis upon which to evaluate and demonstrate the social, economic, and cultural impact of SE. (shrink)

After an initial period of feminist theorizing concerned with understanding patriarchy as a structure of male domination, many thinkers turned away from theorizing domination as such and focused instead on women's (constructed) subjectivity, identity, and agency. While this has fostered important insights into the formation of women's preferences, desires, and choices, this focus on subjectivity and subject formation has largely overshadowed deeper understandings of patriarchy as a structure of male domination while producing elisions between agency and freedom. In this article, (...) I move to show how domination as a structural concept can help us to reclaim the idea of ‘patriarchy’ as a source of women's systematic oppression while freedom as non-domination, derived from early republican conceptualizations of freedom, can help us to disambiguate freedom from agency by taking as central the relative positions of actors within social and political structures. Structural freedom as non-domination is thus useful for feminist thinkers in that it gives us critical purchase on the dynamics inherent in unequal social and political relationships and can be linked clearly to the institutions and ideologies that shape and justify interactions between more powerful and less powerful groups. Further, from this point of view intersecting structures of domination can be analysed rather than intersecting identity categories, allowing us to take intersectionality into account and avoiding the need to ground feminist action on a unitary ‘category woman’. Finally, this analysis points toward the radical democratic connexion between freedom and participation in the creation of the material and symbolic structures that frame our collective lives. (shrink)

Academic freedom is often regarded as an absolute value of higher education institutions. Traditionally, its value is related to such topics as tenure, and the need for academic work to be free from undue political influence and other pressures that can challenge time-consuming research processes. However, when an analysis of student freedom begins with arguments about free research and free speech, undergirded as they generally are by liberal political philosophy, other considerations, related to broader views of freedom, can slip through (...) the cracks. In this essay, I want to take a step back from typical discussions of academic freedom, to take a broader perspective, before considering how freedom relates to student experience. The first part of this essay explores diverse elaborations and defences of freedom: How it is upheld in the liberal philosophy of Kant, the critical pedagogy of Freire, existentialism, and the capabilities approach to development. Exploring the often contrasting insights and implications of these views, I then connect relevant theoretical understandings derived from them to an exploration of the experience of freedom and of students. This essay thus considers how student freedom, and student academic freedom, are more precarious concepts than typically assumed. (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)

Intensified and extensive data production and data storage are characteristics of contemporary western societies. Health data sharing is increasing with the growth of Information and Communication Technology platforms devoted to the collection of personal health and genomic data. However, the sensitive and personal nature of health data poses ethical challenges when data is disclosed and shared even if for scientific research purposes. With this in mind, the Science and Values Working Group of the COST Action CHIP ME ‘Citizen's Health through (...) public-private Initiatives: Public health, Market and Ethical perspectives’ identified six core values they considered to be essential for the ethical sharing of health data using ICT platforms. We believe that using this ethical framework will promote respectful scientific practices in order to maintain individuals’ trust in research. We use these values to analyse five ICT platforms and explore how emerging data sharing platforms are reconfiguring the data sharing experience from a range of perspectives. We discuss which types of values, rights and responsibilities they entail and enshrine within their philosophy or outlook on what it means to share personal health information. Through this discussion we address issues of the design and the development process of personal health data and patient-oriented infrastructures, as well as new forms of technologically-mediated empowerment. (shrink)

The article represents a contribution to the discussions about the basis, motives, and goals of European integration, which were stimulated by the recent “normative turn” in EU studies. My aim in this the article is threefold: By addressing the issue of internal legitimacy of EU decision-making, I wish to show that the European Union is in need of a public “story” of European integration; however, a closer analysis suggests that there is much normative disagreement on values and principles that are (...) supposed to define such “Europeanness”. This is also relevant for the role of Europe on the scene of international or global politics, where the EU aspires to become a leading actor, or is supposed to do so by cosmopolitan-minded authors. Lastly, the text defends the usefulness of the traditional conceptual apparatus of political theory, which which has – in relation to the European integration – in recent times come under attack. (shrink)

