This article argues that Christianity has the potential to strengthen people’s health when solving the forgiveness dilemma. However – paradoxically – the starting point for the analysis is the presumption that a hasty and imprudent decision to forgive may negatively impact the health of the decision-maker, and that Christianity may contribute to people making unconsidered decisions by prompting them to forgive. In the first part of the analysis, the concept of health and its biblical understanding are (...) discussed. The second part includes both a reflection on forgiveness-related dilemmas and the tension between the decision to forgive and the feeling of regret that may negatively influence health. In the third part, the Christian concept of forgiveness with reference to the aforementioned issues is discussed. (shrink)

Not only the direct physical experiences of deployment can severely harm soldiers’ mental health. Witnessing violations of their moral principles by the enemy, or by their fellow soldiers and superiors, can also have a devastating impact. It can cause soldiers’ moral disorientation, increasing feelings of shame, guilt, or hate, and the need for general answers on questions of right and wrong. Various attempts have been made to keep soldiers mentally sane. One is to provide convincing causes for their deployment, (...) which risks an “end justifies the means” way of thinking. The good cause can provide a moral justification for horrible atrocities. Another method, introduced in the USA, Canada, and Australia, aims to strengthen military personnel’s resistance by promoting and maintaining a happy, optimistic state of mind through the use of positive psychology. Alongside making soldiers “morally fit” for all kinds of situations, the focus could also be on moral recovery and forgiveness. Such a care-based military ethics approach, aimed at mutual understanding and interdependence, could help soldiers handle the emotional impact of moral conflicts. This demands that military units reflect on their organizational culture and rethink oaths and codes of conduct that focus mainly on efficiency and readiness, as well as the soldierly self-image with its seemingly still deeply rooted warrior ethos. Today, resilience and positive psychology in the military is apparently mainly geared to assuring its soldiers’ readiness. An appropriate set of virtues and understanding of virtue ethics that are less centered on self-perfection and autonomy could point to a different form of character-building and lead to a better understanding of others. (shrink)

Forgiveness and reconciliation are central to moral life; after all, everyone will be wronged by others and will then face the dual decisions of whether to forgive and whether to reconcile. It is therefore important that we have a clear analysis of each, as well as a thoroughly articulated understanding of how they relate to and differ from each other. -/- Forgiveness has received considerably more attention in the Western philosophical literature than has reconciliation. In this paper I (...) aim to give it the attention it deserves and develop an account of interpersonal reconciliation. On my view reconciliation is fundamentally bilateral (whereas forgiveness is fundamentally unilateral). It entails transparency and agreement between the wrongdoer and the victim as to the nature of a past wrong or set of wrongs. And, it requires that moral repair be made between the two parties (which entails that both parties bear proper attitudes towards each other). In making my case I contrast reconciliation with toleration and collaboration, in order to demonstrate that reconciliation also entails forgiveness (though forgiveness does not entail reconciliation). (shrink)

Forgiveness is clearly an important aspect of our moral lives, yet surprisingly Kant, one of the most important authors in the history of Western ethics, seems to have very little to say about it. Some authors explain this omission by noting that forgiveness sits uncomfortably in Kant’s moral thought: forgiveness seems to have an ineluctably ‘elective’ aspect which makes it to a certain extent arbitrary; thus it stands in tension with Kant’s claim that agents are autonomous beings, (...) capable of determining their own moral status through rational reflection and choice. Other authors recognise that forgiveness plays a role in Kant’s philosophy but fail to appreciate the nature of this duty and misrepresent the Kantian argument in support of it. This paper argues that there is space in Kant’s philosophy for a genuine theory of forgiveness and hopes to lay the grounds for a correct interpretation of this theory. I argue that from a Kantian perspective, forgiveness is not ‘elective’ but, at least in some cases, morally required. I claim that, for Kant, we have an imperfect duty of virtue to forgive repentant wrongdoers that have embarked on a project of self-reflection and self-reform. I develop a novel argument in support of this duty by drawing on Kant’s theory of rational agency, the thesis of radical evil, Kant’s theory of moral development, and the formula of humanity. However, it must be noted that this is a conditional duty and Kant’s position also entails that absence of repentance on the part of the wrongdoer should be taken as evidence of a lack of commitment to a project of self-reflection and self-reform. In such cases, Kant claims, we have a perfect duty to ourselves not to forgive unrepentant wrongdoers. I argue that this duty should be understood as one of the duties of self-esteem, which involves the duty to respect and recognise our own dignity as rational beings. (shrink)

Philosophers writing on forgiveness typically defend the Resentment Theory of Forgiveness, the view that forgiveness is the overcoming of resentment. Rarely is much more said about the nature of resentment or how it is overcome when one forgives. Pamela Hieronymi, however, has advanced detailed accounts both of the nature of resentment and how one overcomes resentment when one forgives. In this paper, I argue that Hieronymi’s account of the nature of forgiveness is committed to two implausible (...) claims about the norms bearing on forgiveness. Her account is highly instructive, however, for it brings into relief how certain intuitive views about the norms of forgiveness should be used to constrain our theories about its nature. I conclude by defending this methodological proposal. (shrink)

