In this paper we focus on some new normativist positions and compare them with traditional ones. In so doing, we claim that if normative judgments are involved in determining whether a condition is a disease only in the sense identified by new normativisms, then disease is normative only in a weak sense, which must be distinguished from the strong sense advocated by traditional normativisms. Specifically, we argue that weak and strong normativity are different to the point that one ‘normativist’ label (...) ceases to be appropriate for the whole range of positions. If values and norms are not explicit components of the concept of disease, but only intervene in other explanatory roles, then the concept of disease is no more value-laden than many other scientific concepts, or even any other scientific concept. We call the newly identified position “value-conscious naturalism” about disease, and point to some of its theoretical and practical advantages. (shrink)

Since Boorse [Philos Sci 44(4):542–573, 1977] published his paper “Health as a theoretical concept” one of the most lively debates within philosophy of medicine has been on the question of whether health and disease are in some sense ‘objective’ and ‘value-free’ or ‘subjective’ and ‘value-laden’. Due to the apparent ‘failure’ of pure naturalist, constructivist, or normativist accounts, much in the recent literature has appealed to more conciliatory approaches or so-called ‘hybrid accounts’ of health and disease. A recent paper by Matthewson (...) and Griffiths [J Med Philos 42(4):447–466, 2017], however, may bear the seeds for the revival of purely naturalist approach to health and disease. In this paper, I defend their idea of Biological Normativity against recent criticism by Schwartz [J Med Philos Forum Bioethics Philos Med 42(4):485–502, 2017] and hope to help it flower into a revival of naturalist approaches in the philosophy of medicine. (shrink)

On 11 March 2020, the World Health Organization declared a pandemic of the COVID-19 coronavirus disease that was first recognized in China in late 2019. Among the primary effects caused by the pandemic, there was the dissemination of health preventive measures such as physical distancing, travel restrictions, self-isolation, quarantines, and facility closures. This includes the global disruption of socio-economic systems including the postponement or cancellation of various public events (e.g., sporting, cultural, or religious), supply shortages and fears of the same, (...) schools and universities closure, evacuation of foreign citizens, a rise of unemployment, changes in the international aid schemes, misinformation, and incidents of discrimination toward people affected by or suspected of having the COVID-19 disease. The pandemic has brought to the fore unpreparedness in critical areas that require attention, amid prospects and challenges. Moreover, considerable reorganization efforts are required with implications for assets, resources, norms, and value systems. COVID-19 is challenging the concept of globalization and stimulating responses at the levels of local and regional socio-economic systems that lead to the mobilization of assets that have been unrecognized earlier on, such as various forms of economic capital, social capital, cultural capital, human capital, and creative capital. For example, through digital channels, local groups are forming to create schemes of support for physical and mental wellbeing. These emerging exchanges lead to various social and technological innovations by building on skills and assets that are less important in the free-market economy, such as empathy, skills for crafts, making and fixing; locally grown microgreens; and micromanufacturing. Isolation and local living are also making it much harder to ignore the civic responsibilities towards communities, meant as individuals, vulnerable groups, and local businesses. Whilst the pandemic is limiting physical participation, this challenging time is uncovering alternative ways of mutual support, which may create long-term benefits for socio-economic systems, including environmental and biodiversity protection, reduction of the air pollution, and climate action. The pandemic’s threat to public health will hopefully be overcome with implications for disruption for an extended period that we are unable to forecast at this stage. It is key to focus on studies recognizing the activities and interventions leading to the recovery of socio-economic systems after the pandemic. Reflecting and planning on how societies and economies will go back to “business as usual” requires new forms of communication and cooperation, imaginative design thinking, new styles of management, as well as new tools and forms of participation in various public policies. Many questions related to the care of the vulnerable, economic restart, and the risk of future pandemics, to mention but a few, are already occupying the academic, scientific, experts, and activist communities, who have started to imagine the “new normal.”. (shrink)

The antipsychiatrists in the 1960's, specifically Thomas Szasz, have claimed that mental illness does not exist. This argument was based on a specific definition of physical disease that, Szasz argued, could not be applied to mental illness. Thus, by problematizing mental illness, the spotlight had turned to physical disease. Since then, philosophers of medicine have proposed definitions applying both to pathophysiological and psychopathological conditions. This paper analyzes prominent naturalist definitions which aim to provide value-free accounts of pathological conditions, as well (...) as normative accounts that propose value-laden accounts. The approaches surveyed differ not only in terms of value, but also in terms of their perspective. This perspective concerns whether the concept of health, illness or disease/disorder is emphasized. The emphasis on health or illness is holistic as it looks at the human being as a whole, while focus on disease or disorder is analytic as it considers part functions. I will here argue in favor of holism and will propose a definition of mental health based on Sartre's existential psychoanalysis of Gustave Flaubert. (shrink)

In this paper, we identify some key features of what makes something a disease, and consider whether these apply to pregnancy. We argue that there are some compelling grounds for regarding pregnancy as a disease. Like a disease, pregnancy affects the health of the pregnant person, causing a range of symptoms from discomfort to death. Like a disease, pregnancy can be treated medically. Like a disease, pregnancy is caused by a pathogen, an external organism invading the host’s body. Like a (...) disease, the risk of getting pregnant can be reduced by using prophylactic measures. We address the question of whether the ‘normality’ of pregnancy, its current necessity for human survival, or the value often attached to it are reasons to reject the view that pregnancy is a disease. We point out that applying theories of disease to the case of pregnancy, can in many cases illuminate inconsistencies and problems within these theories. Finally, we show that it is difficult to find one theory of disease that captures all paradigm cases of diseases, while convincingly excluding pregnancy. We conclude that there are both normative and pragmatic reasons to consider pregnancy a disease. (shrink)

Some ‘naturalist’ accounts of disease employ a biostatistical account of dysfunction, whilst others use a ‘selected effect’ account. Several recent authors have argued that the biostatistical account offers the best hope for a naturalist account of disease. We show that the selected effect account survives the criticisms levelled by these authors relatively unscathed, and has significant advantages over the BST. Moreover, unlike the BST, it has a strong theoretical rationale and can provide substantive reasons to decide difficult cases. This is (...) illustrated by showing how life-history theory clarifies the status of so-called diseases of old age. The selected effect account of function deserves a more prominent place in the philosophy of medicine than it currently occupies. _1_ Introduction _2_ Biostatistical and Selected Effect Accounts of Function _3_ Objections to the Selected Effect Account _3.1_ Boorse _3.2_ Kingma _3.3_ Hausman _3.4_ Murphy and Woolfolk _4_ Problems for the Biostatistical Account _4.1_ Schwartz _5_ Analysis versus Explication _6_ Explicating Dysfunction: Life History Theory and Senescence _7_ Conclusion. (shrink)

This article seeks to investigate to what extent the resulting empirical data from various experiments in Moral Psychology (some behavioral, others based on evidence from neuroimaging and in patients with brain lesions associated with moral competence areas) , can contribute to a better understanding of the psychological processes (cognitive and emotional) underlying to our moral practical judgments, helping us to understand the mechanisms that influence our assessment of moral dilemmas in general and bioethics in particular. Various experiments are discussed (and (...) the theoretical models that are supported) that reveal aspects such as the role of disgust or repugnance in the production of moral judgments, the competitive or cooperative role of emotions and cognitions in impersonal and personal moral dilemmas -and between the above mentioned, easy and difficult-, the neurophysiological bases of deontologist and consequentialist, the value attributed to the intent and the results of action, etc. The relevance of these experiments are analyzed to understand the evaluative and deliberative processes concerning various bioethical dilemmas, for which appeals to examples of conflict situations involved and our emotional resources (that activate immediate assessment ) and our higher cortical areas interact (cognitive processes responsible for slower deliberative and reflexive). (shrink)

