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)

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)

Suggestions for transforming ecological sustainability into operative social choice mechanisms can be viewed through the bifocal lens of limits on, and opportunities for, the ecological state. Using lines of reasoning brought in from the comparative study of environmental policy, this article tries to stake out how far the ecological state can go in pursuing objectives of sustainable development without intruding on values and objectives fundamental to democracy. The article discusses social choice mechanisms in terms of the ecological state's authority, management (...) capacities, effectiveness, and legitimacy, drawing up the image of the ecological state as a ' green fist in a velvet glove' with the ultimate objective of integrating 'ecological' evaluations into the public mind so that they become as 'natural' as those 'economic' criteria presently applied. Concluding that such 'ecological' consciousness involves a great leap in ecological information processing and dissemination within and throughout societies, the article invokes the sustainability and success of democratic social welfare states which base authoritative command on enlightened debate and deliberation as evidence that such a leap can be successfully made through processes of informed consensus. (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)

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)

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 last two decades have seen a heated debate between "halfers" and "thirders": those who believe Sleeping Beauty’s credence in a coin landing heads is 1/2 and those who believe it is 1/3 – as well as quite some alternative positions. This paper attempts to settle the debate in favour of thirdism. I present a new argument for thirdism which cannot be resisted using any of the previously used halfer strategies. My argument uses an analogy in which Sleeping Beauty has (...) a lucid dream on each day. To arrive at thirdism, she uses an unproblematic type of Bayesian conditionalisation, the principle of indifference, and the principal principle. I argue that all of these reasoning steps should be uncontroversial. Finally, I argue that all published defences of halfism are untenable. (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)

This book is a scholarly treatise on the nature of health presented in the form of a dialogue between an inquirer and a philosopher. It elaborates a holistic theory of health, according to which people are completely healthy if, and only if, they are able to realize all their vital goals, given reasonable circumstances. health is applied t practices, on particular areas of interest.

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.

This study aims at discovering the essential constituents involved in the experiences of guilt and shame. Guilt concerns a subject’s action or omission of action and has a clear temporal unfolding entailing a moment in which the subject lives in a care-free way. Afterwards, this moment undergoes a reconstruction, in the moment of guilt, which constitutes the moment of negligence. The reconstruction is a comprehensive transformation of one’s attitude with respect to one’s ego; one’s action; the object of guilt and (...) the temporal-existential experience. The main constituents concerning shame are its anchorage in the situation to which it refers; its public side involving the experience of being perceptually objectified; the exclusion of social community; the bodily experience; the revelation of an undesired self; and the genesis of shame in terms of a history of frozen now-ness. The article ends with a comparison between guilt and shame. (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)

Moore's paradox pits our intuitions about semantic oddness against the concept of truth-functional consistency. Most solutions to the problem proceed by explaining away our intuitions. But "consistency" is a theory-laden concept, having different contours in different semantic theories. Truth-functional consistency is appropriate only if the semantic theory we are using identifies meaning with truth-conditions. I argue that such a framework is not appropriate when it comes to analyzing epistemic modality. I show that a theory which accounts for a wide variety (...) of semantic data about epistemic modals (update semantics) buys us a solution to Moore's paradox as a corollary. It turns out that Moorean propositions, when looked at through the lense of an appropriate semantic theory, are inconsistent after all. (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)

This paper is a reply to an article by Steven Edwards in a previous issue of Theoretical Medicine and Bioethics. In this paper Edwards discusses two types of problems which he finds to be inherent in my theory of disability, mainly as presented in my On the Nature of Health, Kluwer 1995. First, Edwards discerns a tension in my basic definition of health, a tension between my “subjectivistic” and my “objectivistic” aspirations in the definition. Second, he finds that my theory (...) of disability does not allow for a distinction between disability due to illness or injury and disability which has no such (at least not immediate) background. In my answer to Edwards's arguments I claim that his first criticism must be due to a misunderstanding of my intentions. I find his second criticism to be more to the point. It raises important issues in the theory of health which partly concern our interpretation of the notion of illness. Edwards introduces the notion of capacity in order to separate between disability due to illness or injury and disability without such a background. In the last part of my paper I argue that this distinction, however, will not fulfil its purpose. (shrink)

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)

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

In an earlier paper by the author, Åqvist , I presented an approach to the logic of historical necessity, or inevitability, in the sense of a “two-dimensional” combination of tense and modal logic for worlds, or histories, with the same time order, known as T × W logic. Distinctive features of that approach were, apart from its two-dimensionality, its being based on discrete and finite time, and its use of so-called systematic frame constants in order to enable us to indicate (...) longitudes and latitudes of any points in the co-ordinate systems under consideration. This led us to study and axiomatize an infinite hierarchy HTWxy of two-dimensional modal tense logics with the characteristic operators for historical necessity and possibility added to the original basic vocabulary. The main purpose of the present paper is then twofold: to extend the logics HTWxy to the interesting branch of philosophical logic constituted by deontic logic as combined with tense logic; and to deal with a curious puzzle known as the so-called epistemic obligation paradox – a well known stumbling-block in this area of research in philosophical logic. We argue for a solution to both these problems, which appeals to a new infinite hierarchy DHTWxym of extensions of the HTWxy in the sense of logics combining dyadic deontic modalities with temporal ones such as those for historical necessity and other two-dimensional modalities. (shrink)

