Contemporary philosophy of health has been quite focused on the problem of determining the nature of the concepts of health, illness and disease from a scientific point of view. Some theorists claim and argue that these concepts are value-free and descriptive in the same sense as the concepts of atom, metal and rain are value-free and descriptive. To say that a person has a certain disease or that he or she is unhealthy is thus to objectively describe this person. On (...) the other hand it certainly does not preclude an additional evaluation of the state of affairs as undesirable or bad. The basic scientific description and the evaluation are, however, two independent matters, according to this kind of theory. Other philosophers claim that the concept of health, together with the other medical concepts, is essentially value-laden. To establish that a person is healthy does not just entail some objective inspection and measurement. It presupposes also an evaluation of the general state of the person. A statement that he or she is healthy does not merely imply certain scientific facts regarding the person’s body or mind but implies also a (positive) evaluation of the person’s bodily and mental state. My task in this paper will be, first, to present the two principal rival types of theories and present what I take to be the main kind of reasoning by which we could assess these theories, and second, to present a deeper characterization of the principal rival theories of health and illness. (shrink)

As a part of a research project on Dignity and Older Europeans Programme) I explore in this paper a set of notions of human dignity. The general concept of dignity is introduced and characterized as a position on a value scale and it is further specified through its relations to the notions of right, respect and self-respect. I present four kinds of dignity and spell out their differences: the dignity of merit, the dignity of moral or existential stature, the dignity (...) of identity and the universal human dignity. Menschenwürde pertains to all human beings to the same extent and cannot be lost as long as the persons exist. The dignity of merit depends on social rank and position. There are many species of this kind of dignity and it is very unevenly distributed among human beings. The dignity of merit exists in degrees and it can come and go. The dignity of moral stature is the result of the moral deeds of the subject; likewise it can be reduced or lost through his or her immoral deeds. This kind of dignity is tied to the idea of a dignified character and of dignity as a virtue. The dignity of moral stature is a dignity of degree and it is also unevenly distributed. The dignity of identity is tied to the integrity of the subject's body and mind, and in many instances, although not always, also dependent on the subject's self-image. This dignity can come and go as a result of the deeds of fellow human beings and also as a result of changes in the subject's body and mind. (shrink)

In recent decades, economists have developed methods for measuring the country-wide level of inequality of opportunity. The most popular method, called the ex-ante method, uses data on the distribution of outcomes stratified by groups of individuals with the same circumstances, in order to estimate the part of outcome inequality that is due to these circumstances. I argue that these methods are potentially biased, both upwards and downwards, and that the unknown size of this bias could be large. To argue that (...) the methods are biased, I show that they ought to measure causal or counterfactual quantities, while the methods are only capable of identifying correlational information. To argue that the bias is potentially large, I illustrate how the causal complexity of the real world leads to numerous non-causal correlations between circumstances and outcomes and respond to objections claiming that such correlations are nonetheless indicators of unfair disadvantage, that is, inequality of opportunity. (shrink)

The aim of this study was to explore the ethical foundations for a caring conversation. The analysis is based on the ethics of Paul Ricoeur and deals with questions such as what kind of person the nurse ought to be and how she or he engages in caring conversations with suffering others. According to Ricoeur, ethics (the aim of an accomplished life) has primacy over morality (the articulation of aims in norms). At the ethical level, self-esteem and autonomy were shown (...) to be essential for a person (nurse) to act with respect and responsibility. The ethical relationship of a caring conversation was found to be asymmetrical, because of the passivity inflicted by suffering. This asymmetry was found to be potentially unethical if not balanced with reciprocity. In the ethical context, the caring conversation is one in which the nurse makes room through the ethos of caritas for a suffering person to regain his or her self-esteem, and thus makes a good life possible. (shrink)

