This essay defends the controversial and indeed counterintuitive claim that there is a good argument to be made from a Lockean perspective for government action to guarantee access to health care. The essay maintains that this argument is in some regards more robust than the well-known argument in defense of universal health care spelled out by Norman Daniels, which this essay also examines in some detail. Locke's view that government should protect people's lives, property, and freedom–where freedom is understood as (...) independence and self-determination–justifies government action to ensure access to health care, because (roughly), just as individuals cannot protect themselves from crime and foreign invasion, so individuals are unable to provide for their own health care. Defense from disease is as important as defense from crime, and–although this is arguable–government action to guarantee access to health care does not itself undermine freedom. (shrink)

Though the revised edition of A Theory of Justice, published in 1999, is the definitive statement of Rawls's view, so much of the extensive literature on Rawls's theory refers to the first edition. This reissue makes the first edition once again available for scholars and serious students of Rawls's work.

In this book by the award-winning author of Just Healthcare, Norman Daniels develops a comprehensive theory of justice for health that answers three key questions: what is the special moral importance of health? When are health inequalities unjust? How can we meet health needs fairly when we cannot meet them all? Daniels' theory has implications for national and global health policy: can we meet health needs fairly in ageing societies? Or protect health in the workplace while respecting individual liberty? Or (...) meet professional obligations and obligations of justice without conflict? When is an effort to reduce health disparities, or to set priorities in realising a human right to health, fair? What do richer, healthier societies owe poorer, sicker societies? Just Health: Meeting Health Needs Fairly explores the many ways that social justice is good for the health of populations in developed and developing countries. (shrink)

APA PsycNET abstract: This is the first volume of a two-volume work on Probability and Induction. Because the writer holds that probability logic is identical with inductive logic, this work is devoted to philosophical problems concerning the nature of probability and inductive reasoning. The author rejects a statistical frequency basis for probability in favor of a logical relation between two statements or propositions. Probability "is the degree of confirmation of a hypothesis (or conclusion) on the basis of some given evidence (...) (or premises)." Furthermore, all principles and theorems of inductive logic are analytic, and the entire system is to be constructed by means of symbolic logic and semantic methods. This means that the author confines himself to the formalistic procedures of word and symbol systems. The resulting sentence or language structures are presumed to separate off logic from all subjectivist or psychological elements. Despite the abstractionism, the claim is made that if an inductive probability system of logic can be constructed it will have its practical application in mathematical statistics, and in various sciences. 16-page bibliography. (PsycINFO Database Record (c) 2016 APA, all rights reserved). (shrink)

In this paper I defend an etiological theory of biological functions (according to which the proper function of a trait is the effect for which it was selected by natural selection) against three objections which have been influential. I argue, contrary to Millikan, that it is wrong to base our defense of the theory on a rejection of conceptual analysis, for conceptual analysis does have an important role in philosophy of science. I also argue that biology requires a normative notion (...) of a "proper function", and that a normative notion is not ahistorical. (shrink)

I defend the historical definition of "function" originally given in my Language, Thought and Other Biological Categories (1984a). The definition was not offered in the spirit of conceptual analysis but is more akin to a theoretical definition of "function". A major theme is that nonhistorical analyses of "function" fail to deal adequately with items that are not capable of performing their functions.

This paper argues that the medical conception of health as absence of disease is a value-free theoretical notion. Its main elements are biological function and statistical normality, in contrast to various other ideas prominent in the literature on health. Apart from universal environmental injuries, diseases are internal states that depress a functional ability below species-typical levels. Health as freedom from disease is then statistical normality of function, i.e., the ability to perform all typical physiological functions with at least typical efficiency. (...) This conception of health is as value-free as statements of biological function. The view that health is essentially value-laden, held by most writers on the topic, seems to have one of two sources: an assumption that health judgments must be practical judgments about the treatment of patients, or a commitment to "positive" health beyond the absence of disease. I suggest that the assumption is mistaken, the commitment possibly misdescribed. (shrink)

In the course of the discussion, Professor Quine pinpoints the difficulties involved in translation, brings to light the anomalies and conflicts implicit in our ...

