In modern representative democracies, much healthcare is publicly funded or provided and so the question of what healthcare systems should do is a matter of public policy. Given that public resources are inevitably limited, what should be done and who should benefit from healthcare? It is a dilemma for policymakers and a subject of debate within several disciplines, but rarely across disciplines. In this paper, I draw on thinking from several disciplines and especially philosophy, economics, and systems theory. I conclude (...) that economist and philosopher John Broome’s writing provides the framework for an answer: a healthcare system in a democracy should do as much good as possible, although sometimes we should sacrifice some overall good for the sake of fairness. This leaves open some detailed questions about what in practice we consider to be good and fair, and about when some good should be traded off in order to be fair. The answers to these questions depend on our values, or as explained by systems theory, our weltanschauung. How policy decisions should be made when citizens’ values differ is a subject of extensive academic debate. However, it is a separate question. Representative democracies have mechanisms for resolving such debates. (shrink)

A group of economists has recently begun addressing questions at the intersection of ethics and economics. They are preparing new definitions of individual choice that combine self-interest and other-interest, new processes of interpersonal exchange that result in cooperation rather than conflict, and new measures of social well-being that include rights as well as outcomes. This article surveys that work, and suggests areas where conceptual inputs from business ethicists are clearly needed, and where multiple opportunities for interactive research are obviously present.

In this paper we argue that Sen's defence of liberal democracy suffers from a moralistic and pro-liberal bias that renders it unable to take pluralism as seriously as it professes to do. That is because Sen’s commitment to respecting pluralism is not matched by his account of how to individuate the sorts of preferences that ought to be included in democratic deliberation. Our argument generalises as a critique of the two most common responses to the fact of pluralism in contemporary (...) (i.e. post-Rawls) liberalism: a broadly procedural understanding of autonomy and the idea of deliberative democracy. That is to say, the difficulties with pluralism we identify can be traced back to the particular version of Kantian deontology prevalent in contemporary liberalism, and to the equally prevalent aspiration to ground political legitimacy in a moralised consensus. (shrink)

In the seventh and most recent edition of their classic book, Principles of Biomedical Ethics, Tom Beauchamp and James Childress define a virtue as a character trait that is “socially valuable and reliably present” and a moral virtue as such a trait that is also both “dispositional” and “morally valuable”. The virtues that they single out as “focal” within biomedical ethics are compassion, discernment, trustworthiness, integrity, and conscientiousness. Not all is well in their treatment of virtue. Beauchamp and Childress seem (...) to worry that an ethical theory in which virtues are fundamental will neglect duties, rights, and societal needs. Further, they insist that there is no reason to think that, within ethical theory, one family of ethical concepts is the most important, nor that one theoretical approach is correct, or even superior to others. I will try to show, that there are strong reasons to see language, concepts, and matters of virtue as fundamental within normative ethical theory, both generally and in such specialized subareas as medical ethics. These reasons reveal themselves when we analyze concepts at the core of the alternative approaches to theorizing ethics that Beauchamp and Childress identify. (shrink)

The capability approach is gaining momentum as a theory of corporate responsibility and business ethics at a time when the UN Guiding Principles have become a most important framework. A novel approach is now emerging that seeks to understand and specify human rights obligations of businesses within the framework provided by the capability approach. This article partially examines the triad corporate responsibility–human rights–capability approach by exploring the relationship between human rights and capabilities. Thus, it offers conceptual and practical implications for (...) a human rights perspective on corporate responsibility. The bulk of our thesis focuses on studying Nussbaum’s and Sen’s claim that human rights are entitlements to capabilities by means of a discussion of the notion of human dignity. In particular, we show the capability approach’s ability to dissipate theoretical and practical challenges posed by the notion of dignity. This article does not offer a detailed explanation of the implications of our investigation for human rights responsibilities of business. However, an outline of its potential contribution toward unfolding those obligations, conceptually and practically, is provided. (shrink)

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)

