This paper presents a new analysis of the concept of non-instrumental need, and, using it, demonstrates how a need-satisfaction theory of well-being is much more plausible than might otherwise be supposed. Its thesis is that in at least some contexts of evaluation a central part of some persons’ well-being consists in their satisfying certain “personal needs”. Unlike common conceptions of other non-instrumental needs, which make those out to be moralised, universal, and minimal, personal needs are expansive and particular to particular (...) persons, generated rather by persons’ non-moral personal commitments. Against objections to the contrary, I show how these are genuine necessities, since unlike mere desires and freely escapable aims, personal needs constitute objective, inescapable, and non-compensable practical requirements. The personal-need-satisfaction theory of well-being combines objectivity with subject-dependence in novel ways, and motivates well-being pluralism at the level of individual agency. Implicating necessity as it does in the structure of individual well-being, this account presents a robust challenge to ethical and political theories that rely on the intrapersonal aggregation of well-being to be unproblematic. (shrink)

From the day on which humans are born they need things. Some of these needs seem “basic,” such as our needs for food, water or shelter. Everybody has these needs. We cannot escape them. We also cannot escape the serious harm that arises when these needs remain unsatisfied. It is thus no wonder that in thinking about what we ought to do some researchers have suggested to first and foremost focus on people's basic needs. Such need‐based theories must answer three (...) main questions: What are basic needs? What are their implications for normative questions? And how can these needs and their satisfaction be measured? Proponents must also defend these theories against objections, such as against the objections that the theories are paternalistic, materialistic, and passivity‐promoting. Depending on their goals and contexts (distributive justice, sustainable development, human rights, etc.), appeals to basic needs may take various different forms. (shrink)

In answering normative questions, researchers sometimes appeal to the concept of basic needs. Their guiding idea is that our first priority should be to ensure that everybody is able to meet these needs—to have enough in terms of food, water, shelter, and so on. This article provides an opinionated overview of basic needs in normative contexts. Any basic needs theory must answer three questions: (1) What are basic needs? (2) To what extent do basic needs generate reasons for action and (...) how are these reasons to be understood? (3) How are basic needs and their satisfaction to be measured? I address these questions in turn. Then I also briefly discuss the theoretical potential of appealing to basic needs in normative contexts. It turns out that future research in this area could benefit from a higher degree of interdisciplinarity and methodological reflection, and that, generally speaking, basic needs theories are more promising than they have often been claimed to be. (shrink)

Why did such highly abstract ideas as truth, knowledge, or justice become so important to us? What was the point of coming to think in these terms? This book presents a philosophical method designed to answer such questions: the method of pragmatic genealogy. Pragmatic genealogies are partly fictional, partly historical narratives exploring what might have driven us to develop certain ideas in order to discover what these do for us. The book uncovers an under-appreciated tradition of pragmatic genealogy which cuts (...) across the analytic-continental divide, running from the state-of-nature stories of David Hume and the early genealogies of Friedrich Nietzsche to recent work in analytic philosophy by Edward Craig, Bernard Williams, and Miranda Fricker. However, these genealogies combine fictionalizing and historicizing in ways that even philosophers sympathetic to the use of state-of-nature fictions or real history have found puzzling. To make sense of why both fictionalizing and historicizing are called for, the book offers a systematic account of pragmatic genealogies as dynamic models serving to reverse-engineer the points of ideas in relation not only to near-universal human needs, but also to socio-historically situated needs. This allows the method to offer us explanation without reduction and to help us understand what led our ideas to shed the traces of their practical origins. Far from being normatively inert, moreover, pragmatic genealogy can affect the space of reasons, guiding attempts to improve our conceptual repertoire by helping us determine whether and when our ideas are worth having. (shrink)

Principles of need are constantly referred to in health care priority setting. The common denominator for any principle of need is that it will ascribe some kind of special normative weight to people being worse off. However, this common ground does not answer the question how a plausible principle of need should relate to the aggregation of benefits across individuals. Principles of need are sometimes stated as being incompatible with aggregation and sometimes characterized as accepting aggregation in much the same (...) way as utilitarians do. In this paper we argue that if one wants to take principles of need seriously both of these positions have unreasonable implications. We then characterize and defend a principle of need consisting of sufficientarian elements as well as prioritarian which avoids these unreasonable implications. (shrink)