The Duhem-Quine thesis famously holds that a single hypothesis cannot be confirmed or disconfirmed in isolation, but instead only in conjunction with other background hypotheses. This article argues that this has important and underappreciated implications for metaethics. Section 1 argues that if one begins metaethics firmly wedded to a naturalistic worldview—due (e.g.) to methodological/epistemic considerations—then normativity will appear to be reducible to a set of social-psycho-semantic behaviors that I call the ‘normative stance.’ Contra Hume and Bedke (2012), I argue that (...) the normative stance provides semantically-grounded entailments from natural truths to normative truths, reducing the latter to the former. Specifically, the normative stance explains the truth-conditions, truth-values, and truth-makers of normative propositions in terms of socially grounded cognitive-behavioral rules and other natural facts, thus explaining how there can be bona fide normative facts and properties in a wholly naturalistic world. I then show that the normative stance explains the apparent stance-independence and non-naturalness of normative reasons, intrinsic value, and categoricity of moral reasons as ‘user-illusions’ generated by people having strong psycho-social propensities—rooted in evolution and social cooperation—to take these normative stances. Section 2 then argues that while the normative stance may appear to naturalists to successfully explain normativity, it will not appeal to those who come to metaethics with different background commitments. I conclude that naturalists should take the normative stance to be a promising metaethical theory of normativity, and that whether it is a true theory of normativity is something that can only be ascertained by determining which background hypotheses—naturalistic or otherwise—we should have when doing metaethics. (shrink)

How do people understand the concepts of mental health and disorder? The objective of this paper is to examine the impact of several factors on people’s judgments about whether a condition constitutes a mental disorder or a healthy state. Specifically, this study examines the impact of the source of the condition, its outcome, individual valuation (i.e., the value the individual attaches to the condition), and group valuation (i.e., the value the relevant group attaches to the condition). While we find that (...) people’s health and disorder judgments are driven by perceived dysfunction, we also find that health and disorder judgments are impacted differently by these factors. Health judgements are impacted by outcome and individual valuation, and disorder judgments are impacted by condition source. These results suggest that the folk concept of mental health is positive (i.e., mental health is more than the absence of mental disorder) and normativist (i.e., value judgments play a significant role in determining whether a condition counts as healthy), while the concept of mental disorder aligns with a naturalist perspective, at least to the extent that dysfunction plays an important role in categorizing a condition as a disorder. However, our finding that people’s dysfunction judgments are influenced by individual valuation and outcomes poses a strong challenge to naturalist accounts. To provide access to our supplementary data, an appendix has been included. (shrink)

The most common theoretical approaches to defining mental disorder are naturalism, normativism, and hybridism. Naturalism and normativism are often portrayed as diametrically opposed, with naturalism grounded in objective science and normativism grounded in social convention and values. Hybridism is seen as a way of combining the two. However, all three approaches share a common feature in that they conceive of mental disorders as deviations from norms. Naturalism concerns biological norms; normativism concerns social norms; and hybridism, both biological and social (...) norms. This raises the following two questions: (a) Are biological and social norms the only sorts of norms that are relevant to considerations of mental disorder? (b) Should addressing norm deviations continue to be a major focus of mental healthcare? This paper introduces several norms that are relevant to mental disorder beyond the biological and social. I argue that mental disorders often deviate from individual, well-being, and regulatory norms. I also consider approaches which question mental healthcare’s focus on addressing norm deviations in the first place, including the neurodiversity paradigm, social model of disability, and Mad discourse. Utilizing these critical approaches, I contend that whether mental health intervention is justified depends, in part, on the type of norm deviation being intervened upon. (shrink)

Nietzsche’s late writings present a value opposition of health and decadence based in his conception of organic life. While this appears to be a moral ideal that risks the naturalistic fallacy of directly deriving norms from facts, it instead describes a meta-ethical ideal: the necessary conditions for any kind of moral agency. Nietzsche’s ideal of health not only evades but also dissolves the naturalistic fallacy by suggesting that the specific content of morality is irrelevant. If health is measured by power (...) over one’s drives rather than the environment, then the source of moral conflict—organic life’s essential tendency toward domination—is surmounted by successful integration of any moral norms, regardless of content. Nietzsche’s concept of health draws on his characterization of organic life as essentially ‘exploitation’: growth through domination of the environment (BGE 259, GM II: 12). In animals, power coincides with happiness, while health and decadence track the correspondence between instinct and happiness (TI II: 11). This simple picture is complicated by the Genealogy, where Nietzsche depicts human nature as an animal illness caused by civilization’s disruption of the natural correspondence of instinct and happiness. Civilization shapes this ‘sick animal’ into the distinctly human ‘sovereign individual’ (GM III: 13, II: 2), restoring the harmony of instinct and happiness in an internal hierarchy of drives. So, sovereign individuality is a distinctly human model of health. Although life is exploitation, human health does not coincide with greater environmental power, but rather an internal qualitative expansion of power: greater variety and tension among drives, greater ‘wholeness in diversity’ in the ‘social structure’ of the self (BGE 212, 12). Nonetheless, health is not a moral criterion, but instead the precondition of moral agency. The subordination of drives to a commanding hierarchy grounds the ability to uphold any moral principles at all, to make and keep promises to oneself and others. Moral agency coincides, in turn, with overcoming the source of moral conflict in organic life’s drive for growth. The unification of opposing drives provides pleasure in power over oneself rather than one’s environment, the ‘happiness of high tension’ among drives (BGE 260), and in environmental resistance, a need for ‘equal opponents’ (TI IX: 38, EH 1: 7). Consequently, Nietzsche’s meta-ethical ideal supports a moral pluralism that supports any moral content. Moral conflicts arise precisely to the degree individuals are incapable of achieving moral agency, but they dissolve as moral agency of any kind is more widely achieved. (shrink)

The following scenario seems possible: a community uses concepts that play the same role in guiding actions and shaping social life as our normative concepts, and yet refer to something else. As Eklund argues, this apparent possibility poses a problem for any normative realist who aspires to vindicate the thought that reality itself favors our ways of valuing and acting. How can realists make good on this idea, given that anything they might say in support of the privileged status of (...) our normative concepts can be mirrored by the imagined community? E.g., the realist might claim that using our concepts is what we ought to do if we are to describe normative facts correctly, but members of the other community can claim the same about their concepts, using their own concept of ought. A promising approach to this challenge is to try to rule out the possibility of alternative normative concepts, by arguing that any concepts that have the same normative role must share a reference as well. In this paper I argue that normative quasi-naturalism, a view that combines expressivism about normative discourse with a naturalist metaphysics of normativity, supports referential normativity and solves the problem of alternative normative concepts. (shrink)

Public funders of health research have been widely criticized on the grounds that their allocations of funding for disease-specific research do not reflect the relative burdens imposed by different diseases. For example, the US National Institutes of Health spends a much greater fraction of its budget on HIV/AIDS research and a much smaller fraction on migraine research than their relative contribution to the US burden of disease would suggest. Implicit in this criticism is a normative claim: Insofar as the scientific (...) opportunities are equal, each patient merits research into their condition proportional to the burden of disease for which that condition is responsible. This claim—the proportional view—is widely accepted but has never been fully specified or defended. In this paper, I explain what is required to specify the view, attempt to do so in the most charitable way, and then critically evaluate its normative underpinnings. I conclude that a severity-weighted proportional view is defensible. I close by drawing out five key lessons of my analysis for health research priority-setting. (shrink)

Debates about the genuine disease status of controversial diseases rely on intuitions about a range of factors. Adopting tools from experimental philosophy, this paper explores some of the factors that influence judgments about whether low sexual desire should be considered a disease and whether it should be medically treated. Drawing in part on some assumptions underpinning a divide in the literature between viewing low sexual desire as a genuine disease and seeing it as improperly medicalized, we investigate whether health and (...) disease judgments are affected by factors such as an individual’s gender, the cause of the low desire, whether the desire is high or low, and both personal and societal valuations of the condition. Our main findings indicate that (a) the cause of a condition influences whether it is judged a disorder, (b) how the individual values the condition influences whether the condition is seen as a proper target of medical intervention, and (c) perceived dysfunction influences judgments regarding health, disorder classification, medicalization, and medical intervention. Our findings help further illuminate the intricate interplay of factors that influence judgments about health and disease in controversial conditions. (shrink)