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

The basic work for this book was carried out during the spring of 1989 in Edinburgh, where I had been granted a research position at The Institute for Advanced Studies in the Humanities. I should like to express here my indebtedness to the Institute for the opportunity thus afforded me. I should also like to say how very grateful I am for the stimulating conversations I had there with Professor Timothy Sprigge and Dr. Elizabeth Telfer. Dr. Telfers’s own treatise Happiness (...) has been a major influence on my view of the questions involved. The basic view of health and illness presented in this book is more fully set out in my On the Nature of Health. As in the case of my previous larger projects, I have received a great amount of support and may wise comments from Professor Ingmar Pörn, Helsinki. Three Danish experts – Anton Aggernaes, Erik Ostenfeld and Peter Sandøe – have made valuable comments. Professor Heng ten Have, Nijmegen, has improved my reading of the philosophy of Jeremy Bentham. I should also like to thank my colleagues at the Department of Health and Society, University of Linköping, for helping me to avoid a number of the pitfalls that can so easily stumble into when it comes to a treatise like this. Especially I should like to mentioned Per-Erik Liss, Ingemar Nordin and Bo Petersson, all three of whom have read and commented on the entire manuscript. A Swedish version of this book, Livskvalitet och hälsa, came out in 1991. I have been made quite a number of corrections and additions, one type of addition being replies to critical points made in reviews of the Swedish version. I should like to thank Malcolm Forbes for valuable help putting my English into publishable condition. Linköping, May 1993 Lennart Noredenfelt. (shrink)

In policy-making the consumption of specially labelled products, and its role in improving the welfare of livestock, has attracted considerable attention. There is in many countries a diverse market for animal welfare-friendly products which is potentially confusing and may lack transparency. We ask whether special quality labels that involve medium levels of animal welfare, as compared with labels promoting premium levels of animal welfare, have a role to play in promoting improvements in animal welfare. The Danish pork market is our (...) reference case, but we also widen the context by comparing the markets for pork in three other European countries. Our findings suggest that in order to improve animal welfare through demand for welfare-friendly products it is important to maintain separate the market for products with strong animal welfare profiles from markets for products with medium levels of animal welfare where, often, animal welfare is bundled together with other food quality attributes. We conclude that such quality labels may indeed play an important role in promoting higher animal welfare standards provided that they offer real improvements in animal welfare as compared with standard products. They will be attractive to consumers with a positive, but not especially strong interest in animal welfare as an individual food attribute who would otherwise be inclined to purchase standard products. (shrink)

The paper contrasts Lennart Nordenfelt’s normative theory of health with the naturalists’ point of view, especially in the version developed by Christopher Boorse. In the first part it defends Boorse’s analysis of disease against the charge that it falls short of its own standards by not being descriptive. The second part of the paper sets out to analyse the positive concept of health and introduces a distinction between a positive definition of health and a positive conception of health. An (...) objection against Nordenfelt’s account is developed by making use of a specific example of an ambitious athlete. It is stated that Nordenfelt’s conceptualisation includes too many phenomena under the umbrella of ill health. An ideal conception of health like Nordenfelt’s is in danger of supporting medicalization. In conclusion, although Nordenfelt’s theory is not altogether rejected and even seen in congruence with Boorse’s account, it is claimed that the naturalistic framework should obtain conceptual priority. (shrink)

This book is a scholarly treatise on the nature of health presented in the form of a dialogue between an inquirer and a philosopher. It attempts to do two things: first, to introduce modern philosophy of health to non-philosophers, in particular to people with a professional relation to health care; and second, to elaborate and specify in some detail the author's holistic theory of health. According to this theory, a person is completely healthy if, and only if, she or he (...) is able to realize all her or his vital goals given reasonable circumstances. This theory is presented by the philosopher in the book, but it is at the same time scrutinized and criticized by the inquirer. Some of the criticisms presented, and to which the philosopher responds, have been put forward in published reviews of the author's earlier works. Towards the end of the book the author demonstrates how his philosophy of health can be applied to related areas, such as the theory of disability, and to modern ethical discussion, such as that concerning prioritization in health care. The book is supplemented with a list of definitions of central concepts and with an annotated bibliography. (shrink)