In this paper, we engage with the question of the normative content of the resilience concept. The issues are approached in two consecutive steps. First, we proceed from a narrow construal of the resilience concept – as the ability of a system to absorb a disturbance – and show that under an analysis of normative concepts as evaluative concepts resilience comes out as descriptive. In the second part of the paper, we argue that (1) for systems of interest (primarily social (...) systems or system with a social component) we seem to have options with respect to how they are described and (2) that this matters for what is to be taken as a sign of resilience as opposed to a sign of the lack of resilience for such systems. We discuss the implications of this for how the concept should be applied in practice and suggest that users of the resilience concept face a choice between versions of the concept that are either ontologically or normatively charged. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:On Concepts and Theories of AddictionLennart Nordenfelt (bio)Keywordsaddiction, disease, will power, autonomy, holistic view of healthThe article "A Liberal Account of Addiction" is a good piece of analytic philosophy applied to psychiatry. It is well-informed both with regard to empirical matters and philosophical conceptualization. The arguments are often—but, as I will show, not always—quite convincing. The conclusions of the paper also have crucial consequences for practice, for the treatment (...) of patients, and for social policy.The authors argue that current scientific understandings of the problem of addiction are fundamentally flawed. They distinguish between two main positions in science: The Disease View and the Willpower View. According to the Disease View, drug-seeking behavior is the direct result of some physiological change in the drug seeker's brain. According to the Willpower View, the addict is no longer rational; he or she uses drugs as a result of a fundamentally non-voluntary process.The authors dismiss the Disease View in the following way. They first note that drug addicts are in many ways rational planners. The addicts may have to think a lot to find the best ways to find the heroin, cigarettes, or alcohol, and they normally act according to this planning. They are not in any simple sense "caused" to act in a particular way. Moreover, referring to recent neurological literature, the authors note that the changes caused by drug addiction—which have to do with activating reward pathways in the brain—are identical with the outcomes of many other human activities that we do not call addiction. "In fact, any pleasurable experience causes dopamine to be released within the brain, activating these reward pathways" (Foddy and Savulescu 2010, 4). These experiences can be the result of coffee drinking, sexual activity, and physical exercise. Thus, the physical changes in the brain are not effects peculiar to the pharmacology of the drugs; they are instead the effects of the pleasure that the subject has experienced.The argument against the Willpower View is lengthy and more involved. The proponent of the Willpower View must argue that there is some flaw in the subject's autonomy. The drug addict is in some sense unable to avoid taking the drug. The authors of the present article scrutinize this idea on the basis of distinguishing between different senses of autonomy: Substantive autonomy and procedural autonomy. They state that we must here be talking about procedural autonomy, namely, autonomy regarded as dependent only on our capacity to process information and make choices in accordance with our preferences. We cannot, as in the case of substantive autonomy, require that the preferences themselves be reasonable. [End Page 27] In such a case, many of our ordinary actions would be judged non-autonomous.The most reasonable Willpower accounts rely on the idea that addicted people in some sense lack self-control. The authors cite different interpretations of the concept of lacking self- control and they conclude that "none of these … theories can say that addicts are necessarily lacking in self-control unless they also make unreasonable normative or false factual claims about the nature of drug- or pleasure-oriented choices" (Foddy and Savulescu 2010, 10). For instance, according to one interpretation the subject does not endorse his own desire for drugs, but takes the drug anyway. According to another interpretation, the addict regrets taking the drug after having done so. Against such claims the authors claim that many addicts indeed endorse their desires for drugs and many addicts do not regret their addictive behavior.So what is the positive account proposed by the authors? They put forward what they call a Liberal View. It contains three claims about addiction: First, we do not know whether an addict values anything more than the satisfaction of his addictive desires; second, we do not know whether an addict behaves autonomously when he uses drugs; and third, addictive desires are just strong regular desires.According to the Liberal View, one has to accept that the addicts may have drug taking as their highest priority and that they do not have any reduced procedural autonomy. The authors say: "Once we abandon normative bias, we must accept... (shrink)

The paper deals with certain issues with which Olivecrona was mainly concerned in his Philosophy of Law, notably (i) his views about the logical or syntactical form of imperatives as used in the law, and (ii) his views on the semantics of imperatives in the law and on the question whether and to what extent the notions of truth and falsity are applicable to those imperatives at all. In the light of an important critical notice of Olivecrona's work by Marc-Wogau (...) (1940 ), we examine some textual evidence for attributing to Olivecrona a so-called Atheoretical Thesis to the effect that imperatives in the law are neither true nor false or lack truth-value altogether. We close the paper by commenting on the celebrated distinction due to Hedenius (1941 ) and further elaborated by Wedberg (1951 ) between genuine ("rule-stating") normative sentences in the law and spurious ones (stating merely that a given rule is (or is not) in force in a given society at a given time). Two interesting difficulties bound up with that distinction will be dealt with. By means of various quotations we try to capture something of the flavour characterizing the legal philosophical discussion in Sweden in the mid-twentieth century during la belle époque of Scandinavian Legal Realism of which Olivecrona was a typical representative. (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)