Instrumentalists about need believe that all needs are instrumental, i.e., ontologically dependent upon ends, goals or purposes. Absolutists view some needs as non-instrumental. The aims of this article are: clearly to characterize the instrumentalism/absolutism debate that is of concern (mainly §1); to establish that both positions have recent and current adherents (mainly §1); to bring what is, in comparison with prior literature, a relatively high level of precision to the debate, employing some hitherto neglected, but important, insights (passim); to show, (...) on grounds not previously to the fore in the literature, that insofar as instrumentalism’s advocates have provided arguments for the position, these are unsound (§2); to argue against instrumentalism using a new dilemma concerning whether ‘end’, ‘goal’ and ‘purpose’ are interpreted in a mentalistic manner (§3); to elucidate the implications of the needs/need-satisfiers and preconditions/means distinctions for the debate (§4). (shrink)

Cranston argued that scarcity makes universal welfare rights impossible. After showing that this argument cannot be avoided by denying scarcity, I consider four challenges to the argument which accept the possibility of conflicts between the duties implied by rights. The first denies the agglomeration principle; the second embraces conflicts of duties; the third affirms the violability of all rights-based duties; and the fourth denies that duties to compensate are overriding. I argue that all four challenges to the scarcity argument are (...) unsuccessful. I then discuss Eddy’s recent challenge, which makes welfare rights context dependent, but I argue that this also fails because it makes rights unknowable. I conclude that the scarcity argument, restated in the light of the discussion, shows that universal welfare rights, as ordinarily understood, are impossible and I explain the philosophical and practical significance of this conclusion. (shrink)

The concept of need is often proposed as providing an additional or alternative criterion to cost-effectiveness in making allocation decisions in health care. If it is to be of practical value it must be sufficiently precisely characterized to be useful to decision makers. This will require both an account of how degree of need for an intervention is to be determined and a prioritization rule that clarifies how degree of need and the cost of the intervention interact in determining the (...) relative priority of the intervention. Three common features of health care interventions must be accommodated in a comprehensive theory of need: the probabilistic nature of prognosis (with and without the intervention); the time course of effects; and the fact that the most effective treatments often combine more than one intervention. These common features are problematic for the concept of need. We outline various approaches to prioritization on the basis of need and argue that some approaches are more promising than others. (shrink)

One generally considered plausible way to allocate resources in health care is according to people’s needs. In this paper I focus on a somewhat overlooked issue, that is the conceptual structure of health care needs. It is argued that what conceptual understanding of needs one has is decisive in the assessment of what qualifies as a health care need and what does not. The aim for this paper is a clarification of the concept of health care need with a starting (...) point in the general philosophical discussion about needs. I outline three approaches to the concept of need and argue that they all share the same conceptual underpinnings. The concept of need is then analyzed in terms of a subject x needing some object y in order to achieve some goal z. I then discuss the relevant features of the object y and the goal z which make a given need qualify as a health care need and not just a need for anything. (shrink)

This book offers an original account of a distinctly republican theory of social and global justice. The book starts by exploring the nature and value of Hegelian recognition theory. It shows the importance of that theory for grounding a normative account of free and autonomous agency. It is this normative account of free agency which provides the groundwork for a republican conception of social and global justice, based on the core-ideas of freedom as non-domination and autonomy as non-alienation. As the (...) author argues, republicans should endorse a sufficientarian account of social justice, which focuses on the nature of social relationships and their effects on people's ability to act freely and realize their fundamental interests. On the global level, the book argues for the cosmopolitan extension of the republican principles of non-domination and non-alienation within a multi-level democratic system. In so doing, the book addresses a major gap in the existing literature, presenting an original theory of justice, which combines Hegelian recognition theory and republican ideas of freedom, and applying this hybrid theory to the global domain. Fabian Schuppert creates a grand synthesis uniting neo-republican insights on freedom with Hegelian recognition theory. The result is an account of agency that arises from the idea of non-domination whose aim it is to safeguard individual freedom. When combined with Hegelian recognition theory a social focus also emerges. This amalgam comments on many of the major disputes concerning global justice from a cosmopolitan perspective. Because of the broad scope and the many contemporary discussions engaged this book will be of keen interest to scholars as well as a welcome addition to the classroom. (shrink)