More than two decades after the passage of the Americans with Disabilities Act , people with disabilities continue to live at the margins of American democracy and capitalist society. This persistent exclusion poses a conundrum to political theorists committed to disability rights, multiculturalism, and social justice. Drawing from feminist insights, specifically the work of Nancy Fraser, among others, I examine the necessary conditions for meaningful inclusion to be realized within a deliberative democracy. Using Fraser's concept of “participatory parity” (...) as a proxy for inclusion, I strategize how to overcome informal barriers—economic inequality and misrecognition—that persist even after disabled people are granted the legal right to participate. The analysis concludes that a truly inclusionary and multicultural democracy requires the redistribution of wealth and a more expansive model of political deliberation, one that can recognize unconventional modes of communication through practices of translation. (shrink)

Community-based participatory research (CBPR) focuses on specific community needs, and produces results that directly address those needs. Although conducting ethical CBPR is critical to its success, few academic programs include this training in their curricula. This article describes the development and evaluation of an online training course designed to increase the use of CBPR in mental health disciplines. Developed using a participatory approach involving a community of experts, this course challenges traditional research by introducing a collaborative process meant (...) to encourage increased participation by special populations and narrow the parity gap in effective mental health treatment and services delivery. (shrink)

Democracy is crucially about inclusion: a theory of democracy must account for who is to be included in the democratic process, how, and on what terms. Inclusion, if conceived democratically, is fraught with tensions. This article identifies three such tensions, arising respectively in: (i) the inauguration of the democratic public; (ii) enabling equal participation; and (iii) the relationship between instrumental and non-instrumental accounts of democracy’s value. In each case, I argue, rather than seeking somehow to dissolve or avoid such tensions, (...) theories of democracy should allow us to live with their implications reflexively: to work with them. Such tensions are counter-democratic to the extent that they derail what Nancy Fraser calls “participatory parity,” under which citizens count as “full partners in social interaction.” But the extent to which they do this is not itself dependent on points of paradox in the very idea of inclusion. Such parity relies on complex factors, social and economic, which democratic institutions and procedures will not by themselves address. To achieve full democratic inclusion we must already have addressed such factors; no account of democracy itself, however finely-tuned, will do this. (shrink)

In recent works Nancy Fraser has developed a model of ?metademocracy? that promises to reconcile the competing claims of universal justice (grounded in human rights) and localized democracy (grounded in popular sovereignty). By instituting a global democratic procedure in which all enjoy participatory parity, Fraser hopes to ensure that some people are not denied standing as ?subjects of justice? simply because of their territorial location while keeping faith with the democratic commitment to autonomy and self-legislation. Despite the compelling (...) nature of this model, I argue that Fraser fails to bridge the gulf between justice and democracy because her model of metademocracy is built on the ?metanorm? of ?participatory parity?. Drawing on the work of Hannah Arendt, I claim that this foundationalist move re-asserts the priority of justice over democracy because it takes equality as a moral given rather than the ever-precarious achievement of human organization. (shrink)

Male-dominated and sex segregated elite professional and amateur sport1 in North America constitutes a "sport nexus" (Burstyn, 1999; Heywood & Dworkin, 2003) that combines economic and cultural influence to reinforce and perpetuate gender injustice. The sport nexus is an androcentric sex-segregated commercially powerful set of institutions that is highly visible and at the same time almost completely taken for granted to the extent that its anti-democratic impetus goes virtually unnoticed. The sport nexus’s hegemonic role in defining sporting norms (Coakley & (...) Donnelly, 2004) means that its role in shaping lower level amateur and recreational sporting institutions and cultures is highly significant. Fraser (2007) defines gender justice, and hence democracy, in terms of "participatory parity," that is, material and cultural equality for women. The sport nexus itself is characterized by highly gendered occupational segregation (Coventry, 2004). It further contributes to gender injustice, homophobia and transphobia by promoting the ideology of the two sex system (Fausto-Sterling, 2000) and gendering citizenship as fundamentally male (Burstyn, 1999). Feminist strategies for sport reformation attempt to reduce or eradicate the role of the sport nexus in legitimating and perpetuating gender injustice. In this article I consider the potential of these strategies and conclude with a set of recommendations for transforming organized sport at both elite and recreational levels. (shrink)