The traditional Lockean justification of property rights has been argued to be no longer valid in a world in which much wealth does not derive from acquisitions of natural resources, and in which much property, such as money, is intangible. This means that libertarians need to reconsider whether and why property rights are justified for objects that fall outside of the scope of the Lockean justification. This paper gives a justification of property rights in relation to modern money, which uses (...) the self-ownership principle as its central premise. Since modern money is a form of credit, I start with a justification of credit property rights. I then consider both money under gold convertibility and present-day fiat systems, showing that the justification of credit property rights remains valid under these conditions. (shrink)

According to an infinite frequency principle, it is rational, under certain conditions, to set your credence in an outcome to the limiting frequency of that outcome if the experiment were repeated indefinitely. I argue that most infinite frequency principles are undesirable in at least one of the following ways: accepting the principle would lead you to accept bets with sure losses, the principle gives no guidance in the case of deterministic experiments like coin tosses and the principle relies on a (...) metaphysical property, ‘chanciness’, whose necessary and sufficient conditions are unknown. I show that a frequency principle that is based on the principal principle suffers from problems related to the definition of ‘chance’ or ‘chanciness’, which could lead to all three of the above problems. I introduce a version of the infinite frequency principle that does not rely on a notion of chance or chanciness and does not suffer from any of these problems. (shrink)

Experts have been claimed to perceive risks in a different way than the general public. It is likely that experts often see risks in their own field of expertise as smaller than the public does, but that does not imply that their risk perception is also driven by other factors. Topical experts and general risk assessors are two quite different types of experts. Still, common assertions as to the simple structure of expert risk perception, said to be related only to (...) technical or statistical risk estimates, builds on a meager database consisting of 15 general risk assessors. Results from a study reported here show that the factors explaining experts’ risk perception are similar to those of a comparable group of nontopical experts with a similar level of technological literacy and to the general public, and that the level of explained variance is quite comparable for experts and the general public. (shrink)

We consider an infinite hierarchy of systems of Alethic Modal Logic with so-called Levels of Perfection, and add to them suitable definitions of such interesting deontic categories as those of supererogation, offence, conditional obligation and conditional permission. We then state three problems concerning the proper characterization of the resulting logic(s) for our defined notions, and discuss two of these problems in some detail.

This book contains scholarly contributions to several current debates in the philosophy of medicine and health care regarding the nature of health and health promotion, concepts and measurements of mental illness, phenomenological conceptions of health and illness, allocation of health care resources, criteria for proper medical science, the clinical meeting, and ethical constraints in such a meeting.With one exception, the authors in this book are or have been teachers or graduate students at the interdisciplinary Department of Health and Society at (...) Linköping University, Sweden. While all the texts have a philosophical focus, many other disciplines have influenced the choice of specific perspectives. The university backgrounds of the authors range from medicine, psychology, sociology, and religion to philosophy. What binds the authors together is their deep interest in the theory of medicine and in the pursuit of a philosophy of humanistic medicine and health care. (shrink)

The main purpose of this paper is to clarify some senses of dignity that are particularly relevant for the treatment and care of the elderly. I make a distinction between two quite different ideas of dignity, on the one hand the basic kind of dignity possessed by every human being, and on the other hand the dignity which is the result of a person's merits, whether these be inherited or achieved. Common to both these ideas is that having a dignity (...) entails having a set of rights, in the case of basic dignity the set of rights which we call human rights, the rights which the United Nations, among others, has tried to determine. The dignities of merit also provide some rights, although normally rights with limited scope covering, for instance, a professional area. This observation gives my preliminary answer to the fundamental question of what distinguishes dignity from other high values that could be attached to humans. I discuss further a kind of value that might be mistaken for a kind of dignity, viz. what I call public status. This status is to be distinguished from social status (the status of e.g. kings, governors, and officials) that I take to be a proper dignity of merit. The public status is the status gained solely via public perception and not directly via any merits on the part of the dignified. Finally, I turn to the topic of the dignity of the elderly and try to determine whether there is some dignity peculiar to the elderly, and which is over and above the basicMenschenwrde. My two preliminary proposals are the following: the elderly have a dignity of wisdom and they have a highly general dignity of merit, which results from their life-long efforts and achievements, and for this they deserve our gratitude. (shrink)

