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 (‘health’ is not defined as absence of disease (...) but in positive terms) and a positive conception of health (health is seen as an ideal). 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 is the first wide-ranging, multi-authored handbook in the field of philosophy of medicine, covering the underlying conceptual issues of many important social, political and ethical issues in health care. It introduces and develops over 70 topics, concepts, and issues in the field. It is written by distinguished specialists from multiple disciplines, including philosophy, health sciences, nursing, sociology, political theory, and medicine. Many difficult social and ethical issues in health care are based on conceptual problems, most prominently on the definitions (...) of health and disease, or on epistemological issues regarding causality or diagnosis. Philosophy is the discipline that deals with such conceptual, metaphysical, epistemological, methodological, and axiological matters. This handbook covers all the central concepts in medicine, such as ageing, death, disease, mental disorder, and well-being. It is an invaluable source for laypeople, academics with an interest in medicine, and health care specialists who want be informed and up to date with the relevant discussions. The text also advances these debates and will set the agenda for years to come. (shrink)

Psychopathy has been the subject of investigations in both philosophy and psychiatry and yet the conceptual issues remain largely unresolved. This volume approaches psychopathy by considering the question of what psychopaths lack. The contributors investigate specific moral dysfunctions or deficits, shedding light on the capacities people need to be moral by examining cases of real people who seem to lack those capacities. -/- The volume proceeds from the basic assumption that psychopathy is not characterized by a single deficit--for example, the (...) lack of empathy, as some philosophers have proposed—but by a range of them. Thus contributors address specific deficits that include impairments in rationality, language, fellow-feeling, volition, evaluation, and sympathy. They also consider such issues in moral psychology as moral motivation, moral emotions, and moral character; and they examine social aspects of psychopathic behavior, including ascriptions of moral responsibility, justification of moral blame, and social and legal responses to people perceived to be dangerous. -/- As this volume demonstrates, philosophers will be better equipped to determine what they mean by “the moral point of view” when they connect debates in moral philosophy to the psychiatric notion of psychopathy, which provides some guidance on what humans need in order be able to feel the normative pull of morality. And the empirical work done by psychiatrists and researchers in psychopathy can benefit from the conceptual clarifications offered by philosophy. (shrink)

In this paper, I discuss the risks of brain injuries in collision and contact sports and make a proposal to address them without limiting the autonomy of athletes. I aim to analyse the circumstances of profound uncertainty that athletes are facing in terms of the long-term impact of brain injuries. My strategy is to circumvent drastic measures in dealing with such risks, such as banning certain sports or changing their nature by introducing constitutive rule changes, and to scaffold individual autonomy (...) instead. I will focus on two aspects. First, I address the choice whether to take up or continue to play a risky sport given the mentioned profound level of ignorance. I argue that we can scaffold autonomy to make rational choices, particularly by enabling the application of heuristics. Second, I discuss performative skills that can help to prevent brain injuries. It is important to consider collision and contact sports as instances of joint action. The performance of others is an important factor in determining the level of risk in such sports. Hence, supporting athlete’s skills to prevent collisions can reduce the risk of brain injury. I conjecture ways to scaffold players’ skills and performance with this aim in mind. (shrink)

Extant literature on Goodman’s ‘New Riddle of Induction’ deals mainly with two versions. I consider both of them, starting from the (‘epistemic’) version of Goodman’s classic of 1954. It turns out that it belongs to the realm of applications of inductive logic, and that it can be resolved by admitting only significant evidence (as I call it) for confirmations of hypotheses. Sect. 1 prepares some ground for the argument. As much of it depends on the notion of evidential significance, this (...) concept is defined and its introduction motivated. Further, I introduce and explain the distinction between support and confirmation: put in a slogan, ‘confirmation is support by significant evidence’. The second section deals with the Riddle itself. I demonstrate that, given the provisions of the first section, not ‘anything confirms anything’: significant green-evidence confirms only green-hypotheses (and no grue-hypotheses), and significant grue-evidence confirms only grue-hypotheses (and no green-hypotheses), whichever terms we use for expressing these evidences or hypotheses. The third section rounds off my treatment. First I show that Frank Jackson’s use of his counterfactual condition is unsuccessful. Further, I argue that no unwanted consequences result, if one starts from the other, ‘objective’, definition of ‘grue’, as it constitutes no more than a mere fact of logic that cannot do any harm. Finally, I present a grue-case involving both kinds of definition, where the exclusive confirmation of either the green- or the grue-hypothesis is shown. (shrink)