The strong correlation between people’s socioeconomic position and health within high income countries is a well-documented fact. A person’s occupation, income and education level tell us a lot about that person’s prospects on a long and healthy life, such that we can speak of a ‘social gradient in health’, or a ‘socioeconomic health gap’. This association is often perceived to be unjust. Therefore, it is generally thought that governments should aim to reduce socioeconomic health inequalities. However, this idea needs ethical (...) justification, for it is not evident if and why exactly these inequalities are unjust. For instance, are inequalities in health unjust per se? Or because the underlying socioeconomic inequalities are unjust? And does justice require equal health levels, or a minimum level of health? What complicates the issue, is that the width of the health gap, or the steepness of the social gradient, depends on what health measures are used. Overall, the more subjective the measure, the greater the inequalities appear to be. But are all these measures equally morally relevant? This dissertation aims to give a better understanding of these philosophical questions. It does so by investigating the question of what we should understand by health in the first part, after which it addresses the question of how to evaluate socioeconomic health inequalities in the light of justice. The introduction begins with a description of the phenomenon of socioeconomic health inequalities, and how it has been addressed by politicians, epidemiologists and philosophers in the past and today. The chapter continues by formulating the central question of the dissertation – that of which health inequalities should be focused in the light of a concern with social justice. It explicates how this dissertation contributes to answering that question, by discussing the potential relation between the conceptualisation of health and justice evaluations, and by discussing which questions are addressed in each of the following chapters. The chapter 2 addresses the question of how health is conceptualised in the philosophical and public heath literature, and how theoretical concepts of health differ. It proposes to approach health concepts as a Wittgensteinian family of thick concepts and argues that while theories on health generally argue in favour of one specific concept, a comparison of concepts shows that we may need different concepts of health given the variety of health practices. By explicating the differences between five concepts of health, this chapter argues that each captures aspects of health that all seem relevant when we talk and think about health. Classifying these concepts based on their distinctions reveals them as members of a conceptual family: each of the discussed concepts differs from the others in at least one respect and resembles the others in several respects. Moreover, the discussion of the concepts shows that ‘health’ always both describes a condition and values that condition at the same time. Having both descriptive and evaluative dimensions, we can see health concepts as ‘thick concepts’. Given this evaluative dimension, it is important to reflect on the question of what understanding of health guides specific practices. Moreover, the distinctions revealed by the classification can serve as a conceptual toolbox for reflection on the assumptions and purposes of health practices. How such reflection could work is illustrated by a brief exploration of what health aspects are focused upon in three specific health practices. Chapter 3 presents a study into the question of how health is conceptualised by ordinary citizens and to what extent conceptualisations of health differ between socioeconomic groups. By making use of the method of concept mapping, this study analyses how different socioeconomic groups formulate their own answers regarding the question ‘what does health mean to you?’. It presents concept maps of health for three different socioeconomic groups living in the city of Utrecht that reveal that all groups have a multidimensional understanding of health. An interpretation of the concept maps reveals nuanced differences between groups. The multiple aspects of health were also ranked by importance. It appears that each group assigned most importance to mental health. All in all, the study shows that people in lower socioeconomic groups are more likely to show a conceptualisation of health that refers to 1) the absence of health threats, 2) a person within his/her circumstances, 3) the value of functional notions, and 4) an accepting attitude towards life. Chapter 4 addresses the question of what the theoretical and empirical study to concepts of health could imply for health equity practices. It does so by exploring further the suggestions made in chapters 2 and 3. Regarding the question of which health aspects should guide health equity policies, this chapter discusses the question of whether we should primarily look at subjective or objective health measures, and whether a universal or relative standard of health should be central. While justice-related concerns of impartiality and equal treatment may seem to favour an objective perspective and a universal health standard, it appears that we have good reason to account for the subjective perspective as well. It is also argued that a concern for recognition and participatory parity gives room for relative health standards. Th room for relative health standards confronts us with the question of how to deal with mechanisms like adaptive preferences that the concept maps reveal. It proposes a way out, by arguing for society-relative health standards. Chapter 5 examines the question of whether inequalities in health should be evaluated ‘directly’, thus independently of a distribution of their social determinants. It proposes a sufficientarian perspective, such that the central question of evaluation is that of whether everyone is – or can be – healthy enough. By discussing two sufficientarian approaches to health and social justice – by Powers & Faden and by Nussbaum – this chapter distinguishes two ways of setting a threshold level for health. Both approaches appear to provide an unsatisfactory basis for justice evaluations and lead us away from direct evaluation if we try to settle health minima that are less arbitrary. In anticipation to chapters 6 and 7, it is argued that the perspective of sufficient health for relational equality escapes this arbitrariness: compared to that of a decent human life, it better helps to answer both the question of what socioeconomic health inequalities a society is due to avoid, and the question of when socioeconomic health inequalities are unjust considering their consequences. Chapter 6 discusses to what extent Daniels’s theory of health justice provides a satisfactory answer to the question of what health inequalities a society is due to avoid. Daniels proposes an indirect evaluative approach by arguing that we should evaluate socioeconomic health inequalities in the light of Rawls’s principles of justice as fairness. That is, if socioeconomic inequalities are in accordance with fair equality of opportunity and with the difference principle, the corresponding health inequalities would be just. It is shown that the suggestion that Rawls’s principles regulate the social determinants of health neglects that not all social determinants of health belong to society’s basic structure as conceived of by Rawls and are thereby not subjected to the principles of justice. To acknowledge the social mechanisms leading to socioeconomic health inequalities in their full complexity, it is argued that we should broaden our understanding of society’s structure in accordance with Young’s notion of social structural processes. This renders the question of what health inequalities a society is due to avoid into a question of what we can expect from the side of the various actors that uphold the social structures that produce socioeconomic health inequalities. Lastly, it is discussed how a shift to Young’s theory completes the shift to non-ideal theorising that seem already initiated by Daniels, and that with this, the distinction between direct and indirect evaluation dissolves. Chapter 7 discusses to what extent equality in health is of instrumental value for a society of free and equals. It thus takes up the idea proposed in chapter 5, that an evaluation of the consequences of health inequalities is also due. Taking relational equality as an evaluative framework reveals three ways in which inequalities in life expectancy threaten this ideal. That is, via unequal risks to stigmatisation, unequal risks to unemployment and the risk of unequal pension enjoyments. It is thereby shown that these risks are especially great for those lower down the socioeconomic strata. It thus concludes that equality in health is of instrumental value to relational equality. The chapter continues to argue that our instrumental approach opens a new perspective: to mitigate the identified injustices by changing society, rather than by reducing inequalities in health. This is argued to be an advantage in the light of the realistic assumption that of the socioeconomic health inequalities will persist. The paper thus offers a complementary approach to both the evaluation and the mitigation of the injustice of socioeconomic inequalities in health. The discussion chapter summarises the central findings of the analyses of health concepts and discusses questions regarding the philosophical and practical merits of comparing theoretical health concepts, the need for developing new health measures or concepts and the importance or nonsense of studying citizen’s views on health. Repeating this for the dissertation’s second part, the central findings of the chapters on justice evaluation are summarised and followed by a discussion of questions and issues that have remained unaddressed so far. Here, central points of discussion are my take on rules of distribution, the distinction of direct and indirect evaluation, the role of ideal and non-ideal theory, the idea of relational equality, and personal responsibility for health. The chapter concludes by noting that also in the light of justice evaluations, all commonly used health measures are relevant for justice. Therefore, my recommendations for policy and further research entail that inequalities in each of these measures deserve attention by both policymakers and researchers. Specifically, policymakers and researchers should give attention to how exactly each of these health inequalities come about, in such a way that a discussion about the question of who can be assigned responsibility to alleviate them is well-informed; and both should give attention to the effects of health inequalities on the opportunities for people to live on equal standing, in such a way that when these opportunities are diminished, actions can be considered to aim to restore relational equality. (shrink)