Forgiveness as a positive response to wrongdoing is a widespread phenomenon that plays a role in the moral lives of most persons. Surprisingly, Kant has very little to say on the matter. Although Kant dedicates considerable space to discussing punishment, wrongdoing and grace, he addresses the issues of human forgiveness directly only in some short passages in the Lectures on Ethics and in one passage of the Metaphysics of Morals. As noted by Sussman, the TL passage, however, betrays (...) some ambivalence. Kant establishes a duty of virtue to be forgiving (TL, 6:460), yet he immediately warns against its excess: meek toleration of recurrent wrongs could manifest a lack of self-respect and a violation of a duty to oneself (TL, 6:461). Sussman claims that this ambivalence ultimately arises from the fact that forgiveness sits uncomfortably in Kant’s moral thought. First, forgiveness has an ‘ineluctably elective aspect’ that makes it, to a certain extent, arbitrary and dependent on particular features of the forgiver’s psychology and, as such, in tension with Kant’s central claims that human beings are autonomous agents capable of determining their own moral status. Second, according to Sussman, Kant’s moral retributivism, i.e. ‘the particular moral position that every moral wrong against another deserves punishment of the wrongdoer’ seems to be in tension with the possibility of a ‘truly redemptive forgiveness’. Moreover, forgiveness also seems to be in tension with a passage of the Religion in which Kant argues that the moral guilt from our original evil disposition cannot be understood as a debt or liability that can be compensated, erased, transferred or otherwise wiped out by others (Rel, 6:72). Thus, to the extent that forgiveness might be thought to involve the forgoing of moral guilt, it seems incompatible with Kant’s views on culpability and punishment. This chapter seeks to clarify Kant’s views on forgiveness in order to show that, although not often appreciated, personal forgiveness plays an important role in the lives of ordinary human agents as understood by Kant. In particular, I aim to show there is a conception of forgiveness available to Kant that is not incompatible with Kant’s views of punishment and culpability. In Section 1, I argue that, for Kant, far from being merely ‘elective,’ forgiveness is, under certain conditions, morally required. I provide a brief summary of an interpretation of Kant’s theory of forgiveness that I have defended in recently published work , in order to argue that Kant’s duty to be forgiving should be understood as an imperfect duty of virtue which is conditional on repentance. Kant is not ambivalent about this duty because he maintains that when the relevant conditions are not met, we have a perfect duty to ourselves not to forgive unrepentant wrongdoers. The TL passage thus identifies two different duties. In Section 2, I show that forgiveness, as conceptualised by Kant, does not require the forgoing of punishment or the overcoming of moral guilt and that this could, in fact, be seen as an attractive feature of Kant’s position. I end by offering a very brief assessment of Kant’s views. (shrink)

This paper defends an account of forgiveness that is sensitive to recent work on anger. Like others, we claim anger involves an appraisal, namely that someone has done something wrong. But, we add, anger has two further functions. First, anger communicates to the wrongdoer that her act has been appraised as wrong and demands she feel guilty. This function enables us to explain why apologies make it reasonable to forgo anger and forgive. Second, anger sanctions the wrongdoer for what (...) she has done. This function allows us to explore the moral status of forgiveness, including why forgiveness is typically elective. (shrink)

It is sometimes thought that the normative justification for responding to large-scale violations of human rights via the judicial appararatus of trial and punishment is undermined by the desirability of reconciliation between conflicting parties as part of the process of conflict resolution. I take there to be philosophical, as well as practical and psychological issues involved here: on some conceptions of punishment and reconciliation, the attitudes that they involve conflict with one another on rational grounds. But I shall argue that (...) there is a conception of political reconciliation available which does not involve forgiveness and this forms of reconciliation may be the best we can hope for in many conflicts. Reconciliation is nevertheless likely to require the expression of what Darrell Moellendorf has called 'political regret' and the denunciatory role aspect of punishment makes it particularly well-suited to this role. (shrink)

The concept of respect for persons is often rejected as a basis for understanding forgiveness. As many have argued, to hold your offender responsible for her actions is to respect her as a person; but this kind of respect is more likely to sustain, rather than dissolve, your resentment toward her (Garrard & McNaughton 2003; 2011; Allais 2008). I seek to defend an alternative view in this paper. To forgive, on my account, involves ceasing to identify your offender with (...) her wrongdoing, and this requires a corresponding affective change on your behalf. While there are different ways this may happen, I argue that respect for your offender as a person can play a significant role in the process. (shrink)

According to the standard account of forgiveness, you forgive your wrongdoer by overcoming your resentment towards them. But how exactly must you do so? And when is such overcoming fitting? The aim of this paper is to introduce a novel version of the standard account to answer these questions. Its core idea is that the reactive attitudes are a fitting response not just to someone’s blameworthiness, but to their blameworthiness being significant for you, or worthy of your caring, in (...) virtue of your relationship to it. Someone’s blameworthiness is significant for you to the extent you’re bound up with what grounds it––e.g. with the wrongdoer’s being a participant in human relationships, with their attitudes, or with the victim’s being a source of demands. So you may fittingly not care about someone’s blameworthiness if it’s sufficiently insignificant for you in this manner––e.g. if their wrong happened far off in place and time. And forgiveness revolves around this. You forgive your wrongdoer if and only if, partly out of goodwill towards them, you cease to care about their blameworthiness––a bit as if their wrong had happened far off. If I’m right, this agent-relativity-based account can resolve the apparent ‘paradoxy of forgiveness’, satisfies a number of desiderata, and is plausible on an intuitive level. (shrink)