While being generally appreciative of Sen's theory of capabilities, the point of this paper is to raise some conceptual challenges that arise in addressing entrenched conditions of power and domination from the capability paradigm. The enhancement of people's capability prospects with regard to education, employment, decent living standards and political participation can empower them to challenge various dominating conditions in society. It can also bestow a sense of self-confidence in people to stand up against discriminating practices. Yet, the objectives of (...) the capability theory remain less secure as long as citizens’ capability prospects are dependent on and subjected to arbitrary power and domination. I argue that Sen's theory of capabilities can be strengthened and developed as an effective antidote to the liberal hegemony in political theory by drawing on resources from Pettit's republicanism particularly by accommodating the robustness condition of freedom and by envisioning individual freedom as intimately tied to the common good of the polity. (shrink)

Within recent scholarship, a long-standing tendency to view Foucault as pessimistic about the possibilities of activism is now being reversed. For many contemporary commentators who emphasize the themes of personal agency, transgression and radical freedom in their assessment of his thought, Foucault offers new possibilities for political practice and for the pursuit of self-determination. However, an examination of Foucault’s work, particularly in the transitional period preceding his so-called ‘ethical’ writings, indicates his appreciation of basic human needs and functions that complicates (...) the current understanding of Foucault as a philosopher of freedom. Particularly in his discussions of the ideas of ‘desubjectivation’ and ‘limit-experience’, Foucault’s work recognizes that prior conditions of psychological, economic and social ‘well-being’ are prerequisites for any subsequent performance of freedom. Examining this dimension of Foucault’s work reveals interesting points of convergence between his thought and the capabilities approach advocated by philosophers such as Amartya Sen and Martha Nussbaum. Like them, Foucault’s work recognizes that there are some minimal levels of human functioning below which talk of self-determination is misplaced. As such, political philosophy needs to be concerned with the grounds of personal and political obligation, no less than the limits and possibilities 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)

This paper explores the role of deliberation in the context of the capability approach to human well-being from the standpoint of the individual doing the reflecting. The concept of a ‘strong evaluator’ is used develop a concept of the agent of capability. The role of values is discussed in the process of deliberating, particularly the nature of and difference between prudential values and intrinsic values. Some consideration is given to the limits and constraints on deliberation and finally a brief example (...) of deliberation is considered—that of occupational choice. (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)

The expropriation of marginalized women’s labor is a key issue in business ethics in these times of global outsourcing and informal work arrangements. This has led to a transnational advocacy movement for securing the labor rights of homeworkers, who are poor women working on piece-rate contracts out of their homes. Drawing on materialist feminism, our paper critically explores the homeworker network in Pakistan, that was set up as part of a global push by international institutions and networks to localize the (...) issue across geographies. Our focus is the national women’s NGO that leads advocacy efforts on the issue in the country and its relationship with other actors. Through fieldwork spanning 3 years we find that the network employs a top-down ‘us versus them’ approach in advocacy and mobilization. The race-to-the-bottom between the network’s national and district-level actors for donor funding further undermines prospects for developing indigenous narratives of resistance. The network, while mission bound to enhance the collective agency of its constituency, has depoliticized what should have been a class-based feminist struggle. From a materialist perspective, we conclude that the NGOized network rests upon and feeds off of its constituency, creating an additional layer of primitive accumulation over the workers it represents. (shrink)

Capability theorists have suggested different, sometimes incompatible, ways in which their approach takes account of the value of freedom, each of which implies a different kind of normative relation between functionings and capabilities. This paper examines three possible accounts of the normative relation between functionings and capabilities, and the implications of each of these accounts in terms of degrees of paternalism. The way in which capability theorists apparently oscillate between these different accounts is shown to rest on an apparent tension (...) between anti-paternalism and anti-fetishism. The paper then advances a fourth account, which incorporates a concern with the content-independent or ‘non-specific’ value of freedom. Only the fourth account would remove all traces of paternalism from the capability approach. Whatever reasons advocates of the capability approach might have had for rejecting this fourth account, those reasons are not internal to the capability approach itself. (shrink)

ABSTRACT:This article considers the economic case for so-called sweatshop wages and working conditions. My goal is not to defend or reject the economic case for sweatshops. Instead, proceeding from a broadly pluralist understanding of value, I make and defend a number of claims concerning the ethical relevance of economic analysis for values that different agents utilize to evaluate sweatshops. My arguments give special attention to a series of recent articles by Benjamin Powell and Matt Zwolinski, which represent the latest and (...) best defense of the economic case for sweatshops. In the process, I challenge Zwolinski’s “non-worseness claim” (NWC), and the idea that opposition to sweatshop wages and working conditions fails to respect that the autonomy of would-be sweatshop workers. Ultimately, I conclude that even if the economic case for sweatshops rests on a solid empirical foundation, agents possess good reason to advocate for better wages and working conditions for sweatshop workers, and to prefer less exploitative or coercive relationships. Sweatshop labor undermines a compelling vision of free markets, according to both Kantian and republican conceptions of freedom, and the relationships formed by those who participate in such markets. (shrink)