This article argues that a theory of recognition cannot provide the comprehensive basis for a critical theory or a conception of social justice. In this respect, I agree with Fraser's impulse to include more in such a theory, such as distributive justice and participatory parity. Fraser does not go far enough, to the extent that methodologically she seeks a theory of the same sort as Honneth's. Both Honneth's and Fraser's comprehensive theories cannot account for a central phenomenon of (...) contemporary societies: domination as structural exclusion rather than tyranny or the lack of parity. This phenomenon shows that at the very least freedom (rather than merely justice or recognition) ought to remain central to any critical theory of globalization. Most of all, both theories fail to provide a way to decide whether democratic practices can produce justice. A pluralist and pragmatic form of critical theory is thus superior to any comprehensive normative theory. (shrink)

Cognitively disabled persons routinely face legal and structural barriers to democratic participation. However, as this paper argues, theoretical accounts of democratic participation may also undermine disabled persons’ abilities to participate in and contribute to the political process. I seek to advance an account of participatory parity for cognitively disabled persons, arguing that participatory parity requires access to deliberative spaces, in addition to material and intersubjective conditions. Building the idea of support, or respect for the expressed preferences (...) of the disabled person, into democratic theory, is a prerequisite for inclusive democratic spaces. In line with this emphasis on support, I suggest that the characterization of deliberative interventions as ‘reasonable speech acts’ hinders participatory parity for cognitively disabled persons. I therefore propose a series of enabling strategies intended to expand philosophical understandings of deliberation beyond reasonable speech acts. (shrink)

Feminist literature on care has extensively addressed inequalities that cut across the social categories of gender, class and ethnicity in relation to care work. One category that has received less attention in theories of caregiving so far is age. Built on the feminist literature of care and taking young (female) carers as its subject matter, this article tackles age as a third social category of intersectional inequalities along with class and gender. Firstly, through dealing with Nancy Fraser’s justice framework of (...) participatory parity, it is argued that addressing the intersectional inequalities that young (female) carers face necessitates a justice framework that contemplates both the distributional and recognitional aspects of care. In this respect a dual conceptualisation of care is presented – both as a social good and a social process. Secondly, a critical analysis will be presented of the elements of the justice framework of Fraser, where the notion of subordinated status will be related to the identities of young carers. Lastly, the normative framework participatory parity will be discussed in relation to the politics of need, as care practices define the needs of young carers that are contextualised in the care processes, but also in a childhood space. (shrink)

This review article takes up certain key issues that are at stake in the valuable collection of essays edited by Lovell. It considers critically the argument that the adoption of Fraser's perspectival dualism implies regression to a base—superstructure theory of the social. It assesses the advantages of extending the dualism of redistribution and recognition to include also the need for participatory parity in the post-Westphalian political order. It raises again the question of whether Honneth is sociologically more forceful (...) than Fraser in arguing that material inequality is merely a facet of a more profound disrespect (lack of recognition). Lovell's assessment of Honneth's `recognition monism' is commended in that it resurrects an earlier critique of structural-functionalism to make a helpful distinction between social integration and (non-normative) system integration. She addresses these issues in terms of a wider critical realism concerned with disaggregating those social relations which are more causally generative from others: an approach which permits illuminating debates over the degree to which patriarchy and heteronormativity are contingent or necessary to late capitalism. Lovell also introduces Bourdieu into the debate, and especially his conceptions of misrecognition and symbolic violence. Finally, Sayer's vigorous arguments about the moral significance of distribution and class are considered as contributing to the current ethical turn. The article ends with an attempt to defend Bourdieu, whom Sayer sees both as a profound sociologist of class but also a theorist oriented too exclusively to agents' egoistic search for strategic advantage. The author concludes that although Fraser's perspectival trinity (or dualism) approach seems preferable to Honneth's monism, this should not obscure the empirical interweaving of deficiencies of distribution and of recognition in social reality. Indeed, new studies show the far-reaching consequences of this. In those societies where maldistribution is most marked, exposure to certain psychosocial risks such as low status (recognition) and low social capital literally incorporate stress, via biological pathways. Hence unequal health outcomes of a surprising range can also be detected. (shrink)

Este artículo recoge la propuesta de Nancy Fraser de paridad en la participación como criterio que integra las reivindicaciones más valiosas de otras corrientes feministas con el objetivo de ampliar la justicia social en nuestras sociedades neoliberales. Asimismo, muestra los límites de su formulación: Fraser considera los condicionantes sociales que permitirían la realización de la paridad en la participación, pero no analiza en profundidad los condicionantes subjetivos de los que también depende. Por último, se sugiere superar esos límites ampliando el (...) ideal normativo de Fraser con el pragmatismo de Dewey. El objetivo es visualizar aspectos de la justicia ocultos en la propuesta de Fraser en pro de una radicalización democrática.This article describes Nancy Fraser’s proposal of participatory parity as a criterion for the integration of the most valuable claims of other feminist schools with the goal of increasing social and gender justice within our neoliberal societies. At the same time, it shows its limits: Fraser examines the social constraints that would allow for the implementation of participatory parity, however it lacks a thorough analysis of the subjective constraints on which it also depends. Lastly, it aims to overcome those limits extending Fraser’s normative ideal with Dewey’s pragmatism. The main goal is to highlight aspects of justice hidden in Fraser’s proposal towards a democratic radicalization. (shrink)