It is widely assumed that severe mental disabilities prevent relevant deliberative capacities from developing or persisting. Accordingly, excluding many people with mental disabilities from discourse practices seems justified. Against this common assumption I wish to show that the general exclusion is not justified and amounts to a form of epistemic injustice, as theorised by Miranda Fricker. The received norm of capable deliberators is connected to a specific model of deliberation. I introduce an alternative model of deliberation, which I dub the (...) joint effort model. According to this model, people with minority minds (as I call them) add valuable cognitive diversity to the process of deliberation, which is a relevant element of epistemic improvement. In this part of the argument I rely on empirically informed theoretical work by Hélène Landemore. I scrutinise the minimal requirements of capable deliberators from the perspective of a joint effort model of deliberation, and I highlight specific beneficial contributions people with minority minds can make to discourse practices. I will argue that people with minority minds can be presumptively deemed capable deliberators and that therefore their general exclusion is unjustified. (shrink)

The concept of mental disorder is often defined by reference to the notion of mental dysfunction, which is in line with how the concept of disease in somatic medicine is often defined. However, the notions of mental function and dysfunction seem to suffer from some problems that do not affect models of physiological function. Functions in general have a teleological structure; they are effects of traits that are supposed to have a particular purpose, such that, for example, the heart serves (...) the goal of pumping blood. But can we single out mental functions in the same way? Can we identify mental functions scientifically, for instance, by applying evolutionary theory? Or are models of mental functions necessarily value-laden? I want to identify several philosophical problems regarding the notion of mental function and dysfunction and point out some possible solutions. As long as these questions remain unanswered, definitions of mental disorder that rest upon the concept of mental dysfunction will lack a secure foundation. (shrink)

Ageing is often deemed bad for people and something that ought to be eliminated. An important aspect of this normative aspect of ageing is whether ageing, i.e., senescence, is a disease. In this essay, I defend a theory of disease that concludes that ageing is not a disease, based on an account of natural function. I also criticize other arguments that lead to the same conclusion. It is important to be clear about valid reasons in this debate, since the failure (...) of bad analyses is exploited by proponents of the view that ageing is indeed a disease. Finally, I argue that there could be other reasons for attempting to eradicate senescence, which have to do with an evaluative assessment of ageing in relation to the good life. I touch on some reasons why ageing might be good for people and conclude that we cannot justify generalized statements in this regard. (shrink)

In 2012, the symposium "Christopher Boorse and the Philosophy of Medicine" was held at the University of Hamburg. The initial ideas presented at this event, which celebrated Chris's contribution to the development of what is now a vibrant area of research, especially to the theory of disease, form the core of the papers published in this issue. Similarly to what Robert Nozick once said about John Rawls's work, it can be demanded that philosophers of medicine must now either work within (...) Boorse's theory or explain why not. It is simply the main contender in the so-called naturalist camp of contributions to the theory of disease. All of the papers in this issue address his approach in some respect, and all of them are friendly toward his theory up to a point. In this brief introduction, I try to extract common threads. In doing so, I focus on three issues that have the capacity to determine future debates. The first is the methodology of developing a theory of disease, especially what conceptual analysis amounts to and what it may achieve. The second is the issue of value-ladenness of the concepts of health and disease, a topic that has been at the forefront of the philosophical debate, but which -- to my mind -- has often been misunderstood. The third issue is the problem of the unity of medical terminology. We can ask whether there is only one core medical concept, be it "disease," "pathology," "disorder," "malady," or something else. Alternatively, we might propose different concepts for different purposes. (shrink)

The paper defends the World Health Organisation (WHO) definition of health against widespread criticism. The common objections are due to a possible misinterpretation of the word complete in the descriptor of health as ‘complete physical, mental and social well-being’. Complete here does not necessarily refer to perfect well-being but can alternatively mean exhaustive well-being, that is, containing all its constitutive features. In line with the alternative reading, I argue that the WHO definition puts forward a holistic account, not a notion (...) of perfect health. I use historical and analytical evidence to defend this interpretation. In the second part of the paper, I further investigate the two different notions of health (holistic health and perfect health). I argue that both ideas are relevant but that the holistic interpretation is more adept for political aims. (shrink)