Contemporary philosophy of health and disease has been quite focused on the problem of determining the nature of the concepts of health and disease from a scientific point of view. Some theorists claim and argue that these concepts are value-free and descriptive in the same sense as the concepts of atoms, metal, and rain are value-free and descriptive. According to this descriptive or naturalist line of thought, the notions of health and disease are furthermore related to the idea of a (...) normal or natural function. A bodily organ is healthy insofar as it functions normally, and it is diseased when it does not fulfill its functions. Other philosophers claim that the concept of health, together with other medical concepts, is essentially value-laden. To establish that a person is healthy does not just entail some objective inspection and measurement. It presupposes also an evaluation of the general state of the person. My purpose in this article is to scrutinize the relation between the notion of a natural function, on the one hand, and the concepts of health and disease on the other. In characterizing the notion of a normal function I will follow the classic analysis put forward by American philosopher Christopher Boorse. I will criticize Boorse’s proposal mainly by using arguments from the analysis of ordinary lay and medical language. I ask questions such as: what do we normally mean when we ascribe health or disease to a person? In the end I will recommend an analysis of these and related medical notions, which is unrelated to the notion of a natural function as normally interpreted. (shrink)

Grammatical gender is independent of biological sex for the majority of animal names (e.g., any giraffe, be it male or female, is grammatically treated as feminine). However, there is apparent semantic motivation for grammatical gender classes, especially in mapping human terms to gender. This research investigated whether this motivation affects deductive inference in native German speakers. We compared German with Japanese speakers (a language without grammatical gender) when making inferences about sex-specific biological properties. We found that German speakers tended to (...) erroneously draw inferences when the sex in the premise and grammatical gender of the target animal agreed. An over-generalization of the grammar–semantics mapping was found even when the sex of the target was explicitly indicated. However, these effects occurred only when gender-marking articles accompanied the nouns. These results suggest that German speakers project sex-specific biological properties onto gender-marking articles but not onto conceptual representations of animals per se. (shrink)

This book presents a unique examination of mental illness. Though common to many mental disorders, delusions result in actions that, though perhaps rational to the individual, might seem entirely inappropriate or harmful to others. This book shows how we may better understand delusion by examining the nature of compulsion.

With Carl Gegenbaur and Ernst Haeckel, inspiredby Darwin and the cell theory, comparativeanatomy and embryology became established andflourished in Jena. This tradition wascontinued and developed further with new ideasand methods devised by some of Haeckelsstudents. This first period of innovative workin evolutionary morphology was followed byperiods of crisis and even a disintegration ofthe discipline in the early twentieth century.This stagnation was caused by a lack ofinterest among morphologists in Mendeliangenetics, and uncertainty about the mechanismsof evolution. Idealistic morphology was stillinfluental in (...) Germany, which prevented a fullappreciation of the importance of Darwinstheory of natural selection for comparativemorphology. Evolutionary morphology andembryology failed to contribute significantlyto the modern synthesis of evolutionarybiology, thereby probably delaying theintegration of developmental biology intomodern evolutionary biology. However, Haeckelsstudent Oscar Hertwig, as well as Victor Franzand Alexej N. Sewertzoff from a youngergeneration, all tried to forge their ownsynthetic approaches in which (inspired byHaeckels work) embryology played an importantrole. Important for all three researchers wereattempts to refine, and sometimes redefine, thebiogenetic law, and to find new scientificexplanations for it (and for the manyexceptions to it). Their research was latermore or less forgotten, and had littleinfluence on the architects of the modernsynthesis. As the relationship betweenevolutionary and developmental biology is nowagain rising in importance in the form ofEvo-Devo, we would like to draw attention tohow this earlier research tradition grappledwith similar questions to those now on theagenda, albeit from sometimes quite differentperspectives. (shrink)