The usual way of discussing normativity and naturalism is by running through a standard range of issues: the relations of fact and value, objectivity, reason and emotion, is and ought, and the so-called ‘naturalistic fallacy’. This is a naturalism that is virtually silent on nature. I outline an alternative approach that relates normativity to our nature as living beings, for whom specific things are good or bad for us. Our nature as evaluative beings is shown to be rooted in and (...) emergent from this biological normativity. There is also significant downward causation, such that our brain-bodies are continually modified by our experience and thoughts. Cultures, as emergent from the affordances of our brain-bodies, create further extensive, irreducible sources of normativity, albeit ones which do not wholly escape biological normativity and can impact back on it. (shrink)

Racial disparities in health outcomes have recently become a flashpoint in the debate about the value of race as a biological concept. What role, if any, race has in the etiology of disease is a philosophically and scientifically contested topic. In this article, I expand on the insights of the new mechanistic philosophy of science to defend a mechanism discovery approach to investigating epidemiological racial disparities. The mechanism discovery approach has explanatory virtues lacking in the populational approach typically employed in (...) the study of race and biomedicine. The explanatory constraints that form an integral part of the new mechanistic approach enable mechanism discovery to avoid the epistemic and normative shortcomings of the populational approach. The methodology of mechanism discovery can fruitfully be extended to the treatment and reversal of epidemiological racial disparities. (shrink)

The critical focus of this paper is on a claim made explicitly by Gilbert Harman and accepted implicitly by numerous others, the claim that naturalism supports concurrent defense of scientific objectivism and moral relativism. I challenge the assumptions of Harman's ‘argument from naturalism' used to support this combination of positions, utilizing. Hilary Putnam’s ‘companions in guilt’ argument in order to counter it. The paper concludes that while domain-specific anti-realism is often warranted, Harman’s own views about the objectivity of facts and (...) the subjectivity of values are better seen as stemming from scientistic ideals of knowledge than from dictates of naturalism. Scientists qua scientists make value judgments, and setting aside scientistic assumptions and unrealizable conceptions of scientific objectivity should lead us to more symmetrical metaphilosophical conception of epistemic and ethical normativity than that which underlies Harman's account. (shrink)

Similarly to other accounts of disease, Christopher Boorse’s Biostatistical Theory (BST) is generally presented and considered as conceptual analysis, that is, as making claims about the meaning of currently used concepts. But conceptual analysis has been convincingly critiqued as relying on problematic assumptions about the existence, meaning, and use of concepts. Because of these problems, accounts of disease and health should be evaluated not as claims about current meaning, I argue, but instead as proposals about how to define and use (...) these terms in the future, a methodology suggested by Quine and Carnap. I begin this article by describing problems with conceptual analysis and advantages of “philosophical explication,” my favored approach. I then describe two attacks on the BST that also question the entire project of defining “disease.” Finally, I defend the BST as a philosophical explication by showing how it could define useful terms for medical science and ethics. (shrink)

In this article we argue that the social value of health research should be conceptualized as a function of both the expected benefits of the research and the priority that the beneficiaries deserve. People deserve greater priority the worse off they are. This conception of social value can be applied for at least two important purposes: in health research priority setting when research funders, policy-makers, or researchers decide between alternative research projects; and in evaluating the ethics of proposed research proposals (...) when research ethics committees assess whether the social value of the research is sufficient to justify the risks and burdens to research participants and others. In assessing how far a proposed research project will advance the interests of people who are more disadvantaged, research priority setters and RECs should examine the diseases that the research targets and the type of research. Just as certain diseases impose a greater burden on people who are more disadvantaged, so certain types of intervention and forms of research are more likely to benefit people who are more disadvantaged. We outline which populations are likely to be representative of the global worst off and identify what types of health research, and which disease categories, are priorities for these populations. (shrink)

John and Curran have convincingly shown that Scanlonian contractualism is a valuable resource for evaluating pandemic response policies, and that we should reject cost–benefit analysis in favour of a contractualist framework. However, they fail to consider the part of contractualism that Scanlon constructed precisely to deal with the question of when the state can restrict individuals from making choices that are harmful to themselves and others: the value of choice view. In doing so, they leave it open for opponents of (...) lockdowns to misuse contractualism to justify mistaken policies. This is because the most powerful contractualist objections to locking down are likely to be based on the VoC. When we apply the value of choice view, we see that a lockdown policy’s justifiability depends on the extent to which particular values of choice are found to be threatened by the policy in question, and what safeguards policy-makers have put in place to increase the value of choice and protect people from the harmful consequences of lockdown. Without the VoC, it is harder to explain why lockdowns, to be non-rejectable, must have certain features. With the VoC, the case for contractualism over cost benefit analysis can be made even stronger. (shrink)

Rare diseases pose a particular priority setting problem. The UK gives rare diseases special priority in healthcare priority setting. Effectively, the National Health Service is willing to pay much more to gain a quality-adjusted life-year related to a very rare disease than one related to a more common condition. But should rare diseases receive priority in the allocation of scarce healthcare resources? This article develops and evaluates four arguments in favour of such a priority. These pertain to public values, (...) luck egalitarian distributive justice the epistemic difficulties of obtaining knowledge about rare diseases and the incentives created by a higher willingness to pay. The first is at odds with our knowledge regarding popular opinion. The three other arguments may provide a reason to fund rare diseases generously. However, they are either overinclusive because they would also justify funding for many non-rare diseases or underinclusive in the sense of justifying priority for only some rare diseases. The arguments thus fail to provide a justification that tracks rareness as such. There are no data in this work. (shrink)

Last year saw the 20th anniversary edition of JECP, and in the introduction to the philosophy section of that landmark edition, we posed the question: apart from ethics, what is the role of philosophy ‘at the bedside’? The purpose of this question was not to downplay the significance of ethics to clinical practice. Rather, we raised it as part of a broader argument to the effect that ethical questions – about what we should do in any given situation – are (...) embedded within whole understandings of the situation, inseparable from our beliefs about what is the case, what it is that we feel we can claim to know, as well as the meaning we ascribe to different aspects of the situation or to our perception of it. Philosophy concerns fundamental questions: it is a discipline requiring us to examine the underlying assumptions we bring with us to our thinking about practical problems. Traditional academic philosophers divide their discipline into distinct areas that typically include logic: questions about meaning, truth and validity; ontology: questions about the nature of reality, what exists; epistemology: concerning knowledge; and ethics: how we should live and practice, the nature of value. Any credible attempt to analyse clinical reasoning will require us to think carefully about these types of question and the relationships between them, as they influence our thinking about specific situations and problems. So, the answers to the question we posed, about the role of philosophy at the bedside, are numerous and diverse, and that diversity is illustrated in the contributions to this thematic edition. (shrink)

Approaching mental health on a global scale with particular reference to low- and mid-income countries raises issues concerning the disregard of the local context and values and the imposition of values characteristic of the Global North. Seeking a philosophical viewpoint to surmount these problems, the present paper argues for a value-laden framework for psychiatry with the specific incorporation of value pluralism, particularly in relation to the Global South context, while also emphasizing personal values such as the choice (...) of treatment. In sketching out this framework, the paper aims to overcome the clash between universalism and relativism about psychiatric categories by focusing on how overlaps between cultures can contribute to ontology-building. A case study analyzing ethnopsychiatric research in the context of South India will illustrate the proposed view, while also pointing out avenues for further research on the causal efficacy of local shared beliefs about mental disorder. If approaches across different traditions and theoretical frames are shown to work in treating similar ailments, causal connections appear to cut across the different ontologies. Ethnopsychiatry would play a central role in such research, namely in disclosing the variables and mechanisms at work within the local approaches. (shrink)

In a recent exchange, John Worrall and Larry Laudan have debated the merits of the model of rational scientific change proposed by Laudan in his book Science and Values. On the model advocated by Laudan, rational change may take place at the level of scientific theory and methodology, as well as at the level of the epistemic aims of science. Moreover, the rationality of a change which occurs at any one of these three levels may be dependent on considerations (...) at the remaining levels. Yet, in spite of the avowedly anti-relativistic motivation of Laudan's model, Worrall criticizes Laudan for irrevocably relativizing scientific rationality to historically variant methodological standards. (shrink)