Recent experimental philosophy arguments have raised trouble for philosophers' reliance on armchair intuitions. One popular line of response has been the expertise defense: philosophers are highly-trained experts, whereas the subjects in the experimental philosophy studies have generally been ordinary undergraduates, and so there's no reason to think philosophers will make the same mistakes. But this deploys a substantive empirical claim, that philosophers' training indeed inculcates sufficient protection from such mistakes. We canvass the psychological literature on expertise, which indicates that people (...) are not generally very good at reckoning who will develop expertise under what circumstances. We consider three promising hypotheses concerning what philosophical expertise might consist in: (i) better conceptual schemata; (ii) mastery of entrenched theories; and (iii) general practical know-how with the entertaining of hypotheticals. On inspection, none seem to provide us with good reason to endorse this key empirical premise of the expertise defense. (shrink)

Intuitively, Gettier cases are instances of justified true beliefs that are not cases of knowledge. Should we therefore conclude that knowledge is not justified true belief? Only if we have reason to trust intuition here. But intuitions are unreliable in a wide range of cases. And it can be argued that the Gettier intuitions have a greater resemblance to unreliable intuitions than to reliable intuitions. Whats distinctive about the faulty intuitions, I argue, is that respecting them would mean abandoning a (...) simple, systematic and largely successful theory in favour of a complicated, disjunctive and idiosyncratic theory. So maybe respecting the Gettier intuitions was the wrong reaction, we should instead have been explaining why we are all so easily misled by these kinds of cases. (shrink)

Ernst Mayr has argued that Darwinian theory discredited essentialist modes of thought and replaced them with what he has called "population thinking". In this paper, I characterize essentialism as embodying a certain conception of how variation in nature is to be explained, and show how this conception was undermined by evolutionary theory. The Darwinian doctrine of evolutionary gradualism makes it impossible to say exactly where one species ends and another begins; such line-drawing problems are often taken to be the decisive (...) reason for thinking that essentialism is untenable. However, according to the view of essentialism I suggest, this familiar objection is not fatal to essentialism. It is rather the essentialist's use of what I call the natural state model for explaining variation which clashes with evolutionary theory. This model implemented the essentialist's requirement that properties of populations be defined in terms of properties of member organisms. Requiring such constituent definitions is reductionistic in spirit; additionally, evolutionary theory shows that such definitions are not available, and, moreover, that they are not needed to legitimize population-level concepts. Population thinking involves the thesis that population concepts may be legitimized by showing their connections with each other, even when they are not reducible to concepts applying at lower levels of organization. In the paper, I develop these points by describing Aristotle's ideas on the origins of biological variation; they are a classic formulation of the natural state model. I also describe how the development of statistical ideas in the 19th century involved an abandoning of the natural state model. (shrink)

Accounts of the concepts of function and dysfunction have not adequately explained what factors determine the line between low‐normal function and dysfunction. I call the challenge of doing so the line‐drawing problem. Previous approaches emphasize facts involving the action of natural selection (Wakefield 1992a, 1999a, 1999b) or the statistical distribution of levels of functioning in the current population (Boorse 1977, 1997). I point out limitations of these two approaches and present a solution to the line‐drawing problem that builds on the (...) second one. (shrink)

Philosophical interest in the biological concept of function stems largely from concerns about its teleological associations. Assigning something a function seems akin to assigning it a purpose, and discussion of the purpose of items has long been off-limits to science. Analytic philosophers have attempted to defend ‘function’ by showing that claims about functions do not involve any reference to a problematic notion of purpose. To do this, philosophers offer short lists of necessary and sufficient conditions for the application of the (...) concept—where the conditions involve only acceptable physical or biological notions—and claim that the set of conditions captures the import of function statements. (shrink)

This book originated as lectures for a course on political philosophy that Rawls taught regularly at Harvard in the 1980s.