The purpose of this paper is to briefl y examine one of the fundamental assumptions made in contemporary liberal political philosophy, namely that persons are free and equal. Within the contemporary liberal political thought it would be considered very uncontroversial and even trivial to claim something of the following form: “persons are free and equal” or “people think of themselves as free and equal”. The widespread nature of this assumption raises the question what justifies this assumption, are there good reasons (...) for holding it? After establishing some methodological remarks, including a distinction between having freedom-equality and being free-equal and restricting the domain of discussion to include only a subset of all moral questions, namely the questions of political morality, the paper deals with some conceptual issues concerning this assumption of persons as free and equal, such as how do free-and-equal-making properties relate to person-making properties. It then moves on to examine three broad ways the free-and-equal-mak-ing properties could be established. First, necessary property approaches, which take some necessary feature of persons to be what makes them free and equal (e.g. possessing an immortal soul). Second, contingent property approaches, which take some contingent feature of persons to be what makes them free and equal (e.g heir practise of reasoning). Third, agreement based approaches, which take some agreement or contract among persons to be the basis for their being free and equal (e.g. evolutionary emergence of our treatment of others). Strengths and weaknesses of all approaches will be examined. (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)

This introduction begins with two simple case studies that reveal a background of socio-economic complexities that hinder development. The availability of healthcare and the issue of cross-border justice are the key points to be addressed in this study. The chapters consider philosophy, economics, and bioethics in order to provide a global perspective. Two theories come into play in this book—the ideal and non-ideal—which offer insight on why and how things are done.

Child poverty is one of the biggest challenges of today, harming millions of children. In this book, it is investigated from a philosophical social justice perspective, primarily in the context of modern welfare states. Based on both normative theory (particularly the capability approach) and empirical evidence, the authors identify the injustices of child poverty, showing how it negatively affects the well-being of children as well as their whole life course. But child poverty is not 'given by nature'. It is avoidable (...) and there is certainly the moral duty to alleviate it. Therefore, Graf and Schweiger develop a normative theory of responsibilities, which clarifies the moral role of different agents in the poor child's environment: the family, the state and many others, that have so far been neglected in philosophical theories. They conclude their book by sketching how their theory can be extended to global child poverty and what it means to show equal respect and concern for every child - no matter where and in which context they were born. (shrink)

What does evaluation mean? This article examines the evaluative process as a practical judgment that links a situation to a set of values in order to decide upon a course of action. It starts by discussing A. Sen’s “relational” and “comparative” account of evaluation, built in critical dialogue with J. Rawls’ deductive theory. Comparison, incompleteness, reality, and deliberation are the key principles of Sen’s approach, which, in some respects, echoes that of J. Dewey. The second part shows the relevance of (...) completing Sen’s approach with Dewey’s pragmatism, since Dewey’s emphasis on practical judgment is a useful counterbalance to Sen’s focus on evaluation as a cognitive process. Dewey introduces a shift from values to valuation and draws a distinction between prizing and appraising, which makes the logic of inquiry and the search for consistency between means and ends in a given situation the fulcrum of evaluation. The third part of this paper addresses the relationship between values and norms in evaluative processes. Neither Sen nor Dewey deals with this question in a systematic way, although norms, which are both similar and different from values, contribute to frame evaluations in different ways: as horizons, resources, or constrains. Bringing norms into the picture means completing the pragmatist account with an institutionalist perspective, as we suggest through the example of the evaluation of work. (shrink)

An economic man, i.e., the leading role in economic ethics, has been deeply investigated in our study considering a human being’s economic behavior and the hypotheses for an economic man in traditional economics based on M. Weber’s and S. N. Bulgakov’s Christian economic man. Among various channels to study business ethics and economic ethics, we chose the definition of an economic man given by Weber and Bulgakov to review a hypothesis about a rational economic man in economics and discussed L. (...) von Mises’s and A. Sen’s contentions for an economic man’s substantive freedom and innermost being. The issue deserved to be further investigated by scholars who concern business ethics and economic ethics consists in reconciling egotism and altruism commonly embedded in an economic man’s heart and boosting more altruistic economic men. (shrink)

The article examines four principles of cost allocation (cost of mitigation, of adaptation, and of compensation) for environmental policies that aim to address climate change: “the polluter pays”, “who benefits pays”, “who is able to pay, pays”, and “the equal per capita”. It shows that they are all problematic. A better case can be built by the joint work of only the two principles of “the polluter pays” and “who benefits pays”.