This article analyses the debate between Nancy Fraser and Axel Honneth in a dialectical fashion. Their controversy about how to construct a critical theory of justice is not just one about the proper balance between `redistribution' and `recognition', it also involves basic questions of social ontology. Differing both from Fraser's `twodimensional' view of `participatory parity' and from Honneth's `monistic' theory of recognition, the article argues for a third view of `justificatory monism and diagnosticevaluative pluralism', also called the `first-things-first' (...) approach. According to it, theories of recognition provide an essential sensorium for analyses of social suffering and of injustice, while with respect to the justification of justice claims, a discursive conception of justification is required. This, however, does not imply a purely `formal' account of justice; rather, it leads to a substantive understanding of the `grammar of justice', motivationally, socially and institutionally. Such an account of a critical theory of justice aims at a multidimensional critique of social and political `relations of justification'. (shrink)

In this paper, I revisit and evaluate Kant’s prerequisites for “perpetual peace,” including the claim, central to contemporary political rhetoric, that formal democracy produces peace. I argue that formal democracy alone is insufficient to address the kinds of deep-rooted structural violence that ultimately manifest interrorism and other forms of direct violence. I claim that the attempt to eliminate structural violence, and so achieve real “perpetual peace,” requires a moresubstantive sort of democracy, of which the United States and the West remain (...) poor examples. It requires a political critique that goes deeper than just thecritique of state power and government action. This paper tries to develop that critique through a conception of structural violence, and of participatory parity asan overarching standard of redress for this type of violence in all of its forms. (shrink)

As social and interdependent beings, we have responsibilities to each other. One of them is to recognize each other appropriately. When we fail to meet this responsibility, we often stigmatize. In this paper, I argue that the COVID-19-related stigmatization is a variation of the lack of recognition understood as an orientation to our evaluative features. Various stereotypical behaviors regarding COVID-19 become stigmatized practices because of labeling, stereotyping, separation, status loss and discrimination, and power. When people stigmatize COVID-19 victims, they orient (...) themselves to their evaluative quality of being vulnerable to the SARS-CoV-2 virus by internalizing the victims as dangerous, understanding them as separable, and being motivated to act with them differently. All this causes the COVID-19 victims to lose status and suffer discrimination for which they do not experience participatory parity in different facets of their lives, rendering the COVID-19-related stigmatization an appalling example of misrecognition. (shrink)

This paper puts forth a critical perspective on remedy for business-related human rights abuses. It reflects on the purpose of remedy in Business and Human Rights and argues that effective remedy should address the multiple root causes of abuses to prevent reoccurrences rather than focus on surface issues and isolated cases. To develop a theoretical framework to conceptualize preventative remedy that addresses multiple root causes, this research draws on Fraser’s radical democratic conception of justice and participatory parity. According (...) to the principle, justice is achieved through social arrangements that enable all actors to engage with one another as peers. To conceptualize effective remedy as participatory parity, the paper examines three dimensions—cultural, economic, and political—where injustices or root causes of abuses must be addressed to realize participatory parity. The paper analyzes the illustrative case of the Fair Food Program through the lens of Fraser’s framework. Analysis reveals effective enforcement as necessary to realize participatory parity and address the three dimensions of justice in the context of severe power asymmetries. In the theorized framework, remedy aims to address the multiple root causes of business-related human rights abuses toward prevention and empower rightsholders to engage meaningfully in remedial processes. (shrink)

In 1935, when the U.S. Supreme Court’s new building opened and displayed the phrase “Equal Justice Under Law,” racial segregation was commonplace, as were barriers limiting opportunities for men and women of all colors to participate in economic and political life. The justices on the Court and the lawyers appearing before them reflected those facts; almost all were white men. Today, the Supreme Court’s inscription has become its motto, read as if it always referenced an understanding of equality that has (...) become central to the identity and the legitimacy of courts. The judiciary “looks” somewhat different than it did and, in a sense, has become more “representative” of the range of people appearing in courts. Given the role that courts had played in sustaining discrimination, the impression that courts ought to welcome everyone is a major achievement. Yet, to assess the impact of new judicial demographics requires analysis of other major alterations in U.S. courts—the influx of diverse litigants newly entitled to pursue legal claims; the economic barriers facing many claimants; the emergence of judiciaries as agency-like promoters of agendas; and the displacement of public adjudication through the privatization of dispute resolution. Studies of women as judges focus mostly on their rulings, but probing the “difference that difference makes” requires looking beyond judicial opinions. Courts in the United States have developed structural capacities to propose rules and legislation, create education programs, commission research and task forces, and lobby for resources. When women of all colors and men of color became lawyers and judges, they created affinity organizations and pressed courts to research court-based bias and to revise rules of ethics, doctrine, and practice. Those changes are part of the impact of diversification within the legal profession, as is the backlash against affirmative efforts to reform practices. Another difference of the last decades is that new rights have brought into court many claimants with limited means. Participatory participation remains elusive, while the “justice gap” is pervasive. Worse yet, in some jurisdictions, courts have served as “revenue centers,” using court-imposed assessments as income. Failure to pay “legal financial obligations” can result in suspension of driver’s licenses, the loss of voting rights, and other sanctions levied disproportionately on people who are poor and of color. Instead of being seen as fonts of fairness, courts are coming to be identified as sites of inequality. In addition, many courts have embraced alternative forms of dispute resolution that make both processes and outcomes less visible to the public. Through doctrine and rules, U.S. courts have shifted their own practices as well as enforced mandates imposed on consumers and employers that push them out of court and out of class or joint actions. In sum, the new faces on the bench ought not to obscure that the project of representation, inclusion, and equality is far from complete. The vivid inequalities in courts are problems for courts because such disparities undermine their ability to be places of justice. (shrink)