In this paper, I explore the implications of recent empirical research on concept representation for the philosophical enterprise of conceptual analysis. I argue that conceptual analysis, as it is commonly practiced, is committed to certain assumptions about the nature of our intuitive categorization judgments. I then try to show how these assumptions clash with contemporary accounts of concept representation in cognitive psychology. After entertaining an objection to my argument, I close by considering ways in which conceptual analysis might be altered (...) to accord better with the empirical work. (shrink)

The treatment-enhancement distinction draws a line between services or interventions meant to prevent or cure conditions that we view as diseases or disabilities and interventions that improve a condition that we view as a normal function or feature of members of our species. The line drawn here is widely appealed to in medical practice and medical insurance contexts, as well as in our everyday thinking about the medical services we do and should assist people in obtaining.

A basic question of medical ethics is whether the norms governing medical practice should be understood as the application of principles and rules of the common morality to medicine or whether some of these norms are internal or proper to medicine. In this article we describe and defend an evolutionary perspective on the internal morality of medicine that is defined in terms of the goals of clinical medicine and a set of duties that constrain medical practice in pursuit of these (...) goals. This perspective is developed by means of a critical examination of the essentialist conception of the internal morality of medicine advocated by Edmund Pellegrino and the critique of internal morality approaches by Robert Veatch and Tom Beauchamp. (shrink)

Conceptual analysis of health and disease is portrayed as consisting in the confrontation of a set of criteria—a “definition”—with a set of cases, called instances of either “health” or “ disease.” Apart from logical counter-arguments, there is no other way to refute an opponent’s definition than by providing counter-cases. As resorting to intensional stipulation is not forbidden, several contenders can therefore be deemed to have succeeded. This implies that conceptual analysis alone is not likely to decide between naturalism and normativism. (...) An alternative to this approach would be to examine whether the concept of disease can be naturalized. (shrink)

In this brief introduction, we would first like to explain how these two special issues of Philosophical Psychology ( 23.3 and 23.4 ) actually came about. In addition, we will provide an outline of their overall structure and shortly summarize the featured papers.

In this paper, I am going to offer a reconstruction of a challenge to intuition-based armchair philosophy that has been put forward by experimental philosophers of a restrictionist stripe, which I will call the 'master argument'. I will then discuss a number of popular objections to this argument and explain why they either fail to cast doubt on its first, empirical premise or do not go deep enough to make for a lasting rebuttal. Next, I will consider two more promising (...) objections, the grounding objection and the expertise objection, which aim at the second, epistemic premise of the argument. Against this background, I will then suggest what I call 'conservative restrictionism' as the most reasonable default reaction to the experimentalist challenge, which is a combination of the two views of local restrictionism and methodological conservativism. (shrink)

This essay develops an account of health, the functional efficiency theory, which derives from Christopher Boorse's biostatistical theory. Like the BST, the functional efficiency theory is a nonevaluative view of health, but unlike the BST, it argues that the fundamental theoretical task is to distinguish levels of efficiency with which the parts and processes within organisms and within systems within organisms function. Which of these to label as healthy or pathological is of secondary importance. Because the statistical distributions that Boorse's (...) account relies on are distributions of functional efficiency, the functional efficiency theory arguably complements rather than challenges the BST. (shrink)

Cosmetic surgery is a fast-growing medical practice. In 1997 surgeons in the United States performed the four most common cosmetic procedures443,728 times, an increase of 150% over the comparable total for 1992. Estimated total expenditures for cosmetic surgery range from $1 to $2 billion. As managed care cuts into physicians' income and autonomy, cosmetic surgery, which is not covered by health insurance, offers a financially attractive medical specialty.

