Ranging over central issues of morals and politics and the nature of freedom and authority, this study examines the role of value-neutrality, rights, equality, ...

This paper proposes a theory of institutional pluralism to deal with the question whether and to what extent limits should be placed on the market. It reconceives the pluralist position as it was presented by Michael Walzer and others in several respects. First, it argues that the options on the institutional menu should not be principles of distribution but rather economic mechanisms or ‘modes of provision’. This marks a shift from a distributive to a provisional logic. Second, it argues that (...) we should drop the assumption that any good should only be placed in one sphere, i.e. distributed according to one distributive principle. This marks a shift to ‘complex pluralism’: for at least some goods it is appropriate that they are provided through the market and through one or more non-market alternatives simultaneously. Finally, it argues that the often used conventionalist justification should be traded for a capability approach to the moral evaluation of markets and non-market alternatives. Any institutional option on our menu has value to the extent that it enhances the morally relevant capabilities of the producers and/or consumers of the good that is to be provided. This approach will be illustrated with two examples of goods for which it yields complex pluralist conclusions: the provision of care and the provision of media content. (shrink)

Recently, some of the leading proponents of the view that there is widespread incommensurability among goods have suggested that the incommensurability of some goods is a constitutive feature of the goods themselves. So, for example, a friendship and a million dollars are incommensurable because it is part of what it is to be a friendship that it be incommensurable with money. According to these ‘constitutive incommensurabilists’ incommensurability follows from the very nature of certain goods. In this paper, I examine this (...) idea and argue that constitutive incommensurabilists have mistaken for constitutive incommensurability a particular emphatic kind of comparability. This examination involves an account of ‘higher’ and ‘lower’ goods and an explanation of how goods of different ‘types’ figure in practical conflict. (shrink)

Commodification of health care is a central tenet of managed care as it functions in the United States. As a result, price, cost, quality, availability, and distribution of health care are increasingly left to the workings of the competitive marketplace. This essay examines the conceptual, ethical, and practical implications of commodification, particularly as it affects the healing relationship between health professionals and their patients. It concludes that health care is not a commodity, that treating it as such is deleterious to (...) the ethics of patient care, and that health is a human good that a good society has an obligation to protect from the market ethos. (shrink)

This essay serves as an introduction to this issue of the Journal of Medicine and Philosophy on commodification and health care. The essay attempts to sharpen the articulation of generally expressed worries about the commodification of health care. It does so by defining commodification, analyzing three components of the good of health care, and attempting to assess how commodification might distort the shape of each of those components. Next, it explores how the good of health care might be distorted by (...) the market-based principle of distributive justice, "to each according to ability to pay." Finally, it identifies two basic questions about the relationship of medicine and the market that merit further exploration. How does the market-based language of "incentives" so pervasive in the world of managed care distort the complex patterns of virtue and vice that motivate actors in the health care arena? If we recognize that we cannot eliminate the influence of money from the health care system, how can we insure that the good of health care remains, in Radin's terms, "incompletely commodified"? (shrink)

Many activities formerly not in the market are being “marketized,” and women's labor is increasingly in the market. I consider the grounds on which to decide what should and what should not be “in” the market. I distinguish work that is paid from work done under “market norms,” and argue that market values should not have priority in education, childcare, healthcare, and many other activities. I suggest that a feminist ethics of care is more promising than Kantian ethics or utilitarianism (...) for recommending social decisions concerning limits on markets. (shrink)

: Many activities formerly not in the market are being "marketized," and women's labor is increasingly in the market. I consider the grounds on which to decide what should and what should not be "in" the market. I distinguish work that is paid from work done under "market norms," and argue that market values should not have priority in education, childcare, healthcare, and many other activities. I suggest that a feminist ethics of care is more promising than Kantian ethics or (...) utilitarianism for recommending social decisions concerning limits on markets. (shrink)

: Care theorists have made significant gains over the past twenty-five years in establishing caring as a viable moral and political concept. Nonetheless, the concept of caring remains underdeveloped as a basis for a moral and political philosophy, and there is no fully developed account of our moral obligation to care. This article advances thinking about caring by developing a definition of caring and a theory of obligation to care sufficient to ground a general moral and political philosophy.

Care theorists have made significant gains over the past twenty-five years in establishing caring as a viable moral and political concept. Nonetheless, the concept of caring remains underdeveloped as a basis for a moral and political philosophy, and there is no fully developed account of our moral obligation to care. This article advances thinking about caring by developing a definition of caring and a theory of obligation to care sufficient to ground a general moral and political philosophy.

Where society is viewed as an association of equal and autonomous persons, the work of caring for dependents, "love's labors", figure neither in political ...

Amartya Sen has made a major contribution to the theory of social justice, and of gender justice, by arguing that capabilities are the relevant space of comparison when justice-related issues are considered. This article supports Sen's idea, arguing that capabilities supply guidance superior to that of utility and resources (the view's familiar opponents), but also to that of the social contract tradition, and at least some accounts of human rights. But I argue that capabilities can help us to construct a (...) normative conception of social justice, with critical potential for gender issues, only if we specify a definite set of capabilities as the most important ones to protect. Sen's "perspective of freedom" is too vague. Some freedoms limit others; some freedoms are important, some trivial, some good, and some positively bad. Before the approach can offer a valuable normative gender perspective, we must make commitments about substance. (shrink)