The categorical denial of third-party forgiveness represents an overly individualistic approach to moral repair. Such an approach fails to acknowledge the important roles played by witnesses, bystanders, beneficiaries, and others who stand in solidarity to the primary victim and perpetrator. In this paper, I argue that the prerogative to forgive or withhold forgiveness is not universal, but neither is it restricted to victims alone. Not only can we make moral sense of some third-party acts and utterances of the (...) form, “I can or cannot forgive…” but also, we ought to recognize them as legitimate instances of third party forgiveness. Concern for the primary victim’s autonomy tends to exaggerate a need for moral deference, while ignoring how others are called upon to support and mediate for victims of violence and oppression. I advocate a cautious extension of the victim’s prerogative to forgive, one that grounds forgiveness in a double relation of sympathetic identification and attentive care. Following Jean Harvey’s recent work, I call this relationship moral solidarity. Furthermore, I argue, there are important moral and political reasons to acknowledge third party forgiveness; these reasons are particularly evident in contexts of oppression. In fact, third party refusals to forgive may have particular moral significance. In situations of abuse, oppression and damaged self-respect, third party refusals may protect the agency of victims who too easily forgive. (shrink)

The papers collected in this volume are a selection of papers that were presented - or scheduled to be presented - at a workshop entitled Forgiveness and Conflict, which took place from 8-10 September 2014, as part of the Mancept Workshops in Political Theory at the University of Manchester. Some of these contributions are now compiled in this volume. The selected papers draw from different philosophical traditions and conceptual frameworks, addressing many aspects of contemporary philosophical debates on the nature (...) and normativity of forgiveness, including its political aspects. The result is a rich collection of essays which covers a wide variety of philosophical issues, displaying cutting edge scholarship in this area. This introduction provides a brief overview of some of the central themes discussed in the volume with a particular emphasis on their innovative aspects. (shrink)

This paper argues that the moral value of unconditional forgiveness is more complicated and constrained than it is often taken to be. When we unconditionally forgive, we engage with someone in a way that doesn’t take seriously their perspective about the meanings and values at stake in our relations with them. Other things being equal, this is problematic; it is normatively condescending, belittling the place of the other person’s moral agency in our relations with them. This doesn’t mean that (...) unconditional forgiveness is always bad or impermissible. It does, though, complicate how we should think about its moral value. (shrink)

Universal health coverage (UHC) is at the center of current efforts to strengthen health systems and improve the level and distribution of health and health services. This document is the final report of the WHO Consultative Group on Equity and Universal Health Coverage. The report addresses the key issues of fairness and equity that arise on the path to UHC. As such, the report is relevant for every actor that affects that path and governments in (...) particular, as they are in charge of overseeing and guiding the progress toward UHC. (shrink)

Proceeding from the assumptions that forgiveness is at least sometimes elective and that it changes the normative relations between victims and wrongdoers, this paper argues that our practices of forgiveness are subject to an overlooked form of moral luck, forgiveness-luck. Forgiveness-luck is introduced via reflection on ‘differential forgiveness’, wherein of two equally culpable and remorseful agents, one is forgiven and the other not, and both justifiably so. In being forgiven—at least if forgiveness is normatively (...) significant— one undergoes a positive alteration in one’s moral status, i.e., a positive alteration in one’s permissions, obligations, or interpersonal reasons that is implied by one’s being the target of a positive moral responsibility-response. It is also illustrated how responsibility-responses other than forgiveness are candidate determinates of one’s moral status. As such, this paper outlines a capacious conception of moral luck, according to which moral statuses beyond blameworthiness (and praiseworthiness) are determinable by factors beyond one’s control. The capacious conception avoids rendering the existence of moral luck a trivial matter (as it preserves the distinction between moral luck and morally significant plain luck) and—at least if moral responsibility is understood in terms of accountability— preserves continuity with narrower conceptions of moral luck. (shrink)

Forgiveness has enjoyed intense scholarly interest since the 1980s. I provide a historical overview, then identify themes in the literature, with an emphasis on those relevant to the moral psychology of forgiveness in the twenty-first century. I conclude with some attention to dual-process theories of moral reasoning in order to suggest that key debates in forgiveness are not at odds so much as they may be aligned with the different moral aims of moral and mental processes that (...) differ in kind. I argue for the view that the moral aims of forgiveness are multiple, following scholars who maintain a multidimensional account of forgiveness with a focus on the functions of forgiveness in relationships and the importance of forgiveness to its practitioners rather than a unified definition or justification that applies to all moral occasions. (shrink)

Food prices are a daily concern in many households’ decision-making, especially when people want to have healthier diets. Employing Bayesian Mindsponge Framework (BMF) analytics on a dataset of 710 Indonesian citizens, we found that people from wealthier households are less likely to have concerns about food prices. However, the degree of health considerations in food consumption was found to moderate against the above association. In other words, people of higher income-based social classes may worry more about food prices if (...) they care more about the health impacts of their food choices. These findings provide more insights for policymakers on the psychological aspects of promoting the balance between finance and health in food consumption. (shrink)

In this paper, we explore how a conversational theory of moral responsibility can provide illuminating resources for building a theory about the nature and norms of moral forgiveness.