This article explores the role of deliberative democracy in political modernization and the dynamic relationship between civil society and the state. It aims to elucidate the essence of deliberative democracy as a mechanism for civil society’s influence on the state, and systematically analyze the conceptual studies of deliberative democracy in the context of civil society’s power potential, both in Ukraine and globally. The study reflects on the evolution of civil society, highlighting its transformation from a state-dominated concept to one of (...) parity with government institutions. The research emphasizes the significance of public discourse in legitimizing government decisions and examines the roles of various scholars in developing the concept of deliberative democracy.Deliberative democracy, a post-classical theory, is contrasted with electoral democracy, focusing on public discourse as a key legitimacy source for legislative acts. The paper delves into the historical origins of deliberation and deliberative democracy, crediting political scientist J.Bessette with coining the term. It discusses the critical elements of deliberative democracy, including public dialogue, rational discourse, and institutionalized exchange of opinions for decision-making. The model incorporates elements of representative, direct, and participatory democracy, highlighting its basis in public consultation and discourse.The article also examines various forms of the deliberative process, including open public discussions and behind-closed-doors exchanges, underscoring the importance of information, argumentation, and persuasion. It critiques the liberal interpretation of democracy and stresses the need for citizen involvement in governance, spotlighting the role of political civil society organizations in fostering democratic deliberation. (shrink)

As yet, there is no enactive account of social cognition. This paper extends the enactive concept of sense-making into the social domain. It takes as its departure point the process of interaction between individuals in a social encounter. It is a well-established finding that individuals can and generally do coordinate their movements and utterances in such situations. We argue that the interaction process can take on a form of autonomy. This allows us to reframe the problem of social cognition as (...) that of how meaning is generated and transformed in the interplay between the unfolding interaction process and the individuals engaged in it. The notion of sense-making in this realm becomes participatory sense-making. The onus of social understanding thus moves away from strictly the individual only. (shrink)

Ruth Chang has defended a concept of "parity", implying that two items may be evaluatively comparable even though neither item is better than or equally good as the other. This article takes no stand on whether there actually are cases of parity. Its aim is only to make the hitherto somewhat obscure notion of parity more precise, by defining it in terms of the standard value relations. Given certain plausible assumptions, the suggested definiens is shown to state (...) a necessary and sufficient condition for parity, as this relation is envisaged by Chang. (shrink)

In this article we address the social value of bioethics research and show how a participatory approach can achieve social impact for a wide audience of stakeholders, involving them in a process of joint moral learning. Participatory bioethics recognizes that research co-produced with stakeholders is more likely to have impact on healthcare practice. These approaches aim to engage multiple stakeholders and interested partners throughout the whole research process, including the framing of ideas and research questions, so that outcomes (...) are tailored to the interests and context, and the type of impact stakeholders envisage. There is an emphasis on realizing social change through the conduct of the research, and it is believed that the engagement of stakeholders in the research process will promote their intrinsic motivation to change their practice. Another distinctive feature of participatory bioethics research is that its central normative commitment is to reflection and dialogue, not to a particular substantive ethical approach. In reflection and dialogue there is an emphasis on inclusion and the co-production of knowledge. Furthermore, empirical and normative research are combined, and there is a deliberate attempt to give voice to otherwise marginalized positions. This provides a model of social impact which is relevant not only for bioethics research, but also for other areas of health care research. We will show the merits of a participatory approach to bioethics research with a case example. It concerns the reduction of coercion and in particular seclusion in Dutch mental healthcare. (shrink)

This paper begins with a response to Josh Gert’s challenge that ‘on a par with’ is not a sui generis fourth value relation beyond ‘better than’, ‘worse than’, and ‘equally good’. It then explores two further questions: can parity be modeled by an interval representation of value? And what should one rationally do when faced with items on a par? I argue that an interval representation of value is incompatible with the possibility that items are on a par (a (...) mathematical proof is given in the appendix). I also suggest that there are three senses of ‘rationally permissible’ which, once distinguished, show that parity does distinctive practical work that cannot be done by the usual trichotomy of relations or by incomparability. In this way, we have an additional argument for parity from the workings of practical reason. (shrink)

Ruth Chang has argued for the existence of a fourth positive value relation, distinct from betterness, worseness and equality, which she calls “parity.” In an earlier article I seemed to criticize Chang's suggestion by offering an interval model for the values of items that I claimed could accommodate all the phenomena characteristic of parity. Wlodek Rabinowicz, offering his own model of value relations, endorsed one central feature of my proposal: the need to distinguish permissible preferences from required ones. (...) But he, along with Chang, correctly pointed out that my own model suffered from serious formal problems. The present article offers an improved interval model, but the main point is not the model itself. Rather, it is the derivation of the model from a response-dependent account of practical rationality. This derivation helps explain why we have a concept for which Rabinowicz's model is appropriate, and therefore supplements Chang's existence arguments. My conclusion is that we can take Chang's view, Rabinowicz's and mine as providing a reinforcing set of views. (shrink)

On parity views of mere addition if someone is added to the world at a range of well-being levels – or ‘neutral range’ – leaving existing people unaffected, addition is on a par with the initial situation. Two distinct parity views – ‘rough equality’ and fittingattitudes views – defend the ‘intuition of neutrality’. The first can be interpreted or adjusted so that it can rebut John Broome’s objection that the neutral range is wide. The two views respond in (...) distinct ways to two of Broome’s other objections. Both views can, nonetheless, be plausibly defended against these objections. (shrink)

In the first part of this paper a relational account of incongruent counterparts is defended against an argument due to Kant. I then consider a more recent attack on such an account, due to John Earman, which alleges that the relationalist cannot account for the lawlike left--right asymmetry manifested in parity-violating phenomena. I review Hoefer's, Huggett's and Saunders' responses to Earman's argument and argue that, while a relationalist account of parity-violating laws is possible, it comes at the cost (...) of non-locality. (shrink)