When assessing institutions and social outcomes, it matters how free society is within them (‘societal freedom’). For example, does capitalism come with greater societal freedom than socialism? For such judgements, freedom theorists typically assume Individualism: societal freedom is simply the aggregate of individual freedom. However, G.A. Cohen’s well-known case provides a challenge: imagine ten prisoners are individually free to leave their prison but doing so would incarcerate the remaining nine. Assume further that no one actually leaves. If we adopt Individualism (...) plus the standard liberal view of freedom, such incarceration seems to leave societal freedom unaffected. This is an important theoretical challenge: it seems we must either reject Individualism or reject, or at least amend, the liberal view. Cohen also suggests his case, and the collective unfreedom therein, helps us capture how proletarians are unfree under capitalism. In this article, I argue that we can solve Cohen’s puzzle, if we focus on how power can reduce freedom. If we adopt the republican view of freedom, we can say that prisoners are unfree in Cohen’s case because they are dominated by the other prisoners. This solution keeps Individualism but moves beyond liberal freedom. I then also show how this individualistic framework captures proletarian unfreedom. (shrink)

This paper aims to clarify the status of capability in Sen’s idea of justice. Sen’s name is so widely associated with the concept of capability that commentators often assume that his contribution to the study of justice amounts to a capability theory, albeit underdeveloped. We argue that such a reading is misleading. Taking Sen’s reticence about operationalization seriously, we show that his contribution is inconsistent with a capability theory. Instead, we defend the idea that the capability approach plays a heuristic (...) role: capability is a step in his argument against alternative materials, but is not meant as a definitive end. Sen defends a critical perspective primarily to encourage public reasoning and respect for agency as regards the definition of what should count in the evaluation of social states. (shrink)

Within the western health-care context autonomyis a central value. Still, as it is used withinthis context it is far from clear what we areactually talking about. In this article theauthor outlines four different uses or aspectsof autonomy: self-determination, freedom,desire-fulfilment and independence. Oneimportant conclusion will be that in order tobe able to respect autonomy in a way thatactually brings value to the patient’s life weneed to clearly assess what aspect of autonomythe patient values and for what reason it isvalued by the (...) patient. (shrink)

Property regimes are based on fundamental values of the society or group that designs and reproduces them. This paper analyses the ethical underpinnings of Progressive Commons in comparison to the values underlying private property and traditional Commons. Against this backdrop, we discuss the potential of Progressive Commons to address major challenges in context of the twenty-first century economy. Seed Commons serve as an example. Our analysis shows that Progressive Commons respond to contemporary societal and environmental challenges by re-interpreting the classical (...) values underlying traditional private and common property regimes, turning them to sovereignty, re-democratization, and social-ecological sustainability in the global context. (shrink)

Public health policies typically assume that there are characteristics and constraints over health that an individual cannot control and that there are choices that an individual could change if he is nudged or provided with incentives. We consider that health is determined by a range of personal, social, economic and environmental factors and we discuss to what extent an individual can control these factors. In particular, we assume that the observed health status of an individual is a result of factors (...) within the individual’s control and constraints the individual faces. We suggest three different constraints: budget, time and psychological constraints and position various determinants of health according to increasing levels of constraint and increasing degrees of individual control. We finally discuss public health policies such as nudging, intervening and rewarding within this new framework and show that the level of constraints and the degree of individual control on health status are essential dimensions to consider when designing and implementing public health policies. (shrink)

Economic approaches to both social evaluation and decision-making are typically Paretian or utilitarian in nature and so display commitments to both welfarism and consequentialism. The contrast between the economic approach and any rights-based social philosophy has spawned a large literature that may be divided into two branches. The first is concerned with the compatibility of rights and utilitarianism seen as independent moral forces. This branch of the literature may be characterized as an example of the broader debate between the teleological (...) and deontological approaches. The second is concerned with the possibility that substantial rights may be grounded in utilitarianism with the moral force of rights being derived from more basic commitments to welfarism and consequentialism. This branch of the literature may be characterized as an exploration of the flexibility of the teleological approach, and, in particular, its ability to give rise to views more normally associated with the deontological approach. This essay is concerned with the second branch of the literature. (shrink)