Much of the most influential free speech scholarship emphasises that ‘political speech’ warrants the very highest standards of protection because of its centrality to self-governance. This central idea mitigates against efforts to justify the regulation of political speech and renders some egregiously offensive or harmful speech worthy of protection from a theoretical perspective. Yet paradoxically, in practice, in many liberal democracies such speech is routinely restricted. In this paper, I develop an argument that is compatible with both the argument from (...) democracy and the notion of political speech, and that can justify the regulation of hate speech, by joining an understanding of the constitutive role of speech in individuals’ lives derived from Nussbaum's capabilities theory with ideas of democratic deliberation and legitimation drawn from a Habermasian framework. This approach attends to the conditions required at an individual level for democratic legitimation to occur at a social level. It permits the development of a robust theoretical justification for the protection of a broad range of speech. It simultaneously provides a guiding framework for regulatory policy designed to ameliorate the effects of, and inhibit the expression of, that speech, which could imperil the conditions required for individuals to develop their own capabilities and which instantiates anti-democratic practice, and thus discourse, preventing the very communications required to perform democracy from being uttered. Thus, my argument also strengthens and transforms the argument from democracy as a justification for free speech protection more generally. (shrink)

The capability approach assigns a central role to the contexts within which social interactions take place, which make individual liberty achievable. However, an auxiliary concept is necessary to explain the contexts of collective action more accurately. In this paper I shall present Taylor’s concept of irreducibly social goods as a supplement to the capability approach. I shall also introduce the concept of hermeneutics as a strategy suitable for evaluating which capabilities are to be considered valid, as an alternative to aggregative (...) methodologies. This conceptual development at the core of the capability approach demands to be framed by a normative criterion that enables us to distinguish between emancipatory and conservative contexts of social action; for that purpose I make use of the subject idealization that Honneth and Anderson present. (shrink)

Journal of Global Ethics, Volume 9, Issue 3, Page 249-262, December 2013.

This article is the result of an empirical research project analyzing the decision behaviour of Austrian managers in ethical dilemma situations. While neoclassical economic theory would suggest a pure economic rational basis for management decisions, the empirical study conducted by the authors put other concepts to a test, thereby analyzing their importance for managerial decision making: specific notions of fairness, reciprocal altruism, and commitment. After reviewing some of the theoretical literature dealing with such notions, the article shows the results of (...) an online survey working with scenarios depicting ethical dilemma situations. By judging such scenarios the respondents showed their preference for the named concepts, though with different degrees of confirmation. The results (with all limitations of an online survey in mind) support the theoretical work on the named concepts: Fairness elements (including Rawlsian principles of justice and an understanding of fairness as conceived by a reference transaction) play a major part in management decisions in ethical dilemma situations. Also, commitment as a behaviour that sticks to rules even if personal welfare is negatively touched, and reciprocal altruism as a cooperative behaviour that expects a reciprocal beneficial action from other persons have been concepts used by Austrian managers when analyzing ethical dilemmas. The article also tries to put the results into a comparative perspective by taking into account other studies on ethical decision factors conducted with, e.g. medical doctors or journalists, and by discussing intercultural implications of business ethics. (shrink)

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)

The present article explores ‘anti-cosmopolitan’ arguments that shared institutions above the state, such as there are, are not of a kind that support or give rise to distributive claims beyond securing minimum needs. The upshot is to rebut certain of these ‘anti-cosmopolitan’ arguments. Section 1 asks under which conditions institutions are subject to distributive justice norms. That is, which sound reasons support claims to a relative share of the benefits of institutions that exist and apply to individuals? Such norms may (...) require strict equality, Rawls’ Difference Principle, or other constraints on inequality. Section 2 considers, and rejects, several arguments why existing international institutions are not thought to meet these conditions. (shrink)