If one had to identify the biggest change within the philosophical tradition in the twenty-first century, it would certainly be the rapid rise of experimental philosophy to address differences in intuitions about concepts. It is, therefore, surprising that the philosophy of medicine has so far not drawn on the tools of experimental philosophy in the context of a particular conceptual debate that has overshadowed all others in the field: the long-standing dispute between so-called naturalists and normativists about the concepts of (...) health and disease. In this paper, I defend and advocate the use of empirical methods to inform and advance this and other debates within the philosophy of medicine. (shrink)

The COVID-19 pandemic has coincided with the proliferation of ethical guidance documents to assist public health authorities, health care providers, practitioners and staff with responding to ethical challenges posed by the pandemic. Like ethical guidelines relating to infectious disease that have preceded them, what unites many COVID-19 guidance documents is their dependency on an under-developed approach to bioethical principlism, a normative framework that attempts to guide actions based on a list of prima facie, unranked ethical principles. By situating them in (...) relation to the key philosophical debates concerning bioethical principlism, we aim to explore the limits and limitations of pandemic ethical guidance documents as, specifically, ethics documents – documents that fulfil the functions of ethics as a fundamentally normative discipline. This means not only determining whether such ethical guidance documents can, in principle, provide adequate action guidance and action justification, but also, more importantly where pandemics are concerned, determining whether they support consistent decision making and transparent processes of justification. Having highlighted the problems with merely furnishing ethical guidelines with substantive ethical content in terms of principles and values, we argue that organizations that develop these documents should, instead, focus on the procedural dimensions of action guidance and action justification, which extend to questions regarding the make-up of the committees, panels and groups that develop such guidelines, the public transparency of justifications for specific pandemic-related advice or interventions and the development of explicit procedures for transparent and consistent decision making. (shrink)

Our philosophical understanding of mental illness is being shaped by neuroscience. However, it has the paradoxical effect of igniting two radically opposed groups of philosophical views. On one side, skepticism and denialism assume that, lacking clear biological mechanisms and etiologies for most mental illnesses, we should infer they are constructions best explained by means of social factors. This is strongly associated with medical nihilism: it considers psychiatry more harmful than benign. On the other side of the divide, naturalism and reductionism (...) are on the look for failures in the biological functioning of the organism whenever a genuine mental illness occurs. Psychiatry as currently practiced, accordingly, exhibits the gaps of an ongoing research programme; a yet to be completed neuroscience would link mental illnesses with identifiable biological mechanisms. Both sides of this divide claim to be fostered by scientific discoveries and advances in neuroscience, when taken at face value. Against this background, we argue instead for a modest view. To that end, we draw attention to some nuances in the scientific realism debate. While contending that neuroscientific theories and models aim to provide true representations of their target systems, and can justifiably claim to have attained some, we argue that our confidence should not be placed beforehand in specific features of these scientific representations. Hence, it would be unwarranted to extract morals for psychiatry from posits (or their absence) in neuroscientific explanations of mental illnesses. To illustrate our position, we examine some recent discoveries in neuroscience concerning bipolar disorder. We conclude by linking our topic to a broader issue in the philosophy of medicine: insofar as psychiatry is a biomedical specialty, its classifications of health and disease are guided by pragmatic concerns, as well as by scientific discoveries. (shrink)

We ask whether it is reasonable to delay or refuse to take COVID-19 vaccines that have been shown in clinical trials to be safe and effective against infectious diseases. We consider two kinds of vaccine hesitancy. The first is geared to scientifically informed open questions about vaccines. We argue that in cases where the data is not representative of relevant groups, such as pregnant women and ethnic minorities, hesitancy can be reasonable on epistemic grounds. However, we argue that hesitancy is (...) not reasonable if a vaccine has passed well-conducted clinical trials. The second kind of hesitancy is to do with beliefs about the institutions offering a successfully trialled vaccine and the justifiability of cooperating with those institutions. For example, in the UK, distrust of the UK Government or the National Health Service is identified as a factor in the vaccine hesitancy of minority ethnic populations. We ask whether this sort of hesitation is reasonable given normative requirements of fair co-operation, both with those institutions and the wider population. We suggest that the answer is not straightforward. Sometimes the hesitation is unreasonable but understandable. -/- . (shrink)

In The Biopsychosocial Model of Health and Disease, Derek Bolton and Grant Gillett argue that a defensible updated version of the biopsychosocial model requires a metaphysically adequate account of disease causation that can accommodate biological, psychological, and social factors. This present paper offers a philosophical critique of their account of biopsychosocial causation. I argue that their account relies on claims about the normativity and the semantic content of biological information that are metaphysically contentious. Moreover, I suggest that these claims are (...) unnecessary for a defence of biopsychosocial causation, as the roles of multiple and diverse factors in disease causation can be readily accommodated by a more widely accepted and less metaphysically contentious account of causation. I then raise the more general concern that they are misdiagnosing the problem with the traditional version of the biopsychosocial model. The challenge when developing an explanatorily valuable version of the biopsychosocial model, I argue, is not so much providing an adequate account of biopsychosocial causation, but providing an adequate account of causal selection. Finally, I consider how this problem may be solved to arrive at a more explanatorily valuable and clinically useful version of the biopsychosocial model. (shrink)

We recently suggested that there are both pragmatic and normative reasons to classify pregnancy as a disease. Several scholars argued against our claims. In this response, we defend the disease view of pregnancy against their criticism. We claim that the dysfunctional account of disease that some of our critics rely on has some counterintuitive results. Furthermore, we claim that our critics assume what needs to be argued that the primary function of our sexual organs is to reproduce. Since only a (...) small percentage of sexual intercourse leads to pregnancy, it is far from obvious that reproduction is the primary biological function of our sexual organs. We also claim that while taking pregnancy itself as a reference class could avoid the conclusion that pregnancy is a disease, the strategy is problematic since it renders the Boorsean approach to disease and health circular and effectively deprives it of any utility in determining whether a particular phenomenon is a disease or not. (shrink)

In this chapter, I systematically distinguish a variety of ways to rela- tionalize economics and focus on a certain approach to relationalizing normative economics in the light of communal values salient in the African philosophical tradi- tion. I start by distinguishing four major ways to relationalize empirical economics, viz., in terms of its ontologies, methods, explanations, and predictions and also three major ways to relationalize normative economics, with regard to means taken towards ends, decision-procedures used to specify ends, and (...) ends themselves. Then, in the remainder of the chapter, I address what would be involved in relationalizing the ends of economic choices, given ideals of communal relationship characteristically prized by sub-Saharan philosophers, particularly southern African adherents to ubuntu. I advance communal answers to the two large questions of what an economy should distribute and how to engage with stakeholders, and I suggest that the implications will be found plausible by many open-minded enquirers around the world. Although this chapter is a work of ethical philosophy, it is meant to be of broad interest to scholars in economics. (shrink)

Assumptions about obesity—e.g., its connection to ill health, its causes, etc.—are still prevalent today, and they make up what I call the medical model of fatness. In this paper, I argue that the medical model was established on the basis of insufficient evidence and has nevertheless continued to be relied upon to justify methodological choices that further entrench the assumptions of the medical model. These choices are illegitimate in so far as they conflict with both the epistemic and social aims (...) of obesity research. I conclude the paper with a partial solution to these epistemic and social shortcomings. (shrink)

In order to strengthen RI in the private sector, it is imperative to understand how companies organise this process, where it takes place, and what considerations and motivations are central in the innovation process. In this chapter, the questions of whether and where normative considerations play a role in the innovation process, and whether dimensions of RI are present in the innovation process, are addressed. In order answer these research questions, a theoretical framework is developed based on Jones’s theory of (...) ethical decision making and Cooper’s stagegate model of innovation management. In order to answer the research questions, a specific case of innovations that contribute to public health is explored, namely, that of food companies that participate in a Front-of-Pack logo for healthier food. As the use of healthy food logos does not necessarily have a positive impact on sales and profits, it is expected that in the decision-making process, as part of their innovation process, companies make several trade-offs between economic, technical and moral factors. As the social-ethical values at stake in corporate innovation processes have remained to a large extent unexplored in research on innovation management, the aim of this chapter is to identify the motivations and barriers for companies embracing and continuing a FoP logo for healthier food, and to assess whether ethical considerations play a role in this innovation process. From the findings in this research, it will become clear that although the studied companies participated in a programme for healthy food and thus are responsive to the needs of society, and although the companies feel responsible for public health, ethical considerations do not play a central role in the operational innovation process. Instead, technical and economic considerations seem to prevail in the operational innovation process. Furthermore, none of the procedural dimensions of RI seems to be present at this level in the innovation trajectory. It is argued that this may be an indication that the ethical decision-making process for RI is not located at the level of the operational innovation process itself, but is something that might be located on a higher strategic level in the company. It is at this level that the moral decision is taken to adopt the FoP logo and to engage in the RI process. The findings cast a new light on the discourse on RI in general, and in the private sector in particular. (shrink)