ABSTRACT In this paper, I discuss several arguments against non‐therapeutic mutilation. Interventions into bodily integrity, which do not serve a therapeutic purpose and are not regarded as aesthetically acceptable by the majority, e.g. tongue splitting, branding and flesh stapling, are now practised, but, however, are still seen as a kind of ‘aberration’ that ought not to be allowed. I reject several arguments for a possible ban on these body modifications. I find the common pathologisation of body modifications, Kant's argument of (...) duties to oneself and the objection from irrationality all wanting. In conclusion, I see no convincing support for prohibition of voluntary mutilations. (shrink)

In this paper, I discuss several arguments against non‐therapeutic mutilation. Interventions into bodily integrity, which do not serve a therapeutic purpose and are not regarded as aesthetically acceptable by the majority, e.g. tongue splitting, branding and flesh stapling, are now practised, but, however, are still seen as a kind of ‘aberration’ that ought not to be allowed. I reject several arguments for a possible ban on these body modifications. I find the common pathologisation of body modifications, Kant's argument of duties (...) to oneself and the objection from irrationality all wanting. In conclusion, I see no convincing support for prohibition of voluntary mutilations. (shrink)

The chapter starts from a specific interpretation of what it means to know the difference between right and wrong, which stems from Gilbert Ryle. To know the difference between right and wrong implies caring about morality. The author links Ryle’s ideas to the notion of being a moral person. Two different ideas found in moral philosophy are delineated, namely, the amoral person, that is, someone who rejects the demands of morality, and the morally incapacitated person, that is, someone who cannot (...) take those demands into account. Psychopaths are not amoral in the philosophers’ sense of the word, but are incapable of, or seriously deficient in, taking the moral point of view. (shrink)

Freitag (2015) and Schramm (2014) have proposed different, although converging, solutions of Goodman’s New Riddle of Induction. Answering their proposals, Dorst (2016 and 2018) has used the fictitious character of a ‘grue-speaker’ as his principal device for criticizing counterfactual-based treatments of the Riddle. In this paper, I argue that Dorst’s arguments fail: On the observation of no other than green emeralds, the ‘grue-speaker’ cannot use the symmetry between the ‘green’- and ‘grue’-languages for claiming ‘grue’- instead of ‘green’-evidence, and the (...) counterfactuals involved (explicitly by Schramm and implicitly by Freitag) remain unaffected by Dorst’s proposal for how to evaluate them. (shrink)

This chapter introduces the main findings of the medical research on psychopathy as well as the most significant threads of the philosophical debates surrounding psychopathy. It also introduces the articles collected in this volume. The introduction focuses on issues in moral psychology and metaethics, such as moral motivation, moral responsibility, and moral understanding. It shows the difficulty in conceptualising psychopathy and in using psychopathy as a test case for philosophical theories.

Ideal for students in the philosophy of medicine, healthcare and public health, this book offers an introduction to the philosophical debates around health justice. It presents clear conceptual definitions of health, disease and illness and the various theories of justice, developing a specific normative argument in the debate on health justice.

In this paper, I want to scrutinise the value of utilising the concept of disease for a theory of distributive justice in health care. Although many people believe that the presence of a disease-related condition is a prerequisite of a justified claim on health care resources, the impact of the philosophical debate on the concept of disease is still relatively minor. This is surprising, because how we conceive of disease determines the amount of justified claims on health care resources. Therefore, (...) the severity of scarcity depends on our interpretation of the concept of disease. I want to defend a specific combination of a theory of disease with a theory of distributive justice. A naturalist account of disease, together with sufficientarianism, is able to perform a gate-keeping function regarding entitlements to medical treatment. Although this combination cannot solve all problems of justice in health care, it may inform rationing decisions as well. (shrink)