Govier conceives of forgiveness as “a process of overcoming attitudes of resentment and anger that may persist when one has been injured by wrongdoing” (viii). She offers an account of bilateral, unilateral, and mutual forgiveness. Her work has pronounced political import in that she argues that attitudes and dispositions can be attributed to groups, that groups can suffer harm, and that groups can be responsible agents of wrongdoing. As a consequence, Govier contends that groups can forgive. Her method (...) is to employ a host of examples taken from recent (World War II and after) history, sprinkle in a few invented examples, and lay out long-winded and typically repetitive arguments. The result is an occasionally provocative and often overly one-sided treatment punctuated by earnestness. (shrink)

I introduce a distinction between health need and medical need, and raise several questions about their interaction. Health needs are needs that relate directly to our health condition. Medical needs are needs which bear some relation to medical institutions or processes. I suggest that the question of whether medical insurance or public care should cover medical needs, health needs, or only needs which fit both categories is a political question that cannot be resolved definitionally. I also (...) argue against an overly strict definition of medical need on the grounds that this presupposes, wrongly, that medical intervention should always be a last resort. (shrink)

In this paper I argue that certain ways in which the relationship among discrimination, emotions and health is presented can undermine equity. I identify a model of this relationship the discrimination-emotion-health model - and claim that while the model is important for understanding the detrimental impact that discrimination and oppression can have on emotions and health, certain implications of the model are troubling. I identify six critiques of the model, and show that equity could be undermined, for (...) example, when stereotypes of the oppressed are reinforced and the experiences of the privileged are normalized. I then assess the implications of my analysis of the model and its critique for a framework of health equity, demonstrating what such a framework would need to look like in order for it to best represent discrimination as a psychosocial determinant of health. (shrink)

Innovation is progressively needed in responding to global challenges. Moreover, the increasing complexity of challenges implies demand for the usage of multisectoral and policy mix approaches. Wicked problems can be tackled by "integrated innovation" that combines the coordinated implementation of social, technological, and health innovation co-created by entities of the public sector, the private sector, the non-governmental sector, and the informal sector. This Research Topic focuses on filling the knowledge gaps about the selected types of innovation. First, regarding social (...) innovation that can be understood as new strategies, concepts, products, services, and organizational forms that allow the satisfaction of human needs. Second, a technological innovation that refers to new or remarkably improved products, goods, or services in terms of their technical specifications, components, materials, software, design, or other functional features. Third, health innovation that focuses on novel or enhanced health policies, systems, products, technologies, services, and care delivery schemes to improve people’s health. Finally, this Research Topic highlights attempts to develop integrated innovation that can add value to social policy, health policy, and environmental policy by improving efficiency, effectiveness, quality, sustainability, safety, and affordability. (shrink)

Glen Pettigrove's work enlarges my own thinking on forgiveness. In this review, I argue for even more attention to some philosophical connections that I suggest he neglects. But it is undeniably the case that Pettigrove advances a new view of forgiveness, taking the results of his analysis of the utterance, “I forgive you,” to inform a “broader definition that encompasses a wider range of experiences” than are accommodated by predominant conceptions of forgiveness as an emotional state (151). (...) Philosophers interested in moral emotions and moral practices should read this book in order to have a fuller sense of the state of forgiveness studies and the possibilities for thinking about forgiveness in its many manifestations. Philosophers who are already very familiar with the literature on forgiveness will find that Pettigrove takes up exceptionally detailed discussion of forgiveness as it relates to understanding, love, grace, gratitude, and desert. (shrink)

This paper argues that societal duties of health promotion are underwritten (at least in large part) by a principle of beneficence. Further, this principle generates duties of justice that correlate with rights, not merely “imperfect” duties of charity or generosity. To support this argument, I draw on a useful distinction from bioethics and on a somewhat neglected approach to social obligation from political philosophy. The distinction is that between general and specific beneficence; and the approach from political philosophy has (...) at times been called equality of concern. After clarifying the distinction and setting out the basis of the equality of concern view, I argue that the result is a justice-based principle of “specific” beneficence that should be reflected in a society’s health policy. I then draw on this account to criticize, refine, and extend some prominent health care policy proposals from the bioethics literature. (shrink)

A number of experiences have demonstrated how digital solutions are effective in improving quality of life (QoL) and health outcomes for older adults. Smart Health Age-Friendly Environments (SHAFE) is a new concept introduced in Europe since 2017 that combines the concept of Age-Friendly Environments with Information Technologies, supported by health and community care to improve the health and disease management of older adults and during the life-course. This chapter aims to provide an initial overview of the (...) experiences available not only in Europe, based on the research work of the participants of the International Interdisciplinary Network on Health and Well-being in an Age-Friendly Digital World (NET4Age-Friendly), which could be of interest to preventive, health and social authorities. The chapter reports good practices, pain points, and bottlenecks that may require a collaborative, interdisciplinary research approach to facilitate the transformations towards smart, sustainable, health and age-friendly cities and communities. (shrink)

This Research Topic focuses on both strengths and weaknesses of social innovation, technological innovation, and health innovation that are increasingly recognized as crucial concepts related to the formulation of responses to the social, health, and environmental challenges. Goals of this Research Topic: (1) to identify and share the best recent practices and innovations related to social, environmental and health policies; (2) to debate on relevant governance modes, management tools as well as evaluation and impact assessment techniques; (3) (...) to discuss dilemmas in the fields of management, financing, designing, implementing, testing, and maintaining the sustainability of innovative models of delivering social, health and care services; and (4) to recognize and analyze social, technological and health innovation that has emerged or has been scaled-up to respond to crisis situations, for example, a pandemic of the COVID-19 coronavirus disease. (shrink)

In this paper we explore the relationship between forgiving and punishment. We set out a number of arguments for the claim that if one forgives a wrongdoer, one should not punish her. We then argue that none of these arguments is persuasive. We conclude by reflecting on the possibility of institutional forgiveness in the criminal justice setting and on the differences between forgiveness and acts of mercy.