What if human joy went on endlessly? Suppose, for example, that each human generation were followed by another, or that the Western religions are right when they teach that each human being lives eternally after death. If any such possibility is true in the actual world, then an agent might sometimes be so situated that more than one course of action would produce an infinite amount of utility. Deciding whether to have a child born this year rather than next is (...) a situation wherein an agent may face several alternatives whose effects could well ramify endlessly on such suppositions, for the child born this year would be a different person—one who preferred different things, performed different actions, and had different descendants—from a child born next year. It has recently been suggested that traditional utilitarianism stumbles on such cases of infinite utility. Specifically, utilitarianism seems to require, for its application, that all experience of pleasure and pain cease at some time in the future or asymptotically approach zero.2 If neither of these conditions holds, then the utility produced by each of two alternative actions may turn out to be infinite, and utilitarianism thus loses its ability to discriminate morally between them. (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)

I distinguish four different interpretations of ‘equality of opportunity.’ We get four interpretations because a neglected ambiguity in ‘opportunity’ intersects a well-known ambiguity in ‘equality.’ The neglected ambiguity holds between substantive and non-substantive conceptions of ‘opportunity’ and the well-known ambiguity holds between comparative and non-comparative conceptions of ‘equality.’ Among other things, distinguishing these four interpretations reveals how misleading ‘equal opportunity for advantage’ formulations of luck egalitarianism can be. These formulations are misleading in so far as they obscure the difference between (...) two separate claims about which inequalities are consistent with true equality. Luck egalitarianism claims that inequalities that have been chosen in some suitable sense are consistent with true equality, while the traditional ideal of equality of opportunity only claims that inevitable inequalities that have been determined through fair competitions are consistent with true equality. Obscuring the difference between these two claims therefore serves both to arrogate the rhetorical advantages of the traditional ideal to luck egalitarianism and to cover over a limitation to luck egalitarianism’s ambition to provide a comprehensive principle of distributive justice. (shrink)

In modern representative democracies, much healthcare is publicly funded or provided and so the question of what healthcare systems should do is a matter of public policy. Given that public resources are inevitably limited, what should be done and who should benefit from healthcare? It is a dilemma for policymakers and a subject of debate within several disciplines, but rarely across disciplines. In this paper, I draw on thinking from several disciplines and especially philosophy, economics, and systems theory. I conclude (...) that economist and philosopher John Broome’s writing provides the framework for an answer: a healthcare system in a democracy should do as much good as possible, although sometimes we should sacrifice some overall good for the sake of fairness. This leaves open some detailed questions about what in practice we consider to be good and fair, and about when some good should be traded off in order to be fair. The answers to these questions depend on our values, or as explained by systems theory, our weltanschauung. How policy decisions should be made when citizens’ values differ is a subject of extensive academic debate. However, it is a separate question. Representative democracies have mechanisms for resolving such debates. (shrink)

We evaluate the suitability of Nussbaum's substantive account of capabilities in light of conceptual and empirical work that has shown that positivity is widely valued and pursued as an end by many people, and evidence that positive outcomes, even economic ones, are often caused by well-being rather than the other way around. While Nussbaum sees positive emotions as incidental to the experience of well-being, we argue that the experience of such mental states is partly constitutive of flourishing.

This article analyses the challenges for the strategies and practices of transformational development in a changing context. This reflection is based on contributions received during the process of dialogues and regional consultations, realised from August 2012 until March 2014, of the ACT Alliance, an international coalition of churches and faith-based organisations (FBOs) working in the areas of humanitarian response, development and advocacy. The main processes that affect the changing development context are addressed, such as the ongoing globalisation as well as (...) the consequences, mainly regarding the shrinking space for civil society. It discusses the concepts of human development and of transformational development, based on a people-centred development vision, a human rights-based approach and advocacy, which addresses the root causes and effects of poverty, inequality and injustice. Transformational development practices, from Latin America, are presented and analysed. The article concludes that the changing development context also offers opportunities, especially regarding regional and global alliances of FBOs, civil society organisations and of social movements. (shrink)