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)

Amartya Sen’s work has contributed to shifting our focus from food availability to food access and utilisation, together called ‘nutritional capability’. Existing food insecurity instruments have been informed partially by the capability approach, but remain focused on material deprivation and its economic sub-dimensions. This narrow focus has become problematic, particularly in high-income countries, where material deprivation is largely overcome and food poverty manifests itself differently from that in low-income countries. Food poverty in high-income countries should thus be approached from a (...) ‘food capability’ perspective that fully recognises the multidimensionality of eating lives and the multiple factors that affect their dietary standards. To demonstrate the usefulness of this perspective, the Alkire-Foster method for multidimensional food poverty was utilised to analyse food poverty in Japan. The Alkire-Foster measure has a dual cut-off approach and its adapted method can produce a multidimensional food poverty index by setting reasonable food deprivation and poverty thresholds. The national data used for empirical demonstration was obtained from a web-based questionnaire conducted in Japan, to which 973 participants (aged 20–60 years) responded. The measurement identified a 20.6% food-poor population and inequalities in food capabilities among subgroups. Although economic deprivation was tightly linked to food poverty, the results suggested that gender- and age-based inequalities were larger than socioeconomic status-based ones, which reflected much wider societal problems in Japan than growing economic poverty, such as gender inequality and population ageing. The proposed measurement is effective for monitoring food policy impacts and complementing existing food insecurity assessment tools. The results will be useful for promoting social debate about what the minimal dietary standard should be in high-income societies. (shrink)

In an interesting letter to Anna George, the daughter of Henry George, Bernard Shaw wrote: “Your father found me a literary dilettante and militant rationalist in religion, and a barren rascal at that. By turning my mind to economics he made a man of me”. I am not able to determine what making a man of Bernard Shaw would exactly consist of, but it is clear that the kind of moral and social problems with which Shaw was deeply concerned could (...) not be sensibly pursued without examining their economic aspects. For example, the claims of property rights, which some would defend and some would dispute, are not just matters of basic moral belief that could not possibly be influenced one way or the other by any empirical arguments. They call for sensitive moral analysis responsive to empirical realities, including economic ones. (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)

The new biotechnology raises expectations for modifying human behaviour through its use. This article focuses on the ethical analysis of the not so remote possibility of rehabilitating criminals by means of neurotechnological techniques. The analysis is carried out from a synthetic position of, on the one hand, the consequentialist conception of what is right and, on the other hand, the emphasis on individual liberties. As a result, firstly, the ethical appropriateness of adopting a general predisposition for allowing the neurorehabilitation of (...) prisoners only if it is safe and if they give their consent will be defended. But, at the same time, reasons will be given for requiring, in certain circumstances, the exceptional use of neurotechnology to rehabilitate severely psychopathic prisoners, even against their will, from the same ethical perspective. (shrink)