New biotechnologies have the potential to both dramatically improve human well-being and dramatically widen inequalities in well-being. This paper addresses a question that lies squarely on the fault line of these two claims: When as a matter of justice are societies obligated to include a new biotechnology in a national healthcare system? This question is approached from the standpoint of a twin aim theory of justice, in which social structures, including nation-states, have double-barreled theoretical objectives with regard to human well-being. (...) The first aim is to achieve a sufficient level of well-being in each of six core dimensions. In the special case of healthcare systems, this aim is focally but not exclusively attentive to achieving health sufficiency as one of the core dimensions. The second aim is to combat the emergence and persistence of densely woven patterns of systematic disadvantage that tend to undermine the achievement of a sufficient level of health and the other core elements of well-being of some persons and groups. Judgments about entitlements to health related resources, including new biotechnologies, are made in light of a threshold notion of health sufficiency. What is enough or sufficient health? The answer that is defended here is that sufficient health is enough health for a decent human life, understood as enough health to live a full life course without preventable, significant functional disability or decrement in health, or treatable pain or suffering. When a state must include a new biotechnology in its national healthcare system is also influenced by ancillary concerns about the connection between health and other core dimensions of well-being. What counts as a significant functional impairment or health decrement is thus explicated, in part, in relation to the theory’s sufficiency aim for the other essential dimensions of well-being, and thus for a decent life, overall. Those elements of health that play a critical role in the experience of sufficient reasoning, affiliation, security, respect and self determination are especially important; any loss of health function or capacity that threatens the individual’s prospects for sufficiency in these other dimensions, including the relational egalitiarian concerns they entail, constitutes a significant functional impairment. Within national borders, individuals are thus entitled to those health-related goods and services that are essential for a sufficiency of each of the dimensions of well-being; with regard to self determination and respect, what is sufficient by way of guaranteed access to specific goods and services is going to depend on the implications of such access for where an individual stands in relation to her co-nationals. The content of any entitlement to health-related goods and services is also necessarily dynamic. What can be done for health and the other core dimensions of well-being as a function of technological innovation and diffusion is in constant flux. The paper concludes by considering the implications of this analysis for the conditions under which states are obligated to include access in their healthcare systems to one biotechnology, deep brain stimulation. (shrink)

In ‘Human Fallibility and the Need for Forgiveness’, Claudia Blöser has proposed a Kantian account of our reasons to forgive that situates our moral fallibility as their ultimate ground. Blöser argues that Kant’s duty to be forgiving is grounded on the need to be relieved from the burden of our moral failure, a need that we all have in virtue of our moral fallible nature, regardless of whether or not we have repented. Blöser claims that Kant’s proposal yields a (...) plausible account of the normative status of forgiveness. Kant classifies the duty to be forgiving as a wide duty of virtue, and according to Blöser, this means that Kantian forgiveness is elective in the sense that forgiveness is good in general but without being obligatory in each particular case. In the course of presenting her own reconstruction of Kant’s account, Blöser also objects to some aspects of an interpretation of Kant’s theory of forgiveness which I had previously defended in my paper ‘Forgiveness and Moral Development’. Although there are a lot of points of agreement between our interpretations, the aim of this article is to highlight four key points of disagreement. These issues are worth discussing because they have implications not only for a plausible interpretation of a recognisable Kantian account of forgiveness but also for wider debates in the contemporary literature on forgiveness. First, I show that Kant is not committed to a form of weak situationism as suggested by Blöser and that Kant’s grounding of the duty to be forgiving does not appeal to moral luck. Second, I argue that although Kant’s duty to be forgiving is elective in one sense of the term, it is not elective in another important sense of the term, and that it is in fact better not to interpret Kantian imperfect duties as being elective. Third, I show that awareness of moral fallibility per se does not provide a morally appropriate ground for forgiveness and offer an alternative reconstruction of Kant’s account- in which fallibility plays a role, but it is not the main reason to forgive. Finally, I argue that Blöser’s account of the need to be forgiven is not recognisable Kantian because, from a Kantian perspective, repentance is a necessary condition for the desirability and, in fact, the very possibility of ameliorating our own guilt. (shrink)

This pаpеr invеstigаtеs thе intеrgеnеrаtiоnаl еffеcts оf mаtеrnаl еducаtiоn оn child hеаlth in 68 dеvеlоping cоuntriеs аcrоss fivе cоntinеnts оvеr nеаrly thrее dеcаdеs. Еxplоiting thе bеtwееn-sistеrs vаriаtiоn in thе еducаtiоnаl аttаinmеnt оf thе mоthеrs, wе find thаt mоthеr’s еducаtiоn is pоsitivеly аssоciаtеd with child hеаlth mеаsurеd by thе thrее mоst cоmmоnly usеd indicеs, nаmеly hеight-fоr-аgе, wеight-fоr-hеight, аnd wеight-fоr-аgе. Оur mеchаnism аnаlysеs furthеr shоw thаt thеsе fаvоrаblе еffеcts cоuld bе, аt lеаst in pаrt, аttributеd tо fеrtility bеhаviоr, аssоrtаtivе mаtching, hеаlth cаrе (...) utilizаtiоn, аccеss tо infоrmаtiоn, hеаlth knоwlеdgе, аnd lаbоr mаrkеt оutcоmе. Givеn thе lоng-lаsting impаcts оf еаrly-lifе hеаlth оvеr thе lifе cyclе, оur findings undеrlinе thе impоrtаncе оf mаtеrnаl еducаtiоn in imprоving еcоnоmic аnd sоciаl cоnditiоns in dеvеlоping cоuntriеs. (shrink)