This article explores the main similarities and differences between Derek Parfit’s notion of imprecise comparability and a related notion I have proposed of parity. I argue that the main difference between imprecise comparability and parity can be understood by reference to ‘the standard view’. The standard view claims that 1) differences between cardinally ranked items can always be measured by a scale of units of the relevant value, and 2) all rankings proceed in terms of the trichotomy of (...) ‘better than’, ‘worse than’, and ‘equally good’. Imprecise comparability, which can be understood in terms of the more familiar notions of cardinality and incommensurability, rejects only the first claim while parity rejects both claims of the standard view. -/- I then argue that insofar as those attracted to imprecise comparability assume that all rankings are trichotomous, as Parfit appears to, the view should be rejected. This is because imprecise equality is not a form of equality but is a sui generis ‘fourth’ basic way in which items can be ranked. We should, I argue, understand imprecise equality as parity, and imprecise comparability as entailing ‘tetrachotomy’ – that if two items are comparable, one must better than, worse than, equal to, or on a par with the other. Thus those attracted to the idea that cardinality can be imprecise should abandon trichotomy and accept parity and tetrachotomy instead. -/- Finally, I illustrate the difference between Parfit’s trichotomous notion of imprecise comparability and parity by examining how each notion might be employed in different solutions to the problem posed by the Repugnant Conclusion in population ethics. I suggest that parity provides the arguably more ecumenical solution to the problem. (shrink)

The principles of ontological parity and ordinality have distinct functions in Buchler's ontology. Ontological parity could be independently subscribed to, whereas ordinality signals the positive conception of the nature of reality as irreducibly complex or indefinitely related, which Buchler's metaphysical system seeks to articulate. Both principles inform Buchler's system, but each has a distinctive function. They are not, I suggest, necessarily at odds with one another, as some critics claim. I do identify several difficulties that follow from (1) (...) the level of generality claimed by Buchler and (2) the claim of irreducible complexity or indefinite relatedness. (shrink)

According to Ruth Chang the three standard positive value relations: “better than”, “worse than” and “equally good” do not fully exhaust the conceptual space for positive value relations. According to her, there is room for a fourth positive value relation, which she calls “parity”. Her argument for parity comes in three parts. First, she argues that there are items that are not related by the standard three value relations. Second, that these items are not incomparable, and third, that (...) the phenomena she has focused on are not due to the vagueness of the comparative predicates. This paper focuses on the second part of the argument and an objection is presented. By assuming the Small Unidimensional Difference Principle, which is a key premise for the second part of the argument, Chang’s argument could be accused of begging the question. More so, by assuming this principle, the space for incomparability gets severely limited. If these worries are justified, then Chang’s argument for parity as a fourth form of comparability is unsuccessful. (shrink)

This paper argues for the existence of a fourth positive generic value relation that can hold between two items beyond ‘better than’, ‘worse than’, and ‘equally good’: namely ‘on a par’.

I discuss the general form of arguments that profess to prove that the view that things endure in tensed time through causally produced change (the dynamic view) must be false because it involves contradictions. I argue that these arguments implicitly presuppose what has been called the temporal parity thesis, i.e. that all moments of time are equally existent and real, and that this thesis must be understood as the denial of the dynamic view. When this implicit premise is made (...) explicit, the arguments turn out to be either circular, they presuppose what they profess to prove, or mere demonstrations of the fact that the dynamic view is incompatible with its own negation. Furthermore, I discuss the metaphysical consequences of accepting the temporal parity thesis, arguing that it deprives us of the means to provide natural explanations to empirical phenomena. (shrink)

It is often supposed that, given two potential objects of choice X and Y, a specific set of circumstances, and a specific choosing agent, one of the following must be true: (1) opting for X is a better choice than opting for Y, (2) opting for Y is a better choice than opting for X, or (3) opting for X and opting for Y are exactly equally good choices. My aim in this paper is to show how some philosophical insights (...) concerning color perception can illuminate the possibility of two options, X and Y, being such that, even given a specific set of circumstances and a specific choosing agent, none of (1), (2), or (3) holds, but X and Y are positively related to one another as “on a par.”. (shrink)

The enactive approach to cognition distinctively emphasizes autonomy, adaptivity, agency, meaning, experience, and interaction. Taken together, these principles can provide the new sciences of language with a comprehensive philosophical framework: languaging as adaptive social sense-making. This is a refinement and advancement on Maturana’s idea of languaging as a manner of living. Overcoming limitations in Maturana’s initial formulation of languaging is one of three motivations for this paper. Another is to give a response to skeptics who challenge enactivism to connect “lower-level” (...) sense-making with “higher-order” sophisticated moves like those commonly ascribed to language. Our primary goal is to contribute a positive story developed from the enactive account of social cognition, participatory sense-making. This concept is put into play in two different philosophical models, which respectively chronicle the logical and ontogenetic development of languaging as a particular form of social agency. Languaging emerges from the interplay of coordination and exploration inherent in the primordial tensions of participatory sense-making between individual and interactive norms; it is a practice that transcends the self-other boundary and enables agents to regulate self and other as well as interaction couplings. Linguistic sense-makers are those who negotiate interactive and internalized ways of meta-regulating the moment-to-moment activities of living and cognizing. Sense-makers in enlanguaged environments incorporate sensitivities, roles, and powers into their unique yet intelligible linguistic bodies. We dissolve the problematic dichotomies of high/low, online/offline, and linguistic/nonlinguistic cognition, and we provide new boundary criteria for specifying languaging as a prevalent kind of human social sense-making. (shrink)