This paper responds to discussion and criticism contained in a mini-symposium on Just health: meeting health needs fairly. The replies clarify existing positions and modify or develop others, specifically in response to the following: Thomas Schramme criticises the claim that health is of special importance because of its impact on opportunity, and James Wilson argues that healthcare is not of special importance if social determinants of health have a major causal impact on population health. Annette Rid is concerned that the (...) relevance condition in accountability for reasonableness is unclear and does little work. Harald Schmidt aims to flesh out where an account of responsibility for health should go since one is under-developed in Just health. Michael Schefczyk and Susanne Brauer challenge aspects of the prudential lifespan account. Samia Hurst asks what impact a population view should have on clinician obligations. (shrink)

Some ethical issues facing contemporary medicine cannot be fully understood without addressing medicine's internal morality. Medicine as a profession is characterized by certain moral goals and morally acceptable means for achieving those goals. The list of appropriate goals and means allows some medical actions to be classified as clear violations of the internal morality, and others as borderline or controversial cases. Replies are available for common objections, including the superfluity of internal morality for ethical analysis, the argument that internal morality (...) is merely an apology for medicine's traditional power and authority, and the claim that there is no single, "core" internal morality. The value of addressing the internal morality of medicine may be illustrated by a detailed investigation of ethical issues posed by managed care. Managed care poses some fundamental challenges for medicine's internal morality, but also calls for thoughtful reflection and reconsideration of some traditionally held moral views on patient fidelity in particular. (shrink)

This essay replies to critics since 1995 of my “biostatistical theory” of health. According to the BST, a pathological condition is a state of statistically species-subnormal biological part-functional ability, relative to sex and age. Theoretical health, the total absence of pathological conditions, is then a value-free scientific notion. Recent critics offer a mixture of old and new objections to this analysis. Some new ones relate to choice of reference class, situation-specificity of function, common diseases and healthy populations, improvements in population (...) health, the practice of pathologists, “Cambridge changes” in health status, and comparative vs. absolute health concepts. I make no changes in doctrine, except to consider treating “normal aging” as pathological by taking young adults as the standard for all adults. (shrink)

What grounds and justifies conclusions in medical ethics? Is the source external or internal to medicine? Thee influential types of answer have appeared in recent literature: an internal account, an external account, and a mixed internal / external account. The first defends an ethic derived from either the ends of medicine or professional practice standards. The second maintains that precepts in medical ethics rely upon and require justification by external standards such as those of public opinion, law, religious ethics, or (...) philosophical ethics. The third claims that distinct medical ethics have emerged from distinct cultural frameworks, each with norms that govern physicians. There is merit in each perspective, but each overreaches its supporting arguments and fails to appreciate what is legitimate in the theses of its competitors. I propose a fourth account that offers a way to escape limitations of the other three, while retaining their most attractive features. (shrink)

I begin this commentary with an expanded typology of theories that endorse an internal morality of medicine. I then subject these theories to a philosophical critique. I argue that the more robust claims for an internal morality fail to establish a stand-alone method for bioethics because they ignore crucial non-medical values, violate norms of justice and fail to establish the normativity of medical values. I then argue that weaker versions of internalism avoid such problems, but at the cost of failing (...) to provide a clear sense in which their moral norms are internal or can ground a comprehensive approach to moral problems. Finally, I explore various functions that an internal morality might serve, concluding with the observation that, while there may be a core of good sense to the notion of an internal morality of medicine, our expectations for it must be drastically lowered. (shrink)

The book aims to develop a new approach to philosophy of medicine. Much attention is paid to the relative merits of philosophical analysis in the Anglo-Saxon tradition, and phenomenology. Themes considered are cultural bias in philosophy of medicine, regular versus alternative medicine, concepts of health and disease, and the mind-body problem.

An updated and expanded successor to Culver and Gert's Philosophy in Medicine, this book integrates moral philosophy with clinical medicine to present a comprehensive summary of the theory, concepts, and lines of reasoning underlying the ...

One INTRODUCTION 1. Background The theory of the nature of health and disease, or of the concepts of health and disease, has been central in modem ...