The Future of Human Reproduction and Family Structure -/- Introduction -/- The future of human reproduction and family structure is set to undergo profound transformations due to advancements in science, technology, and shifting societal values. Breakthroughs in artificial reproduction, gene editing, AI-assisted parenting, and new family models are poised to redefine what it means to conceive, raise children, and form families. As these changes unfold, they will challenge traditional concepts of marriage, parenthood, and biological reproduction. This essay explores the (...) potential future of human reproduction and family structure, examining the scientific, ethical, and social implications. -/- 1. The Future of Human Reproduction -/- A. Assisted Reproductive Technologies (ART) and Genetic Engineering -/- Scientific advancements are making reproduction more accessible and customizable, allowing individuals to control fertility and genetic traits like never before. -/- 1. Artificial Wombs (Ectogenesis) -/- Artificial wombs, or ectogenesis, could enable embryos to develop outside the human body. This technology would: -/- Help individuals unable to carry pregnancies. -/- Reduce health risks associated with childbirth. -/- Offer reproductive freedom to same-sex couples and single individuals. -/- However, artificial wombs may raise ethical concerns about the emotional and psychological impact on maternal bonding and child development. Additionally, they may lead to commercialized pregnancy, where companies provide “womb services” for those who can afford them. -/- 2. Gene Editing & Designer Babies -/- Gene-editing tools like CRISPR allow parents to modify embryos to: -/- Eliminate genetic diseases. -/- Enhance intelligence, physical abilities, and even personality traits. -/- While this technology offers great potential for eradicating inherited disorders, it could also create genetic inequality between those who can afford enhancements and those who cannot, leading to the emergence of a genetic upper class. Governments may implement strict regulations, but underground markets for genetic enhancements could emerge. -/- 3. Lab-Grown Gametes -/- Scientists are developing methods to create sperm and eggs from stem cells, which could enable: -/- Infertile individuals to have biological children. -/- Single individuals to conceive without a partner. -/- While this could redefine reproduction by making parenthood accessible to all, it also raises ethical questions about whether parenthood should be solely based on biological connection or expanded to include other forms of caregiving. -/- B. Cloning and Synthetic Biology -/- 1. Human Cloning -/- While human cloning is currently illegal in most countries, advances in genetic engineering may eventually make it possible. Cloning could: -/- Allow individuals to reproduce without a partner. -/- Be used for medical purposes, such as replacing lost children. -/- Raise existential concerns about individuality and identity. -/- However, human cloning raises profound ethical concerns, including human rights, consent, and the potential exploitation of cloned individuals for labor or military purposes. -/- 2. Synthetic Embryos & Artificial Life -/- Scientists are developing synthetic embryos without using sperm or eggs, which could: -/- Enable reproduction without biological parents. -/- Help infertile individuals conceive. -/- Lead to new ethical dilemmas regarding the moral status of artificially created life forms. -/- If synthetic embryos become a reality, society may need to redefine what it means to be “human” and whether artificial life forms deserve legal rights. -/- C. Population & Environmental Considerations -/- 1. Controlled Population Growth -/- As overpopulation threatens global resources, some governments may: -/- Regulate reproduction using artificial reproductive technologies. -/- Implement birth quotas to maintain ecological balance. -/- Encourage reproduction in aging societies facing workforce decline. -/- These policies would raise ethical questions about personal freedom versus societal needs. -/- 2. Reproduction in Space -/- If humans colonize planets like Mars, reproduction in space will require: -/- Artificial wombs to protect embryos from cosmic radiation. -/- Genetic modifications to help humans adapt to low gravity. -/- New family structures, as space-born humans may develop unique physical traits. -/- This could lead to divergent human evolution, with space-born individuals differing from Earth-born humans over generations. -/- 3. The Future of Family Structure -/- A. Non-Traditional Family Models -/- 1. Multi-Parent Families -/- Technologies like three-parent IVF already exist, and in the future, more than two people may be able to contribute genetic material to a child. This could: -/- Redefine legal parenthood. -/- Enable new forms of family structures. -/- Challenge traditional parenting norms. -/- Laws will need to adapt to recognize multi-parent families and their rights. -/- 2. Single-Parent by Choice -/- With advanced reproductive technologies, more individuals will choose to have children without a partner. This will: -/- Normalize single parenthood. -/- Reduce societal pressure to marry for reproductive purposes. -/- Create new legal structures for co-parenting agreements. -/- B. Changes in Marriage & Parenting Norms -/- 1. Declining Marriage Rates -/- With reproduction becoming independent of relationships, marriage may decline, as people prioritize: -/- Career advancement. -/- Personal fulfillment. -/- Alternative forms of companionship. -/- 2. Co-Parenting Arrangements -/- People may legally agree to co-parent a child without being romantically involved. This would: -/- Offer a stable upbringing without traditional marriage. -/- Encourage partnership-based parenting. -/- Reduce legal disputes over custody. -/- 3. Extended Family Networks -/- Due to economic pressures, multi-generational households may become more common, with grandparents playing a bigger role in raising children. -/- C. AI & Robotics in Parenting -/- 1. AI Parenting Assistants -/- AI-driven robots may assist in: -/- Childcare and education. -/- Emotional development and mentorship. -/- Reducing parental stress. -/- However, heavy reliance on AI could impact traditional parent-child bonding. -/- 2. AI-Generated Children (Digital Offspring) -/- In the future, some people may choose to raise AI-based virtual children in digital environments instead of having biological kids. These “children” could: -/- Simulate real human relationships. -/- Reduce the need for biological reproduction. -/- Raise ethical questions: If AI children learn and grow, are they “alive”? -/- 3. Key Ethical and Social Questions -/- As these technologies reshape reproduction and family life, several ethical concerns arise: -/- 1. Genetic Inequality: Will access to genetic enhancements create a class divide? -/- 2. State vs. Individual Rights: Should governments regulate reproduction? -/- 3. Redefining Parenthood: Who qualifies as a parent in multi-parent or AI-assisted families? -/- 4. Traditional vs. Technological Families: Will humans still value biological reproduction, or will artificial and digital life forms become part of the family? -/- Conclusion -/- The future of human reproduction and family structure will be radically transformed by scientific advancements, shifting social norms, and ethical dilemmas. While artificial wombs, gene editing, and AI parenting promise greater reproductive freedom and inclusivity, they also pose existential challenges about human identity, societal structures, and the ethics of life creation. As these technologies advance, societies must carefully navigate their implications to ensure that progress benefits all of humanity while safeguarding fundamental rights and values. -/- . (shrink)