In this paper I show that Rawls’s contract apparatus in A Theory of Justice depends on a particular presumption that is in conflict with the goal of conserving environmental resources. He presumes that parties in the original position want as many resources as possible. I challenge Rawls’s approach by introducing a rational alternative to maximising. The strategy of satisficing merely goes for what is good enough. However, it seems that under conditions of scarcity Rawls’s maximising strategy is the only rational (...) alternative. I therefore scrutinise the common account of scarcity. I distinguish between absolute and relative scarcity in order to show that scarcity is influenced by our decisions. If we would not accept the claim to as much as possible without further legitimisation, like Rawls does, then scarcity might not be as severe a problem. Finally, I reject Rawls’s proposed solution for dealing with problems of sustainability, namely his idea of the just savings principle. I conclude that Rawlsian Justice as Fairness is bad for the environment. (shrink)

In diesem Artikel wird argumentiert, dass die Philosophie nicht über passende Methoden verfügt, reale politische Probleme angemessen zu analysieren. So sind die tatsächlich vorzufindenden Empfehlungen zur Lösung solcher Fragen meist trivial oder unterkomplex. Es wird geraten, zuerst geeignete Instrumentarien der angewandten bzw. konkreten Ethik zu entwickeln, bevor sich PhilosophInnen zu solch komplexen Fragen wie die der Flüchtlingspolitik äußern.

Mnoge biološke funkcije dopuštaju stupnjevanje. Na primjer, lučenje određenog hormona u organizmu može biti na višoj ili nižoj razini, u usporedbi s istim organizmom drugom prilikom ili u usporedbi s drugim organizmima. Koje razine funkcioniranja predstavljaju slučajeve disfunkcije; gdje da povučemo crtu? To je kvantitativni problem za teorije disfunkcije i bolesti. Cilj mi je braniti verziju bioloških teorija disfunkcije kako bih se uhvatio u koštac s ovim problemom. Međutim, također ću dopustiti da evaluativna razmatranja uđu u teoriju bolesti. Moj argument (...) se temelji na razlikovanju između biološke i kliničke perspektive. Prema mom mišljenju, bolest je ograničena na slučajeve koji spadaju u granice bioloških disfunkcija. Odgovor na kvantitativni problem ne zahtijeva proizvoljne odluke ili društveno vrijednosne sudove. Stoga se zalažem za nearbitrarnu metodu koja se temelji na činjenicama kako bi se riješio kvantitativni problem. Ipak, nisu sve biološke disfunkcije instance bolesti. Dodavanje kliničke perspektive omogućuje nam da spriječimo potencijalnu preveliku uključenost biološke perspektive, zato što postavlja dodatna ograničenja za određivanje granica bolesti. (shrink)

Die hier anzuzeigende Monographie basiert auf einer Habilitationsschrift, die Michael Schramm an der Universität Leipzig eingereicht hat. Ihr Thema ist die Philosophie der Freundschaft im Neuplatonismus, doch behandelt sie darüber hinaus zahlreiche weitere Facetten sowohl des politischen Denkens als auch der Sozialphilosophie dieser intellektuellen Bewegung der Spätantike. Aus praktischen Gründen beschränkt sich die Untersuchung auf das dritte und vierte Jahrhundert und hierbei auf eine Auswahl von vier Autoren, nämlich Plotin, Jamblich, Themistios und Kaiser Julian. Schon diese Zusammenstellung verdeutlicht, dass (...) es Schramm nicht allein um die Theorie ‚professioneller' Philosophen geht, sondern ebenso um Freundschaftskonzepte von im praktischen und politischen Leben stehenden Intellektuellen. (shrink)

Journal of Social Philosophy, EarlyView.

According to Norman Daniels, the moral significance of health needs stem from their impact on the normal opportunity range: pathological conditions involve comparative disadvantage. In this paper I defend an alternative reading of the moral importance of healthcare, which focuses on non-comparative aspects of disease. In the first section I distinguish two contrasting perspectives on pathological conditions, viz a comparative versus a non-comparative. By using this distinction I introduce a related disparity regarding the moral importance of personal responsibility for disease. (...) I claim that people are usually prepared to disregard individual responsibility for disease, if it involves non-comparative harm, but not if it entails mere disadvantage. Since disadvantage means to have less than equal opportunities, Daniels’ conception of opportunity is vital for his theory. It is therefore scrutinised more closely. I try to show that he wavers between two interpretations of the notion of opportunity, which are again linked to the distinction between a comparative and a non-comparative point of view. Finally, I criticise Daniels’ supposition that persons have an interest in the normal opportunity range. (shrink)

The interdisciplinary contributions of this edition promote the development of a new "philosophical psychopathology".