Aims and Objectives. This article uses the concept of embodiment to demonstrate a conceptual approach to applied phenomenology. -/- Background. Traditionally, qualitative researchers and healthcare professionals have been taught phenomenological methods, such as the epoché, reduction, or bracketing. These methods are typically construed as a way of avoiding biases so that one may attend to the phenomena in an open and unprejudiced way. However, it has also been argued that qualitative researchers and healthcare professionals can benefit from phenomenology’s well-articulated theoretical (...) framework, which consists of core concepts, such as selfhood, empathy, temporality, spatiality, affectivity, and embodiment. -/- Design. This is a discursive article that demonstrates a conceptual approach to applied phenomenology. -/- Method. To outline and explain this approach to applied phenomenology, the Discussion section walks the reader through four stages of phenomenology, which progress incrementally from the most theoretical to the most practical. -/- Discussion. Part one introduces the philosophical concept of embodiment, which can be applied broadly to any human subject. Part two shows how philosophically trained phenomenologists use the concept of embodiment to describe general features of illness and disability. Part three illustrates how the phenomenological concept of embodiment can inform empirical qualitative studies and reflects on the challenges of integrating philosophy and qualitative research. Part four turns to phenomenology’s application in clinical practice and outlines a workshop model that guides clinicians through the process of using phenomenological concepts to better understand patient experience. -/- Conclusion and Relevance to Clinical Practice. A conceptual approach to applied phenomenology provides a valuable alternative to traditional methodological approaches. Phenomenological concepts provide a foundation for better understanding patient experience in both qualitative health research and clinical practice, and therefore provide resources for enhancing patient care. (shrink)

In bioethics, the predominant categorization of various types of influence has been a tripartite classification of rational persuasion (meaning influence by reason and argument), coercion (meaning influence by irresistible threats—or on a few accounts, offers), and manipulation (meaning everything in between). The standard ethical analysis in bioethics has been that rational persuasion is always permissible, and coercion is almost always impermissible save a few cases such as imminent threat to self or others. However, many forms of influence fall into the (...) broad middle terrain—and this terrain is in desperate need of conceptual refining and ethical analysis in light of recent interest in using principles from behavioral science to influence health decisions and behaviors. This paper aims to address the neglected space between rational persuasion and coercion in bioethics. First, I argue for conceptual revisions that include removing the “manipulation” label and relabeling this space “nonargumentative]influence,” with two subtypes: “reason-bypassing” and “reason-countering.” Second, I argue that bioethicists have made the mistake of relying heavily on the conceptual categories themselves for normative work and instead should assess the ethical permissibility of a particular instance of influence by asking several key ethical questions, which I elucidate, that relate to (1) the impact of the form of influence on autonomy and (2) the relationship between the influencer and the influenced. Finally, I apply my analysis to two examples of nonargumentative influence in health care and health policy: (1) governmental agencies such as the Food and Drug Administration (FDA) trying to influence the public to be healthier using nonargumentative measures such as vivid images on cigarette packages to make more salient the negative effects of smoking, and (2) a physician framing a surgery in terms of survival rates instead of mortality rates to influence her patient to consent to the surgery. (shrink)

Current challenges in medical practice, research, and administration demand physicians who are familiar with bioethics, health law, and health economics. Curriculum directors at American Association of Medical Colleges-affiliated medical schools were sent confidential surveys requesting the number of required hours of the above subjects and the years in which they were taught, as well as instructor names. The number of relevant publications since 1990 for each named instructor was assessed by a PubMed search.In sum, teaching in all three (...) subjects combined comprises less than two percent of the total hours in the American medical curriculum, and most instructors have not recently published articles in the fields they teach. This suggests that medical schools should reevaluate their curricula and instructors in bioethics, health law, and health economics. (shrink)

An estimated 700,000 people in the United States have "long COVID," that is, symptoms of COVID-19 persisting beyond three weeks. COVID-19 and its long-term sequelae are strongly influenced by social determinants such as poverty and by structural inequalities such as racism and discrimination. Primary care providers are in a unique position to provide and coordinate care for vulnerable patients with long COVID. Policy measures should include strengthening primary care, optimizing data quality, and addressing the multiple nested domains of inequity.

The International Classification of Functioning, Disability and Health provides a classification of human bodily functions, which, while exhibiting non-conformance to many formal ontological principles, provides an insight into which basic functions such a classification should include. Its evaluation is an important first step towards such an adequate ontology of this domain. Presented at the 13th Annual North American WHO Collaborating Center Conference on the ICF, 2007.

Many theorists have found the notion of forgiveness to be paradoxical, for it is thought that only the blameworthy can be appropriately forgiven but that the blameworthy are appropriately blamed not forgiven. Some have appealed to the notion of repentance to resolve this tension. But others have objected that such a response is explanatorily inadequate in the sense that it merely stipulates and names a solution leaving the transformative power of repentance unexplained. Worse still, others have objected that such (...) a response cannot succeed because no amount of repentance can render the blameworthy not blameworthy. I argue that this latter objection is based on a mistaken assumption, the acknowledgement of which has the power to resolve the paradox in a way that meets the explanatory adequacy challenge, and, more generally, has significant implications with which any full theory of forgiveness must engage. (shrink)