This article discusses the possibility of a rationally justified choice between two options neither of which is better than the other while they are not equally good either (‘3NT’). Joseph Raz regards such options as incomparable and argues that reason cannot guide the choice between them. Ruth Chang, by contrast, tries to show that many cases of putative incomparability are instead cases of parity—a fourth value relation of comparability, in addition to the three standard value relations ‘better than’, ‘worse (...) than’ and ‘equally good as’. It follows, she argues, that many choice situations in which rationally justified choice seems precluded are in fact situations within the reach of practical reason. This article has three aims: (1) it challenges Chang’s argument for the possibility of parity; (2) it demonstrates that, even if parity would exist, its problematic implications for practical reason would not differ from those of Raz’s incomparability; (3) it discusses the underlying cause of hard cases of comparison: the fact that none of the three standard value relations applies (‘3NT’). It will be shown that the problematic implications for the rational justification of the choice are due to 3NT itself, irrespective of whether 3NT is explained as incomparability or parity. (shrink)

Recent developments in theories for responsible innovation have focused on the importance of actively accounting for values in our technological designs. Leading among these theories is that of Value Sensitive Design which attempts to guide the design process on the basis of evaluative analysis. However, values often come into conflict and VSD has been criticized for not providing a proper method to resolve such inevitable conflicts. This paper examines three such methods and argues that although each has its merits, they (...) all fail to account for a common source of value conflicts known as value incommensurability. Drawing on literature from the field of axiology, this paper argues that by incorporating the evaluative relation of ‘parity’ each of these three methods, and the VSD framework in general, will be able to properly understand the relation which holds between conflicting design options stemming from the incommensurable of values and be able to guide designers in making rational decision in the face of such conflicts. (shrink)

The (moral) permissibility of an act is determined by the relative weights of reasons, or so I assume. But how many weights does a reason have? Weight Monism is the idea that reasons have a single weight value. There is just the weight of reasons. The simplest versions hold that the weight of each reason is either weightier than, less weighty than, or equal to every other reason. We’ll see that this simple view leads to paradox in at least two (...) ways. We must complicate the picture somehow. I consider two candidate complications. The first, Parity Monism, is inspired by Ruth Chang’s suggestion that parity is a fourth comparative beyond the traditional three (>, <, =). This view complicates the single weight relation by allowing that the weights of reasons can be on a par. Unfortunately, Parity Monism resolves only one of the two paradoxes that afflict simple versions of Weight Monism. To resolve both paradoxes, we need our second candidate complication, Weight Pluralism. This view holds that reasons have at least two weight values (e.g., justifying weight and requiring weight) and these two values aren’t always equivalent. Parity is no substitute for Pluralism. (shrink)

One response to Derek Parfit's invokes the relation of . Since parity is a form of in John Broome's terms, three doubts which Broome raises about accounts involving incommensurateness in Weighing Lives pose a challenge for this response. I discuss two of these. They emerge from a discussion of various intuitions about . I argue that an account based on parity may be no less consistent with Broome's intuitions than is his own vagueness view.

BackgroundExisting clinical ethics support (CES) instruments are considered useful. However, users report obstacles in using them in daily practice. Including end users and other stakeholders in developing CES instruments might help to overcome these limitations. This study describes the development process of a new ethics support instrument called CURA, a low-threshold four-step instrument focused on nurses and nurse assistants working in palliative care. MethodWe used a participatory development design. We worked together with stakeholders in a Community of Practice throughout (...) the study. Potential end users (nurses and nurse assistants in palliative care) used CURA in several pilots and provided us with feedback which we used to improve CURA.ResultsWe distinguished three phases in the development process. Phase one, Identifying Needs, focused on identifying stakeholder and end user needs and preferences, learning from existing CES instruments, their development and evaluation, and identify gaps. Phase two, Development, focused on designing, developing, refining and tailoring the instrument on the basis of iterative co-creation. Phase three, Dissemination, focused on implementation and dissemination. The instrument, CURA, is a four-step low-threshold instrument that fosters ethical reflection.ConclusionsParticipatory development is a valuable approach for developing clinical ethics support instruments. Collaborating with end users and other stakeholders in our development study has helped to meet the needs and preferences of end users, to come up with strategies to refine the instrument in order to enhance its feasibility, and to overcome reported limitations of existing clinical ethics instruments. (shrink)

Pareto principles are at the core of ethics and decision theory. The Strong Pareto principle says that if one thing is better than another for someone and at least as good for everyone else, then the one is overall better than the other. But a host of famous figures express it differently, with ‘not worse’ in place of ‘at least as good.’ In the presence of parity (or incommensurability), this results in a strictly stronger Pareto principle, which I call (...) Super‐Strong Pareto. Super‐Strong Pareto, however, yields cyclic betterness and is therefore false. I point out a number of influential arguments—concerning population ethics, collective action problems, and decision‐making in the face of parity and uncertainty—that crucially rely on Super‐Strong Pareto and are therefore unsound. I then turn to the most influential argument against the possibility of parity—Broome's collapsing argument—and argue that it likewise relies on Super‐Strong Pareto reasoning and is therefore question‐begging. Finally, I turn to the much‐neglected question of how to justify Strong Pareto. The answer I arrive at, which emphasizes tie‐breaking, yields a striking insight, namely that Super‐Strong Pareto amounts to the denial of insensitivity to mild sweetening. That is what makes it problematic in the presence of parity. (shrink)

It is shown how the 300 rays associated with the antipodal pairs of vertices of a 120-cell (a four-dimensional regular polytope) can be used to give numerous “parity proofs” of the Kochen–Specker theorem ruling out the existence of noncontextual hidden variables theories. The symmetries of the 120-cell are exploited to give a simple construction of its Kochen–Specker diagram, which is exhibited in the form of a “basis table” showing all the orthogonalities between its rays. The basis table consists of (...) 675 bases (a basis being a set of four mutually orthogonal rays), but all the bases can be written down from the few listed in this paper using some simple rules. The basis table is shown to contain a wide variety of parity proofs, ranging from 19 bases (or contexts) at the low end to 41 bases at the high end. Some explicit examples of these proofs are given, and their implications are discussed. (shrink)