Since Sen's insightful analysis of Arrow's Impossibility Theorem (Sen, 1970/1979), Arrow's theorem is often interpreted as a consequence of the exclusion of interpersonal information from Arrow's framework. Interpersonal comparability of either welfare levels or welfare units is known to be sufficient for circumventing Arrow's impossibility result (e.g. Sen, 1970/1979, 1982; Roberts, 1980; d'Aspremont, 1985). But it is less well known whether one of these types of comparability is also necessary or whether Arrow's conditions can already be satisfied in much narrower (...) informational frameworks. This note explores such a framework: the assumption of (ONC+0), ordinal measurability of welfare with the additional measurability of a 'zero-line', is shown to point towards new, albeit limited, escape-routes from Arrow's theorem. Some existence and classification results are established, using the condition that social orderings be transitive as well as the condition that social orderings be quasi-transitive. (shrink)

Martha Nussbaum has expanded the capabilities approach to defend positive duties of justice to individuals who fall below Rawls’ standard for fully cooperating members of society, including sentient nonhuman animals. Building on this, David Schlosberg has defended the extension of capabilities justice not only to individual animals but also to entire species and ecosystems. This is an attractive vision: a happy marriage of social, environmental and ecological justice, which also respects the claims of individual animals. This paper asks whether it (...) is one that the capabilities approach can really deliver. Serious obstacles are highlighted. The potential for conflict between the capability-based entitlements of humans and those of nonhuman animals or ‘nature’ is noted, but it is argued that this does not constitute a decisive objection to the expanded capabilities approach. However, intra-nature conflicts are so widespread as to do so: the situation is outside the circumstances of justice as they are standardly understood. Schlosberg attempts to reconcile such conflicts by re-examining what it means to flourish as a sentient nonhuman animal. This fails, because of the distinction between flourishing as a species, which often requires predation, and flourishing as an individual, which is as frequently incompatible with it. Finally, the paper considers how a capabilities theorist might move beyond such conflicts, identifying two possible strategies (which are not themselves unproblematic) for reconciling the demands of humans, animals and ecosystems. (shrink)

As a contribution to development ethics, this article attempts to clarify what 'empowerment' should mean, in so far as it is a valuable goal. I begin with the core ethical idea of empowerment that is to be found in recent work on measuring empowerment, led by Deepa Narayan, namely: empowerment occurs when people are better able to shape their own lives. Since this is a metaphor, I attempt to articulate a corresponding literal meaning. What I find is that people are (...) empowered to the extent that: (a) they exercise enhanced decision-making and influence over strategic life-choices and barriers to agency and well-being freedom; (b) their capacity for such decision-making and influence has also been enhanced; and (c) they are capable of making these gains prevail, given (i) the capabilities they have and assets they control, individually or collectively, and (ii) the opportunity structure in which they act. (shrink)

The present article identifies how social determinants of health raise two categories of philosophical problems that also fall within the smaller domain of ethics; one set pertains to the philosophy of epidemiology, and the second set pertains to the philosophy of health and social justice. After reviewing these two categories of ethical concerns, the limited conclusion made is that identifying and responding to social determinants of health requires inter-disciplinary reasoning across epidemiology and philosophy. For the reasoning used in epidemiology to (...) be sound, for its scope and (moral) purpose as a science to be clarified as well as for social justice theory to be relevant and coherent, epidemiology and philosophy need to forge a meaningful exchange of ideas that happens in both directions. (shrink)

The harmful effects of Covid 19 on children living in poverty have refocused attention on the complex nature of child poverty and the vexed question of its relationship to education. The paper examines a tension at the heart of much discussion of child poverty and education. On the one hand, education is often regarded as essential for children’s flourishing and a means by which children can “escape” poverty; yet on the other hand, education systems, institutions, and practices, often reflect and (...) entrench the disadvantages associated with poverty. Narratives concerning education as an escape from poverty tend not to deal in any depth with the injustices associated with poverty, stressing instead the transformative potential of education. By contrast, largely sociological analyses of the ways in which schooling reproduces inequalities tend to stop short of developing a normative account of how education can contribute to transforming the structural injustices related to poverty and its effects on children’s lives. In working to move beyond this analytic impasse, the paper shows how the cluster of concepts, which Robeyns (2018) locates as central to the capability approach, give insights which help to address these two different lacunae. The notion of conversion factors highlights the significance of taking account of existing relationships in education, while the distinction between capabilities and functionings helps guide practices regarding the education of children living in poverty. Drawing on literature on the heightened inequalities associated with poor children’s experience of lack of schooling during the COVID pandemic, the paper sketches some of the ways in which sociological analysis and normative evaluation can be linked in taking forward an “ethically engaged political philosophy” (Wolff, 2018) to discuss child poverty and education in real schools. (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)