In the thick of the global plague, Richard, Justin and Valery agreed to hold a conversation on the topic of poetics, self-understanding, and health. An analysis and discussion of this trinity requires love of poetry and philosophy. Both supreme human practices take common root in mythology and religion, and also share a notorious categorical divide, that of reason against affect. Is this Platonic divide indeed categorical, given both practices rely on language and creativity to compose their meaning? Interestingly, the (...) practice of poetics does not have the reputation for boosting one's health, in the mainstream understanding of that concept. If anything, poetic practice gained notoriety for corrupting one's mind and, possibly, life. Like philosophy? We touched on these and other classical aporia, on the political struggles in American and Australian poetry. Here is a written record of this encounter, countries and miles apart, three persons simply getting to know one another. (shrink)

Background: A better understanding of the pattern of epidemic-related referrals to healthcare centers might allow the identification of vulnerabilities and the required changes that the healthcare management system should undergo. Objectives: This study aimed to investigate the COVID-19 referral pattern and the role of media and health management planning in changing the trends. Methods: Data extracted from the electronic medical database of Imam Khomeini Hospital Complex (IKHC), located in Tehran, Iran, from February 20 to June 4, 2020 were examined. (...) Individuals were divided into two groups, COVID-19 positive and negative. We used Google Trends to evaluate Google Internet search queries and also available policy documents, programs, and official news related to COVID-19 in Iran during the mentioned period. Results: In this study, 8647 individuals aged 46.05 ± 16.5 years were referred to IKHC. Approximately 57% were male, and 70% were COVID-19 positive. The most clinical symptoms were dyspnea, fever, cough, and myalgia. Chronic kidney disease (CKD) and type 2 diabetes mellitus were the most common underlying health conditions. In the first two weeks, the percentage of negative cases was higher than positive cases and then the pattern was reversed, when people searched for information about COVID-19 in media. Conclusions: Proper and timely information and education to people through the media and health management measures can be effective in reducing unnecessary visits to health centers, preventing the exhaustion of medical staff, and controlling the disease during epidemics. (shrink)

In recent decades, it has been argued that the modern concept of forgiveness is absent from Aristotle’s conception of συγγνώμη as it appears in his Rhetoric and Nicomachean Ethics. In this paper, I argue that Aristotle’s view is more modern than it might appear. I defend the idea that Aristotle’s treatment of συγγνώμη, when seen in conjunction with his theory of ethical decision, involuntary action, and character alteration, commits him to a cognitive and emotional theory of forgiveness that (...) is both well-grounded and thoroughly modern. I go on to claim that Aristotle’s view of συγγνώμη helps to solve at least four controversial problems about the nature of forgiveness raised by modern philosophers: how one can forgive a wrong without condoning it, whether forgiveness is a duty, whether moral luck requires us to forgive more widely, and whether forgiveness ought to be unconditional. (shrink)

Discussions of patient-centred care and patient autonomy in bioethics have tended to focus on the decision-making context and the process of obtaining informed consent, leaving open the question of how patients ought to be counselled in the daily maintenance of their health and management of chronic disease. Patient activation is an increasingly prominent counselling approach and measurement tool that aims to improve patients’ confidence and skills in managing their own health conditions. The strategy, which has received little conceptual (...) or ethical analysis, raises important questions about how clinicians ought to foster confidence and a sense of control in their patients without exposing them to blame, stigma and other harms. In this paper, we describe patient activation, discuss its relationship to personal responsibility, autonomy and health disparities, and make recommendations regarding its use and measurement. (shrink)

Globally, the population is ageing, which has serious consequences for businesses. The prosperity of companies is crucially dependent on the ability to effectively manage their employees, including older workers. Best practice in age management is defined as those measures that combat age barriers and/or promote age diversity. These measures may entail specific initiatives aimed at particular dimensions of age management; they may also include more general employment or human resources policies that help to create an environment in which individual employees (...) can achieve their potential without being disadvantaged by their age. Promoting early retirement is generally not encouraged. Companies now have to encourage longer working lives. Much needs to be done to ensure that work remains a positive experience for workers throughout their career trajectories, and it does not damage their health. It has been found by studies that health is significantly related to retirement timing, influences work performance, and health-related organisational policies can positively influence employee retention. The major contemporary challenges to health at work are those associated with the way work, and work organisations are designed and managed. This is especially true for older workers. A comprehensive and effective approach towards age management can be very beneficial for them. How should companies implement age management? Some possible ways are set out in this policy brief below, which focuses on best practices in age management regarding ergonomic aspects and health interventions for older workers at an organisational level. The intention is to discuss the current situation and to illustrate some organisational techniques in selected countries. This policy brief can serve as an inspiration for, among others, companies and policymakers. Recommendations for successful practice are included. In total, this policy brief covers 8 COST member countries to give a glimpse of the current situation of best practice in age management and show how companies in various states deal with ergonomic aspects, health interventions and the ageing of their labour force. (shrink)

Several authors have recently suggested that classic psychedelics might be safe and effective agents of moral enhancement. This raises the question: can we learn anything interesting about the nature of moral experience from a close examination of transformative psychedelic experiences? The interdisciplinary enterprise of philosophical psychopathology attempts to learn about the structure and function of the “ordinary” mind by studying the radically altered mind. By analogy, in this chapter we argue that we can gain knowledge about the everyday moral life (...) by studying extraordinary experiences of altered moral cognition and experience. We focus on a specific class of cases: experiences of forgiveness induced by psychedelics. We argue that close attention to such experiences reveals the importance of thought/emotion coherence and dissonance in the moral life and vindicates some heterodox ideas about moral phenomenology and psychology. (shrink)