The Philosophy Behind Marriage and Family Structure -/- Marriage and family have been fundamental aspects of human society for millennia. These institutions, deeply rooted in both biological imperatives and cultural traditions, provide individuals with emotional support, societal structure, and a framework for raising future generations. Throughout history, philosophers, sociologists, psychologists, and religious leaders have explored the significance of marriage and family, offering various perspectives on their purpose, evolution, and societal impact. This essay examines the philosophy behind marriage and family structure (...) through different lenses, including social, religious, psychological, biological, existential, economic, and contemporary viewpoints. -/- 1. Social and Functional Perspective -/- From a social standpoint, marriage and family serve as the bedrock of society. Aristotle, in his work Politics, described the family as the smallest social unit, essential for the survival and well-being of the individual and the state. He believed that humans are naturally social beings and that the family provides the first environment where individuals learn social values such as cooperation, responsibility, and justice. -/- Similarly, Confucian philosophy underscores the importance of family in maintaining social harmony. In Confucianism, filial piety—the respect for parents and ancestors—is a cornerstone of moral conduct, with family relationships mirroring broader societal relationships. The family, in this view, is not just a private institution but a microcosm of the entire social order. -/- Historically, marriage has also functioned as a social contract that unites families, clans, and communities, often transcending individual desires for the sake of social cohesion and societal continuity. -/- 2. Religious and Moral Perspective -/- Religious traditions around the world have long emphasized the sanctity of marriage and the importance of family life. In Christianity, marriage is often viewed as a divine covenant that reflects the relationship between Christ and the Church, with an emphasis on love, commitment, and mutual support. Hinduism regards marriage as a sacrament (samskara), binding individuals not only in the present life but also across lifetimes. -/- Islamic teachings similarly highlight marriage as a partnership grounded in compassion, mercy, and shared responsibility. Across these traditions, marriage and family are seen as moral institutions that provide a stable environment for raising children and passing down spiritual values. -/- Religious perspectives often link the stability of society to the strength of family structures, asserting that moral virtues such as loyalty, fidelity, and respect are first cultivated within the family unit. -/- 3. Psychological and Emotional Perspective -/- From a psychological standpoint, marriage and family fulfill essential emotional and developmental needs. The attachment theory proposed by John Bowlby suggests that early relationships within the family shape an individual’s emotional well-being and capacity for forming relationships later in life. Families provide emotional support, a sense of belonging, and a framework for identity development. -/- Carl Jung, a pioneer in analytical psychology, saw marriage as a path toward individuation, where two individuals learn and grow through their relationship. The emotional bonds formed in marriage and family life contribute to mental health, resilience, and a sense of purpose. -/- Moreover, contemporary psychological research emphasizes the importance of secure family environments for children’s cognitive and emotional development. Strong family bonds, characterized by open communication, emotional warmth, and supportive relationships, are associated with better psychological outcomes across the lifespan. -/- 4. Evolutionary and Biological Perspective -/- Biologically, the formation of family units can be understood as an adaptive strategy that supports survival and reproduction. Evolutionary psychologists argue that marriage and family structures evolved to address fundamental challenges related to reproduction, child-rearing, and social cooperation. -/- Anthropologist Helen Fisher suggests that human beings have evolved three distinct but interconnected brain systems related to love: attraction, romantic attachment, and long-term bonding. These systems, she argues, have historically promoted pair bonding, cooperative parenting, and the long-term care of offspring. -/- The biological perspective highlights how family structures have varied across cultures in response to environmental and societal factors. For instance, extended family structures were historically more common in agrarian societies, where cooperative labor was essential, while nuclear family structures became more prevalent in industrialized societies. -/- 5. Existential and Individual Perspective -/- Existential philosophers have explored marriage and family through the lens of individual freedom and personal growth. Jean-Paul Sartre and Simone de Beauvoir questioned traditional marriage structures, suggesting that societal norms around marriage could sometimes limit individual freedom and authenticity. -/- From an existential perspective, marriage can either be an avenue for personal growth or a constraint imposed by societal expectations. The decision to marry and build a family, therefore, becomes an existential act—one that involves choosing companionship and shared purpose in an otherwise uncertain world. -/- For existentialists, the meaning of marriage lies not in external validation but in the authentic relationship between individuals who choose to support and grow with one another despite life’s uncertainties. -/- 6. Economic and Structural Perspective -/- The economic dimension of marriage and family structures has been explored by philosophers such as Karl Marx and Friedrich Engels. In their analysis, traditional family structures were intertwined with systems of property ownership, inheritance, and social class. Engels, in The Origin of the Family, Private Property and the State, argued that the nuclear family, particularly in capitalist societies, reinforced patriarchal power dynamics and preserved wealth within certain classes. -/- In modern societies, the economic functions of marriage and family continue to be significant. Families often serve as units of economic cooperation, pooling resources to meet household needs and invest in children’s education and future. Additionally, shifts in labor markets, gender roles, and social policies have influenced family structures, leading to more diverse forms of partnerships and parenting arrangements. -/- 7. Contemporary and Progressive Perspectives -/- In recent decades, philosophical and sociological discussions about marriage and family have expanded to include issues of equality, diversity, and individual autonomy. The recognition of same-sex marriage in many countries reflects a broader societal shift toward inclusivity and the redefinition of traditional family structures. -/- Feminist philosophers, such as Judith Butler, have critically examined the ways in which traditional marriage and family structures have historically marginalized women and reinforced gender roles. Contemporary perspectives emphasize the importance of shared responsibilities within families, regardless of gender, as well as the recognition of diverse family forms, including single-parent households, cohabiting partnerships, and chosen families. -/- The contemporary view of marriage and family increasingly acknowledges the importance of love, mutual respect, and individual autonomy alongside traditional functions of reproduction and social stability. -/- Conclusion -/- The philosophy behind marriage and family structure encompasses a broad spectrum of perspectives, each offering valuable insights into these enduring human institutions. Socially, marriage and family provide stability and continuity. Religiously, they offer moral guidance and spiritual purpose. Psychologically, they fulfill emotional and developmental needs. Biologically, they support survival and reproduction. Existentially, they present opportunities for personal growth and authentic relationships. Economically, they function as units of resource-sharing and social mobility. -/- As societies evolve, so too do their understanding and practice of marriage and family life. The challenge for modern societies lies in balancing the enduring functions of these institutions with changing social norms, ensuring that marriage and family remain sources of support, growth, and societal cohesion for generations to come. -/- . (shrink)