ABSTRACTThis paper argues that most prominent normative theories on immigration neglect a critical dimension of the migratory phenomenon, a neglect that blinds them to important rights that, under some circumstances, immigrants ought to have as a matter of justice. Specifically, the paper argues that these theories fail to appreciate that the children of immigrant families, regardless of whether they were born in their parents’ country or in the host country, should benefit from educational rights addressing needs that are particular to (...) their situation. These children may be forced to move between these two countries. This situation generates an obligation for both states to act jointly to provide educational opportunities so that these children are fully conversant with both cultures and in both languages. Put succinctly, then, we argue that since children of immigrant families lack any certainty of permanent residence in the host society owing to the threat of deportation and the precarity of their legal status, host and home societies bear the duty to offer an education that allows them to be functional in both societies. (shrink)

Beschäftigt man sich systematisch mit der Konzeption von Gerechtigkeit für Kinder bzw. während der Kindheit, ist es hilfreich, drei verschiedene Fragen zu klären, die normalerweise in Hinblick auf Erwachsene diskutiert werden, doch auch für eine genauere Analyse der Ansprüche von Kindern relevant sind. Welche Güter sind für die Gerechtigkeitstheorie relevant? Nach welchen Prinzipien sollen diese Güter verteilt werden? Wer ist dafür verantwortlich, dass die angestrebte Güterverteilung verwirklicht wird? In dieser Einleitung umreißen wir kurz den gegenwärtigen Diskussionsstand, der in diesen drei (...) großen gerechtigkeitsrelevanten Themenfeldern hinsichtlich von Kindern besteht. Zunächst analysieren wir Ressourcen und Fähigkeiten als angemessene Metrik der Gerechtigkeit für Kinder. Hinsichtlich der Verteilungsprinzipien lassen sich vor allem egalitäre und suffizienztheoretische Herangehensweisen unterscheiden. Schließlich werden in Bezug auf die Frage nach den relevanten „Akteuren der Gerechtigkeit“ für Kinder hauptsächlich die Familie bzw. die Eltern und der Staat diskutiert. (shrink)

Por muchos años los economistas han afirmado que los individuos buscan maximizar la riqueza para maximizar su utilidad, porque "si somos más ricos, somos más felices". Es necesario reconocer que la vida buena, la felicidad, es la combinación de bienes materiales y de bienes relacionales. "Relaciones": es una gran preocupación, porque hoy el "bien escaso", son las relaciones genuinas, la confianza, la fraternidad. El "otro" como persona es, en sí mismo, un valor absoluto no sujeto a transacciones. La sociedad utilitarista (...) cambia los bienes relacionales por bienes de consumo que desprecian la relación con la naturaleza, con la comunidad, con los derechos humanos, con los más vulnerables. El notable economista Amartya Sen es quien despliega la multidimensionalidad del desarrollo humano pero no encara la categoría del don-reciprocidad aunque una lectura profunda podría reconocer que esta categoría subyace en su visión humanista tal vez sin habérselo propuesto nunca. Una de las tareas esenciales dentro del amplio debate sobre el desarrollo humano integral es la profundización de la categoría de la relación, del paradigma relacional. El don, la reciprocidad en economía van ocupando un espacio. For years now, economists have stated that individuals search to maximize richness in order to maximize its utility, because "richer means happier". There is a need to recognize that good life, happiness, is a combination of both materials and relationships. "Relationships": this is matter of preoccupation, because today "the scarce good", are genuine relationships, trust, confidence, fraternity. The "other" as a person is, in itself, an absolute value not subject to transactions. A utilitarian society changes relationships for useful goods that despise the interaction with nature, with the community, with human rights, with the most vulnerable. The renowned economist Amartya Sen displays the multidimensional vision of human development but does not face the category of gift-reciprocity even though a deeper view could recognize that this category underlies in his humanist vision, perhaps without even having thought of this. One of the main tasks inside the wide debate on complete human development is to deepen the category of relationships, the relational paradigm. The gift, the reciprocity in economy are already winning their space. (shrink)