In The Atrocity Paradigm, Claudia Card suggests we forgiveness as a potentially valuable exercise of a victim's moral powers. Yet Card never makes explicit just what 'moral powers' are, or how to understand their grounding or scope. I draw out unacknowledged implications of her framework: namely, that others than the primary victim may forgive, and -- conversely -- that some victims may find themselves morally dis-empowered. Furthermore, talk of "moral powers" allows us to appropriately acknowledge the value of refusals (...) to forgive and the issue of "forgivable" evils, in ways that talk of forgiveness as a duty or virtue cannot. (shrink)

This chapter (5) focuses on the concept of the forgiving God in Islamic religion and theology and claims that Islamic thinking about divine forgiveness accommodates two different views that emphasize two different attributes of God: justice and mercy. The first view is associated with a rationalist school of theology known as Mu'tazilism, while the second is associated with a fideistic school known as Ash'arism. The author argues that the first view, which is based on a strict calculus of desert, (...) leaves little or no room for mercy, and that the second view is more true to our ordinary notion of forgiveness. (shrink)

Our experiences with many sorts of evils yield debates about the role of forgiveness as a possible moral response. These debates include (1) the preliminary question whether evils are, by definition, unforgivable, (2) the contention that evils may be forgivable but that forgiveness cannot entail reconciliation with one’s evildoer, (3) the concern that only direct victims of evils are in a position to decide if forgiveness is appropriate, (4) the conceptual worry that forgiveness of evil may (...) not be genuine or complete if hard feelings recur, (5) the interest of many in holding that forgiveness is never required, and (6) the concern that analyses of evil ought to prioritize the suffering, and credit the perspectives, of victims of evils, in tension with the possibility that forgiveness concerns the well-being of offenders. In this paper, I critically evaluate these concerns from the perspective of nonideal theory. I conclude that crediting victims’ perspectives is importantly basic to empirically informed moral theory, and that objections to forgiveness including (1) evil’s unforgivability ignore victims’ differing accounts. When we take actualities and experiences to be informative and central, some of the usual debates become less pressing, perhaps even moot. (shrink)

Background: The World Health Organization has endorsed a community-based health insurance scheme (CBHIS) as a shared financing plan to improve access to health services and ensure universal coverage of the healthcare delivery system. Such a contributory scheme is the most likely option to provide health insurance coverage when governments cannot offer direct health care support. Despite improvements in access to current healthcare services, Ethiopia’s healthcare delivery remained low, owing to the country’s underdeveloped healthcare finance system. (...) As a result, the present study assessed CBHIS coverage and its predictors in Ethiopia at the individual and community level. Methods: The availability of CBHIS was checked via a criterion: at least one of the cluster respondents had to be enrolled in CBHIS. This study was based on secondary data from the Ethiopia Mini Demography and Health Survey (EMDHS) 2019 and included 7724 respondents. The study population was described using percentage and frequency. Four multilevel mixed-effects logistic regression modelling stages were performed to control for variations due to heterogeneity across clusters, and determinant predictors of CBHIS enrollment were outplayed. Results: The prevalence of CBHIS enrollment in Ethiopia was 33.13%. Rural residents were 3.218 times (AOR = 3.218; 95% CI: 1.521, 6.809), male household heads were 1.574 times (AOR = 1.574, 95% CI: 1.105, 2.241), getting funds from the safety net program were times 2.062 (AOR = 2.062, 95% CI: 1.297, 3.279), attending the primary educational level was 1.686 times (AOR = 1.686, 95% CI: 1.007, 2.821), bank accounts were 1.373 times (AOR = 1.373, 95% CI: 1.052, 1.792), and wealth index was 1.356 times (AOR = 1.356, 95% CI: 1.001, 1.838) more likely associated with CBHIS coverage, whereas the regions, the other religions, and women aged 20– 24 had lower odds of CBHIS coverage. Conclusion: In Ethiopia, regional healthcare expenditure per capital, religious affiliation, women age range, residents, sex of household head, funds from the safety net program, formal educational level, and having bank accounts were associated with community-based health insurance scheme coverage. (shrink)

This chapter provides a high-level overview of key ethical issues raised by the use of surveillance technologies, such as digital contact tracing, disease surveillance, and vaccine passports, to combat the COVID-19 pandemic. To some extent, these issues are entirely familiar. I argue that they raise old questions in new form and with new urgency, at the intersection of information ethics, research ethics, and public health. Whenever we deal with data-driven technologies, we have to ask how they fare in relation (...) to important values like privacy, fairness, transparency, and accountability—values emphasized by information ethics scholars. Likewise, when such technologies put individuals at risk in order to drive scientific research and knowledge construction, we have to ask how they implicate values such as autonomy, beneficence and non-maleficence, and justice—values central to research ethics. And as researchers focusing on health information have long argued, when the data collected by these technologies pertain to individuals and public health, these ethical issues take on a special cast. -/- It is also true, however, that the pandemic has placed these questions in a new and revealing light. I highlight three insights from information ethics and research ethics that can help us navigate this difficult terrain. First, the value of privacy is instrumental, not absolute—there is nothing wrong with asking how to balance privacy against other important values. Second, privacy has both individual and social importance. Weighing privacy, on one hand, and public health, on the other, is not, therefore, a contest between individual and collective interests. Rather, it is an attempt to balance disparate public goods. Third, we ought to put these kinds of ethical decisions in the hands of third parties, rather than leaving them up to those who directly stand to benefit from them. In the case of pandemic surveillance technologies, this should mean more public, democratic oversight. (shrink)