Research question/aim/objectives Providing care for hospitalized children causes moral distress to nurses. Employee participation in discovering and solving the everyday problems of the workplace is one of the ways to hear the voices of nurses. This study aimed to evaluate the effect of participatory management programs on perceived organizational support and moral distress in pediatric nurses. Research design A quasi-experimental study. Participants and research context The present study was conducted on 114 pediatric nurses in Iran. Data were collected using (...) the Perceived Organizational Support Scale and the Moral Distress Scale of nurses. The intervention included implementing a participatory management program in three treatment departments that were randomly selected and it lasted 4 months. Participatory management was at the level of problem-solving with a focus on investigating, solving, and correcting issues and problems of work shifts and departments concerning the physical environment, equipment of the department, improvement of work processes, and team cooperation. In the control group, ordinary organizational approaches to problem-solving were used. Ethical considerations This study was approved by the Ethics Committee of Mashhad School of Nursing and Midwifery. Informed consent was obtained from the study participants. Findings/results Based on the results, both groups were homogenous before the intervention in terms of moral distress and perceived organizational support. The results showed that the moral distress mean scores in the intervention group decreased from 1.45 (0.52) to 1.03 (0.37) after the intervention. Also, the score of the perceived organizational support was 2.12 (1.2) increased after the intervention to 2.68 (1.10) in the intervention group. Conclusions It was found that the participation of nurses in the problem-solving process to solve daily workplace issues can be effective in increasing their perceived organizational support and reducing their moral distress. (shrink)

YOUNG L, and WHARF HIGGINS J.Nursing Inquiry2010;17: 346–358 Using participatory research to challenge the status quo for women’s cardiovascular healthCardiovascular health research has been dominated by medical and patriarchal paradigms, minimizing a broader perspective of causes of disease. Socioeconomic status as a risk for cardiovascular disease is well established by research, yet these findings have had little influence. Participatory research (PR) that frames mixed method research has potential to bring contextualized clinically relevant findings into program planning and policy‐making (...) arenas toward developing meaningful health and social policies relevant to primary prevention. In this article we provide an overview of a PR program that included two quantitative and one qualitative studies and then we discuss lessons learned. The PR process we found was empowering for lone mothers, and transformative for lone mothers and researchers. Further, PR as an approach to research opened spaces in practice and policy‐making arenas to raise upstream issues relevant to the health of low income lone mothers. We conclude that while PR is an effective approach to social determinants research, as a time‐intensive endeavor, and one that does not easily align with research tradition, researchers must consider the strengths and drawbacks of PR when planning to implement such an approach. (shrink)

This article shows that introducing the positive comparative relation parity only helps one block so‐called “Spectrum Arguments” in order to avoid their unsavoury implications if one specifies parity in a specific way with respect to its persistence. The article illustrates how parity must both admit of persistency and be weakly non‐persistent for parity to block Spectrum Arguments, and identifies some consequences of that discovery for the general debate on Spectrum Arguments, value theory and comparability problems.

Crispin Wright and Filippo Ferrari have accused relativism of not accounting for “parity” – the idea that, when we argue over matters of taste, we take our opponents’ opinions to be “as good as ours” from our own, committed perspective. In this paper, I show that i) explaining parity has not been taken to be a desideratum by relativists and thus they cannot be accused of failing to fulfil a promise; ii) Wright’s and Ferrari’s reasons for claiming that (...) parity should be a desideratum are unconvincing. (shrink)

To accomplish a just transition, energy scenarios is a helpful tool. Participatory and deliberative methods are increasingly used when constructing and assessing energy scenarios to improve the democratic legitimacy of the results. This article contributes to the scientific debate by analyzing how such methods can include considerations of justice issues in a more systematic manner. It is based on a study of four workshops conducted in Sweden, in which the participants discussed different energy scenarios from a justice perspective. It (...) discusses what can be achieved by methods for participatory-deliberative ethics assessment of the consequences of energy scenarios and how such methods should be designed. (shrink)

According to the moral error theory, all moral judgments are false. Until lately, most error theorists were local error theorists; they targeted moral judgments specifically and were less skeptical of other normative areas. These error theorists now face so-called “prudential parity objections”, according to which whatever evidence there is in favor of the moral error theory is also evidence for a prudential error theory. The present paper rejects three prudential parity objections: one based on the alleged irreducible normativity (...) of prudential reasons; another on the lack of a story about the normativity of hypothetical reasons; yet another on the very nature of reasons generally. I argue that these objections leave an important variant of a local moral error theory intact. (shrink)

In light of the proposed expansion of eligibility for physician aid in dying (PAD) in Canada to people with psychiatric disorders, there is a new subset of individuals seeking PAD—those with poverty-induced depression. The dominant account defending the expansion is known as the “parity argument.” Defenders of the parity argument maintain that the expansion of PAD to those with psychiatric conditions is needed to reflect that the seriousness of a patient's suffering does not depend on the cause of (...) that suffering. Parity accounts, as they stand, would allow cases of poverty-induced depression to qualify. I raise a moral dilemma that the parity theorist must face considering this new subset of cases—expanding access to PAD, without adequate social protections, could produce more social inequality by aiming to reduce it. I propose six recommendations that policy-makers should consider before expanding PAD given these cases, social injustice, and the social determinants of mental health. (shrink)

A diagrammatic representation is given of the 24 rays of Peres that makes it easy to pick out all the 512 parity proofs of the Kochen-Specker theorem contained in them. The origin of this representation in the four-dimensional geometry of the rays is pointed out.

One Berkeleyan case for idealism, recently developed by Robert M. Adams, relies on a seeming disparity between our concepts of matter and mind. Thomas Reid’s critique of idealism directly challenges the alleged disparity. After highlighting the role of the disparity thesis in Adams’s updated Berkeleyan argument for idealism, this chapter offers an updated version of Reid’s challenge, and assesses its strength. What emerges from this historico-philosophical investigation is that a contemporary Reidian has much work to do to transpose her objections (...) to Berkeley into good objections to Adams’s argument. (shrink)