-/- The Universal Formula for Solving the Free Will Problem and Preventing Global Chaos -/- By Angelito Malicse -/- Free will has perplexed philosophers, scientists, and theologians for millennia. The notion that humans possess the ability to make independent choices has often clashed with scientific findings indicating that decisions are influenced by biological, psychological, and environmental factors. This unresolved dilemma has far-reaching implications for society, as misunderstandings about human decision-making contribute to ignorance, conflict, and societal dysfunction. Without a clear understanding (...) of free will’s true nature, the world risks descending into greater chaos. -/- To address this fundamental issue, I, Angelito Malicse, have developed a universal formula that solves the free will problem by revealing the natural laws that govern human decision-making. This formula is grounded in three universal laws: (1) the Law of Karma, (2) the Universal Law of Balance, and (3) the Law of Feedback Mechanisms. Together, these laws provide a systematic, natural-law-based understanding of how human decisions are made and how societies can avoid disorder. By applying this formula in education, governance, and artificial intelligence systems, humanity can prevent global chaos and foster a more harmonious future. -/- The Law of Karma: Cause, Effect, and System Integrity -/- The first law, the Law of Karma, extends beyond the moralistic idea of good and bad deeds. It asserts that every action, thought, and decision sets off a chain of cause and effect that operates within interconnected systems. For any system—whether biological, psychological, or societal—to function properly, it must be free of defects or misinformation. The presence of false beliefs, ignorance, or flawed information disrupts the system’s stability and creates adverse outcomes. -/- In other words, the integrity of any system relies on the accuracy of the information and decisions driving it. Human decision-making is no exception. When individuals or societies act without understanding natural laws, the resulting imbalance leads to societal issues like poverty, environmental degradation, and political unrest. -/- Examples: -/- Personal Level: A person who neglects their health by consuming an unhealthy diet will eventually suffer consequences like obesity or heart disease. The cause (poor diet) naturally leads to the effect (health complications) because the body operates within strict biological laws. -/- Societal Level: A government that ignores scientific evidence about climate change, continuing to promote unsustainable practices, will face severe environmental and economic consequences. The cause (policy negligence) inevitably results in environmental degradation, economic instability, and societal suffering. -/- This law demonstrates that free will is not an unbounded, random phenomenon. Human decisions, like natural events, follow cause-and-effect principles that cannot be bypassed without consequences. -/- The Universal Law of Balance: The Principle of Equilibrium -/- The second law, the Universal Law of Balance, states that all natural systems—biological, psychological, societal, and ecological—operate according to a fundamental principle of balance. Just as the human body maintains homeostasis to regulate temperature, blood pressure, and other vital functions, decision-making processes also seek balance between internal and external influences. -/- When decisions disrupt this natural balance, the system responds with corrective mechanisms. Ignoring or resisting these mechanisms leads to instability, suffering, and systemic failure. Human free will, therefore, operates within the constraints of nature’s balancing forces. -/- Examples: -/- Psychological Balance: A person experiencing chronic stress must either address the root cause or suffer mental and physical consequences. Mental health interventions like therapy restore the mind’s balance by providing coping mechanisms that align with psychological principles. -/- Societal Balance: Societies with extreme wealth inequality often face social unrest. Policies that promote economic justice restore societal balance, reducing conflict and enhancing societal well-being. -/- This law highlights that free will is governed by the natural tendency of systems to maintain balance. Decisions made without regard for this principle lead to instability at both the individual and societal levels. -/- The Law of Feedback Mechanisms: The Dynamics of Interconnected Minds -/- The third law, the Law of Feedback Mechanisms, asserts that human decision-making is continuously shaped by internal cognitive processes and external environmental interactions. Minds do not operate in isolation; they exist within dynamic feedback systems where individuals influence—and are influenced by—each other’s decisions. -/- Decisions are adjusted based on feedback from personal experiences, social interactions, and environmental conditions. Recognizing these feedback mechanisms reveals that free will functions more like a dynamic system responding to ongoing stimuli rather than an independent, isolated force. -/- Examples: -/- Individual Feedback: A child who receives positive reinforcement for helpful behavior will continue making similar choices because the positive feedback reinforces the action. -/- Collective Feedback: During the COVID-19 pandemic, societies that adjusted behaviors based on scientific feedback—like social distancing and vaccination—contained the virus more effectively. The feedback loop between scientific research and public behavior demonstrated the law in action. -/- This law explains why cultural norms, societal values, and shared beliefs can evolve over time. Collective decisions continuously adjust based on the feedback society receives from its environment and past experiences. -/- The Interplay of the Three Laws -/- The true power of this universal formula emerges from the interaction of these three laws. Human decision-making is not random, chaotic, or wholly autonomous; it follows predictable patterns governed by natural laws. When individuals and societies disregard these principles, imbalance, disorder, and suffering result. -/- For instance, consider environmental degradation: -/- 1. Law of Karma: Societies driven by unchecked industrial growth (cause) face environmental damage (effect) due to ignorance about ecological balance. -/- 2. Universal Law of Balance: Nature responds to pollution and deforestation through climate change, signaling an imbalance that requires corrective action. -/- 3. Law of Feedback Mechanisms: Scientific warnings about rising temperatures, extreme weather events, and resource depletion provide feedback that, when heeded, prompts sustainable policy decisions. -/- By recognizing and applying these laws, societies can respond proactively to emerging challenges and avoid catastrophic outcomes. -/- The Danger of Ignoring the Free Will Problem -/- Without solving the problem of free will through this universal formula, the world risks descending into greater chaos. Decision-making processes driven by false beliefs, misinformation, and short-term interests create systemic imbalances that compound over time. We already witness these consequences in the form of: -/- Environmental Collapse: Decisions that ignore ecological limits disrupt the planet’s natural balance, triggering climate disasters. -/- Political Polarization: Societies that fail to educate citizens about natural decision-making processes become vulnerable to ideological extremism and misinformation. -/- Economic Inequality: Economic policies that prioritize growth over sustainability create unstable, unsustainable economies that ultimately collapse. -/- Understanding that free will is governed by natural laws provides a foundation for more rational, balanced decision-making across all sectors of society. -/- The Role of Education in Implementing the Universal Formula -/- The practical application of this formula must begin in the educational system. A holistic, foundational education that teaches the principles of cause and effect, balance, and feedback mechanisms will equip individuals with the critical thinking skills necessary for responsible decision-making. -/- By integrating these universal laws into educational curricula, students will learn to recognize how decisions shape both their personal lives and the broader societal landscape. This approach does not seek to dismantle religious or cultural beliefs but rather complements them with scientifically grounded insights into human behavior. -/- The Role of AGI In Applying the Formula -/- Advanced General Intelligence (AGI) offers a powerful tool for applying this universal formula in real-time societal contexts. AGI systems, equipped with comprehensive sensor networks, can monitor societal feedback loops and help policymakers anticipate the long-term consequences of decisions. By programming AGI with the principles of the universal formula, societies can develop more balanced, sustainable strategies for addressing global challenges. -/- Conclusion: A Call to Action -/- The world stands at a critical juncture. Societal challenges—from climate change to political polarization—stem from decision-making processes that disregard the natural laws governing human behavior. My universal formula for solving the problem of free will, rooted in the Law of Karma, the Universal Law of Balance, and the Law of Feedback Mechanisms, provides a clear, exact solution to this ancient problem. -/- Implementing this formula through education, governance, and AGI development is essential to preventing global chaos. By understanding that free will is not an arbitrary phenomenon but a natural process governed by universal laws, humanity can foster more balanced, harmonious, and sustainable societies. -/- The future of our world depends on our willingness to embrace and apply this understanding. The time for action is now. -/- – Angelito Malicse -/- . (shrink)

What is it to be mentally healthy? In the ongoing movement to promote mental health, to reduce stigma, and to establish parity between mental and physical health, there is a clear enthusiasm about this concept and a recognition of its value in human life. However, it is often unclear what mental health means in all these efforts and whether there is a single concept underlying them. Sometimes, the initiatives for the sake of mental health are aimed just at reducing mental (...) illness, thus implicitly identifying mental health with the absence of diagnosable psychiatric disease. More ambitiously, there are high-profile proposals to adopt a positive definition, identifying mental health with psychic or even overall well-being. We argue against both: a definition of mental health as mere absence of mental illness is too thin, too undemanding, and too closely linked to psychiatric value judgments, while the definition in terms of well-being is too demanding and potentially oppressive. As a compromise, we sketch out a middle position. On this view, mental health is a primary good, that is, the psychological preconditions of pursuing any conception of the good life, including well-being, without being identical to well-being. (shrink)

This paper defends a distinctly liberal approach to public health ethics and replies to possible objections. In particular, I look at a set of recent proposals aiming to revise and expand liberalism in light of public health's rationale and epidemiological findings. I argue that they fail to provide a sociologically informed version of liberalism. Instead, they rest on an implicit normative premise about the value of health, which I show to be invalid. I then make explicit the unobvious, republican background (...) of these proposals. Finally, I expand on the liberal understanding of freedom as non-interference and show its advantages over the republican alternative of freedom as non-domination within the context of public health. The views of freedom I discuss in the paper do not overlap with the classical distinction between negative and positive freedom. In addition, my account differentiates the concepts of freedom and autonomy and does not rule out substantive accounts of the latter. Nor does it confine political liberalism to an essentially procedural form. (shrink)

Current naturalistic accounts of value face the problem of explaining the normative constraints that value impose on agents. Attempts to solve this problem have progressively relaxed the strictness of naturalistic requirements, up to the point of seeking theistic solutions. However, appeals to God are also problematic, since it is questionable that a relevant notion of God is conceivable at all: if God is wholly other He cannot matter for our choices and if He is a being among natural beings He (...) cannot explain our normative constraints. Engaging a discussion with Fiona Ellis’ treatment of the problem, this essay sketches an account of transcendence, which vindicates the conceivability of a notion of God suitable for the explanation of value. The proposal rests on the possibility of transcendental arguments based on analogy. (shrink)

: The relationship between facts and values—in particular, naturalism and normativity—poses an ongoing challenge for feminist science studies. Some have argued that the fact/value holism of W.V. Quine's naturalized epistemology holds promise. I argue that Quinean epistemology, while appropriately naturalized, might weaken the normative force of feminist claims. I then show that Quinean epistemic themes are unnecessary for feminist science studies. The empirical nature of our work provides us with all the naturalized normativity we need.