In my commentary on Hempeler et al.’s (2024) important contribution to the ethics of psychiatry I will argue that psychiatric practices are necessarily unruly, and that this fact has important impl...

Edmund Gettier (1963) argued that there can be justified true belief (JTB) that is not knowledge. I question the correctness of his argument by showing that Smith of Gettier’s famous examples does not earn justification for his incidentally true beliefs, while a doxastically more conscientious person S would come to hold justified but false beliefs. So, Gettier’s (and analogous) cases do not result in justified _and_ true belief. This is due to a tension between deductive closure of justification and evidential (...) support. For being justified, any believing, disbelieving, or withholding of deductively inferred propositions must be distributed proportionally to given evidential support. This proportionality principle has primacy over deductive closure in case of conflict. My argument does not save the JTB-account. But, instead of merely referring to an intuition, it explains why subjects in Gettier situations do not earn knowledge. (shrink)

Does the reference to a mental realm in using the notion of mental disorder lead to a dilemma that consists in either implying a Cartesian account of the mind-body relation or in the need to give up a notion of mental disorder in its own right? Many psychiatrists seem to believe that denying substance dualism requires a purely neurophysiological stance for explaining mental disorder. However, this conviction is based on a limited awareness of the philosophical debate on the mind-body problem. (...) This article discusses the reasonableness of the concept of mental disorder in relation to reductionist and eliminativist strategies in the philosophy of mind. It is concluded that we need a psychological level of explanation that cannot be reduced to neurophysiological findings in order to make sense of mental disorder. (shrink)

This paper constitutes one extended argument, which touches on various topics of Critical Rationalism as it was initiated by Karl Popper and further developed in his aftermath. The result of the argument will be that critical rationalism either offers no solution to the problem of induction at all, or that it amounts, in the last resort, to a kind of Critical Rationalist Inductivism as it were, a version of what I call Good Old Induction. One may think of David Miller (...) as a contemporary representative of what I consider as the ‘no solution’ version of critical rationalism, while Alan Musgrave stands for the version of ‘critical rationalist induction’. Popper’s own writings admit of either interpretation. (shrink)

The paper presents a subjectivist interpretation of Protagoras’ man-measure fragment, by explaining some key terms (‘all things’, ‘measure’, ‘man’) and reconstructing his ontological, epistemological and anthropological views. The argument uses other fragments and testimonies of Protagoras as well as intertextual allusions to previous authors (especially Anaxagoras) and instances of reception of Protagoras by Plato, Aristotle and Isocrates which are particularly used here for the first time in order to interpret the man-measure fragment. It is argued that Protagoras denied metaphysical speculation (...) and preferred human knowledge based on subjective perception and made plausible by intersubjective discourse. (shrink)

Sufficientarianism is a theory of social justice that determines individual entitlements by setting a threshold of what is enough for a decent life. Sufficientarianism therefore seems to be a suitable ally for theories of climate justice, because it restricts claims of justice to a minimum. Furthermore, the notion of sufficiency has been theorized in ecological discourse, so there is pertinent conceptual overlap between the two perspectives. In this paper, I aim to combine sufficientarianism with eco-sufficiency. I will use a framework (...) of needs to highlight different normative urgencies involved in practices that involve carbon emissions. However, as I will argue, the normative urgency of needs might cause problems for restricting emissions to levels that are compatible with planetary limits. In brief, the very aim of achieving sufficientarian justice might clash with the aim of eco-sufficiency. Sufficientarians should therefore critically engage with needs satisfiers as well, which are the means provided to satisfy needs. This step in my argument will be achieved through complementing sufficientarianism with an element of comparative justice, that is, interpersonal and diachronic considerations that help to determine the comparative urgency of claims. The overarching aim of sustainable sufficientarianism is to provide enough for everyone to live a decent life over time. (shrink)