In _ Psychiatry in the Scientific Image, _Dominic Murphy looks at psychiatry from the viewpoint of analytic philosophy of science, considering three issues: how we should conceive of, classify, and explain mental illness. If someone is said to have a mental illness, what about it is mental? What makes it an illness? How might we explain and classify it? A system of psychiatric classification settles these questions by distinguishing the mental illnesses and showing how they stand in relation to one (...) another. This book explores the philosophical issues raised by the project of explaining and classifying mental illness. Murphy argues that the current literature on mental illness -- exemplified by the Diagnostic and Statistical Manual of Mental Disorders -- is an impediment to research; it lacks a coherent concept of the mental and a satisfactory account of disorder, and yields too much authority to commonsense thought about the mind. He argues that the explanation of mental illness should meet the standards of good explanatory practice in the cognitive neurosciences, and that the classification of mental disorders should group symptoms into conditions based on the causal structure of the normal mind. (shrink)

According to the received tradition, the language used to to refer to natural kinds in scientific discourse remains stable even as theories about these kinds are refined. In this illuminating book, Joseph LaPorte argues that scientists do not discover that sentences about natural kinds, like 'Whales are mammals, not fish', are true rather than false. Instead, scientists find that these sentences were vague in the language of earlier speakers and they refine the meanings of the relevant natural-kind terms to make (...) the sentences true. Hence, scientists change the meaning of these terms, This conclusions prompts LaPorte to examine the consequences of this change in meaning for the issue of incommensurability and for the progress of science. This book will appeal to students and professional in the philosophy of science, the philosophy of biology and the philosophy of language. (shrink)

Frank Jackson champions the cause of conceptual analysis as central to philosophical inquiry. In recent years conceptual analysis has been undervalued and widely misunderstood, suggests Jackson. He argues that such analysis is mistakenly clouded in mystery, preventing a whole range of important questions from being productively addressed. He anchors his argument in discussions of specific philosophical issues, starting with the metaphysical doctrine of physicalism and moving on, via free will, meaning, personal identity, motion, and change, to ethics and the philosophy (...) of color. In this way the book not only offers a methodological program for philosophy, but also casts new light on some much-debated problems and their interrelations. (shrink)

As a procedure, reflective equilibrium is simply a familiar kind of standard scientific method with a new name. A theory is constructed to account for a set of observations. Recalcitrant data may be rejected as noise or explained away as the effects of interference of some sort. Recalcitrant data that cannot be plausibly dismissed force emendations in theory. What counts as a plausible dismissal depends, among other things, on the going theory, as well as on background theory and on knowledge (...) that may be relevant to under-standing the experimental design that is generating the observations, including knowledge of the apparatus and observation conditions. This sort of mutual adjustment between theory and data is a familiar feature of scientific practice. Whatever authority RE seems to have comes, I think, from a tacit or explicit recognition that it has the same form as this familiar sort of scientific inference. One way to see the rationale underlying this procedure in science is to focus on prediction. Think of prediction as a matter of projecting what is known onto uncharted territory. To do this, you need a vehicle—a theory—that captures some invariant or pattern in what is known so that you can project it onto the unknown. How convincing the projection is depends on two factors: how sure one is of the observational base, and how sure one is that the theory gets the invariants right. The two factors are not independent, of course. One's confidence in the observational base will be affected by how persuasively the theory identifies and dismisses noise; one's confidence in the theory, on the other hand, will depend on one's confidence in the observations it takes seriously. Prediction is important as a test of theory precisely because verified predictions seem to show that the theory has correctly captured the general in the particular, that it has got the drift of the observational evidence in which our confidence is ultimately grounded. (shrink)

This entry provides an overview of theories of concepts that is organized around five philosophical issues: (1) the ontology of concepts, (2) the structure of concepts, (3) empiricism and nativism about concepts, (4) concepts and natural language, and (5) concepts and conceptual analysis.