By examining the global public good nature of pandemic preparedness we can identify key social justice issues that need to be confronted to increase citizens’ voluntary compliance with prevention and mitigation measures. As people tend to cooperate on a voluntary basis only with systems they consider fair, it becomes difficult to ensure compliance with public health measures in a context of extreme inequality. Among the major inequalities that need to be addressed we can find major differences in the extensiveness and (...) intensiveness of quarantine experiences, lack of opportunities to participate in common efforts, hardship in complying with disease control recommendations, and an unfair distribution of the cooperative surplus. (shrink)

Although Cottingham and Holland make a persuasive case for the claim that it is difficult to situate a meaningful life within a Darwinian naturalistic cosmology, this paper argues that their case should be modified in response to the apparent fact that certain persons seem genuinely not to experience the ‘bleakness’ that they describe. Although certain of these cases will reflect an incomplete appreciation of the existential implications of Darwinian naturalism, at least some of those cases may be genuine. The resulting (...) possibility that certain persons can embrace Darwinian naturalism and live meaningful lives in apparent immunity to the ‘bleakness charge’ therefore poses new puzzles for Cottingham and Holland, and for wider questions about the meaningfulness of human life. I consider that possibility in light of the work of David E. Cooper and Paul Feyerabend and offer a set of three suggestions for further developing these debates. (shrink)

Brentano is often considered the originator of the fitting-attitudes analysis of value, on which to be valuable is to be that which it’s fitting to value. But there has been comparatively little attention paid to Brentano’s argument for this analysis. That argument advances the stronger claim that fittingness is part of the analysis of normativity. Since the argument rests on an analogy between truth and fittingness, its impact may seem limited by the idiosyncratic features of Brentano’s later notion of truth. (...) I argue, however, that the Brentanian argument is defensible even if fittingness is analogized to a more typical realist account of truth. The result is what I call the worldly Brentanian account of normativity. I defend this account as a form of naturalistic realism. I then show how the account can fare better than prominent alternatives against two kinds of error-theoretic arguments. (shrink)

The influence of Kurt Goldstein on the thinking of Georges Canguilhem extended throughout his entire work. This paper seeks to examine this relationship in order to conduct a study of the norm as a nexus or connection between the concept and life. Consequently, this work will be a reflection on the approach to life as a normative activity and self-realization. For this, it will be necessary to redefine the concepts of health and disease, and make a crossover between the two. (...) At the end of this trajectory, it will be found that these concepts can explain the identity between the concept and life, which leads to the unexpected conclusion that the cure is ultimately self-healing. (shrink)

Should we tell other people the truth? Should we believe what other people tell us? This paper argues that something like these norms of truth-telling and belief govern our production and receipt of testimony in conversational contexts. It then attempts to articulate these norms and determine their justification. More fully specified these norms prescribe that speakers tell the truth informatively, or be trustworthy, and that audiences presume that speakers do this, or trust. These norms of trust, as norms of conversational (...) cooperation, would then seem to be justified on the basis of the interest that each has in the cooperative outcome. The norms of trust would then be justified as Lewisian conventions. Howver, the joint outcome prescribed by these norms is not a equilibrium point: a speaker always does better to have an audience’s trust and the liberty to tell the truth or not as it suits. In this way, testimony presents a problem of trust. The justification of these norms of trust then starts from the recognition that any society that did not resolve this problem of trust would be stymied as a society. The resolution of this problem then requires securing the motivations characteristic of trusting and being trustworthy, where to have these motivations is to have an ethical outlook defined in terms of internalising these norms of trust. This justification genealogical and it is one of value. (shrink)

This chapter concerns the normativity of the concepts of paternalism and libertarian paternalism. The first concept is central in evaluating public health policy, but its meaning is controversial. The second concept is equally controversial and has received much attention recently. It may or may not shape the future evaluation of public health policy. In order to facilitate honest and fruitful debate, I consider three approaches to these concepts, in terms of their normativity. Concepts, I claim, may be considered nonnormative, normatively (...) charged, or normative in that they involve more complex relationships between values or duties. While the last approach is often best, other approaches may be appropriate depending on the context and purpose of discussion. The chapter’s conceptual investigation is illustrated by application to two public health policies: a tax on the consumption of fat and the encouragement of health-promoting food displays in restaurants and supermarkets. (shrink)

Estimates of the burden of disease assess the mortality and morbidity that affect a population by producing summary measures of health such as quality-adjusted life years and disability-adjusted life years. These measures typically do not include stillbirths among the negative health outcomes they count. Priority-setting decisions that rely on these measures are therefore likely to place little value on preventing the more than three million stillbirths that occur annually worldwide. In contrast, neonatal deaths, which occur in comparable numbers, have a (...) substantial impact on burden of disease estimates and are commonly seen as a pressing health concern. In this article we argue in favor of incorporating unintended fetal deaths that occur late in pregnancy into estimates of the burden of disease. Our argument is based on the similarity between late-term fetuses and newborn infants and the assumption that protecting newborns is important. We respond to four objections to counting stillbirths: that fetuses are not yet part of the population and so their deaths should not be included in measures of population health; that valuing the prevention of stillbirths will undermine women's reproductive rights; that including stillbirths implies that miscarriages should also be included; and that birth itself is in fact ethically significant. We conclude that our proposal is ethically preferable to current practice and, if adopted, is likely to lead to improved decisions about health spending. (shrink)

This paper has a twofold aim. On the one hand, we will discuss the much debated question of the source of normativity (which traditionally has nature and practical reason as the two main contenders to this role) and propose a new answer to it. Second, in answering this question, we will present a new account of practical wisdom, which conceives of the ethical virtues as ultimately unified in the chief virtue of phronesis, understood as ethical expertise. To do so, we (...) will first criticize the main current view of phronesis and its bearer (the phronimos), then offer another view of the nature of phronesis and of its relation to the other ethical virtues. Our proposal should not be intended as an interpretation of Aristotle’s own view; rather, it should be seen as a broadly Aristotelian theoretical proposal, which we believe can satisfyingly address most of the problems that afflict the more traditional accounts of practical wisdom. In section 2 of this paper, after criticizing first-nature naturalistic views of moral virtue, we take practical reason to be the cornerstone of second-nature naturalistic views; in section 3, we will outline criticisms to which, in our view, the traditional views of phronesis are ill-suited to respond, and, in section 4, we will outline our view of phronesis as ethical expertise – a view which in our view is immune to the above-mentioned criticisms – by spelling out the three main tenets of phronesis as ethical expertise: a conceptual thesis, an epistemic thesis, and the educational implications of the two. Finally, we will support our proposal with some empirical evidence taken from cognitive science. (shrink)

De Proost & Grey criticize Nickel et al.’s article “Justice and empowerment through digital health: ethical challenges and opportunities,” arguing that it should have embraced relational autonomy and capability approaches. We distinguish two variants of this critique, one saying that a view of digital health empowerment should welcome these approaches, and one saying that a view of digital health empowerment should essentially be defined in terms of these approaches. We are somewhat open to the first variant: relational autonomy and the (...) capability approach are promising ways of spelling out the ethical values behind digital health empowerment, even if they are not completely unproblematic and uncontroversial. However, there are reasons to reject the second variant. A view that leaves the exact normative commitments of digital health empowerment open is persuasive to a wider audience, and more amenable to different constructs of autonomy, capability, and empowerment across disciplines. (shrink)

This paper addresses the relationship between the history and philosophy of science by way of the issue of epistemic normativity. After brief discussion of the relationship between history and philosophy of science in Kuhn’s own thinking, the paper focuses on the implications of the history of science for epistemic normativity. There may be historical evidence for change of scientific methodology, which may seem to support a position of epistemic relativism. However, the fact that the methods of science undergo variation does (...) not entail that epistemic justification varies with the methods employed by scientists. In order to arrive at the relativist conclusion, an epistemological argument is required that justification depends upon operative methods. This raises the question of epistemic normativity. Kuhn himself attempted to deal with this question on a number of occasions, but without success. Following brief discussion of Kuhn on this topic, the paper then turns to the treatment of epistemic normativity in the work of Lakatos, Laudan and Worrall. Lakatos and Laudan proposed that particular episodes from the history of science might be employed to adjudicate between alternative theories of method. Such episodes are selected on the basis of value judgements or pre-analytic intuitions, but such value judgements and intuitions are themselves problematic. Laudan later proposed the normative naturalist view that a rule of method is to be evaluated empirically on the basis of its reliability in conducing to a desired cognitive aim. Against this attempt to naturalize meta-methodology, Worrall argued that the normative force of the appeal to past reliability requires an a priori inductive principle. In my view, the problem of epistemic normativity is solved by combining the particularist focus on specific episodes in the history of science with the naturalistic account of the reliability of method. (shrink)