This book is a contribution to the general philosophy of action and the philosophy of welfare. The author makes separate analyses of concepts such as action, ability, interaction, action-explanation, happiness, health, illness and disability. At the same time he explores and substantiates the idea of a strong interdependence between the concept of action and some of the central concepts of welfare, in particular health and illness and related concepts.

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)

Job characteristics play an essential role for the well-being of employees. When job characteristics are unfavorable, the experienced exchange relationship with one’s supervisor may become relevant to weaken negative consequences. We conducted a diary study over ten consecutive working days with 112 academics. Based on conservation of resources theory, we assumed that daily LMX constitutes a resource for employees that moderates the link between job characteristics and job satisfaction as well as emotional exhaustion. Additionally, we proposed lagged-effects of morning job (...) characteristics and LMX on next-day morning job satisfaction and emotional exhaustion. Findings from hierarchical linear modeling demonstrated that on the day-level higher perceived levels of job control in the morning were associated with higher perceived job satisfaction and lower perceived emotional exhaustion in the afternoon. The experience of increased time pressure in the morning was negatively related to perceived day-level afternoon job satisfaction and positively to perceived day-level afternoon emotional exhaustion. Within one day, perceived LMX moderated the relationship between perceived job control and perceived job satisfaction in the afternoon. We only found lagged effects of the interaction between afternoon job control and afternoon LMX on next-day morning job satisfaction. We discuss daily LMX as a resource for employees both within one day and from day-to day, along with future research directions on the buffering role of LMX. (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)

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)

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 ...

This paper constitutes a defence of the basic philosophical enterprise of characterising concepts such as 'disease' and 'health', as well as other medical concepts. I argue that these concepts play important roles, not only in medical, but also in other scientific and social contexts. In particular, medical decisions about health and diseasehood have important ethical, social and economic consequences. The role played is, however, not always a rational one. But the greater is the need for a reconstruction of this network (...) of concepts for the purpose of efficient and rational communication. (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)

In this article I provide an analysis of some salient concepts of dignity. The text is a development of a work which was initiated in the year 2000 in the research programme Dignity and Older Europeans supported by the European Union. The programme was both theoretical and empirical. The empirical part, which was the most comprehensive, consisted of focus-group interviews with health care and social care personnel, elderly persons within health care or social care, and representatives from the general public. (...) The interviews concerned the care of the elderly and attitudes towards the elderly. Some questions concerned how the interviewees conceived the concept of dignity and what they meant by behaviour respectful of dignity in the care of the elderly. Altogether around 1000 focus-group interviews were conducted in seven of the countries involved. The theoretical part of the programme consisted of an analysis of the concepts of dignity based on studies of dictionary entries in six languages as well as previous philosophical analyses of the concept. In the theoretical part of the study there emerged four different concepts of dignity: dignity of merit, dignity of moral standing, dignity of identity and human dignity. Characterizations of these concepts have been presented and developed in several publications, for example Nordenfelt and. In the present article this analysis is taken a step further. I take as a starting point some previous studies, including Schroeder, Sulmasy and my earlier ones, and propose an improvement and clarification of my earlier classification of dignities. At the same time I enlarge the analysis to concern worths in general and how these are attached to entities in general, not just human beings. The four kinds of dignities which I now propose are called: attributed dignity, dignity of inflorescence, dignity of identity and human dignity. (shrink)

This paper contains an attempt at constructing a semantic framework for the field of health enhancement. The latter is here conceived as an extremely general category covering the whole area of health care and health promotion. With this framework as a basis I attempt to define the place of medicine within the enterprise of health enhancement. I finally indicate some normative issues for the future, in particular problems and possible developments for medicine as a species of health enhancement.

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)

Kierkegaard's view of time and eternity.

A great number of constructive suggestions for the analysis of the concepts and models treated are presented in this book, which mirrors a current debate within the theory of medicine by covering three central topics: the concepts of health and disease; definition and classification in medicine; and causal explanation in medicine. Among the issues dealt with are: How should the concepts of health and disease be characterized in order to be of relevance to clinical practice? Should we try to define (...) particular diseases in explicit terms? What should be the criteria for selecting causes when explaining disease or death? These problems are treated from various points of view, the contributors being drawn from the fields of clinical medicine, epidemiology, psychiatry, social medicine, philosophy, and history of medicine. (shrink)

Resilience is often promoted as a boundary concept to integrate the social and natural dimensions of sustainability. However, it is a troubled dialogue from which social scientists may feel detached. To explain this, we first scrutinize the meanings, attributes, and uses of resilience in ecology and elsewhere to construct a typology of definitions. Second, we analyze core concepts and principles in resilience theory that cause disciplinary tensions between the social and natural sciences. Third, we provide empirical evidence of the asymmetry (...) in the use of resilience theory in ecology and environmental sciences compared to five relevant social science disciplines. Fourth, we contrast the unification ambition in resilience theory with methodological pluralism. Throughout, we develop the argument that incommensurability and unification constrain the interdisciplinary dialogue, whereas pluralism drawing on core social scientific concepts would better facilitate integrated sustainability research. (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)

The article deals with two problems that arise within moorean style act-utilitarianism (a.u.): (i) how is the notion of 'the alternatives to' a particular action to be explicated? (ii) how should a.u. be formulated in order for it to validate the laws of standard deontic logic? it is argued that these intertwined problems can be solved only if the traditional formulations a a.u. are rejected in favor of some new and more viable ones. in the literature the two problems seem (...) to have been seriously considered only by bergstrom and castaneda. in a final section the author extends his new versions of a.u. to 'sequences' of "single" particular actions and argues for the necessity of working with 'tensed' deontic notions as well as for a combination of deontic logic with tense-logic. (shrink)

This paper contains an attempt at constructing a semantic framework for the field of health enhancement. The latter is here conceived as an extremely general category covering the whole area of health care and health promotion. With this framework as a basis I attempt to define the place of medicine within the enterprise of health enhancement. I finally indicate some normative issues for the future, in particular problems and possible developments for medicine as a species of health enhancement.

The author is concerned with a minimal system dl of deontic logic, His main purpose being to draw attention to the existence of interpretations of dl that give rise to various systems of what may be called "atheoretical logic." by this we understand logical systems dealing with expressions that are--Very probably at least--Neither true nor false, Such as sentences expressing promises, Intentions, Wishes, Commands, And similar things. As it is well known, The status of atheoretical logic in this sense is (...) somewhat problematic for the reason that logical relations might be held to apply to true or false sentences only. However, The author here disregards this much discussed difficulty and proceeds to construct systems of atheoretical logic out of dl in a "philosophically naive" manner. (staff). (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.