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)

Background: Since presenteeism is related to numerous negative health and work-related effects, measures are required to reduce it. There are initial indications that how an organization deals with health has a decisive influence on employees’ presenteeism behavior.Aims: The concept of health-promoting collaboration was developed on the basis of these indications. As an extension of healthy leadership it includes not only the leader but also co-workers. In modern forms of collaboration, leaders cannot be assigned sole responsibility for (...) employees’ health, since the leader is often hardly visible or there is no longer a clear leader. The study examines the concept of health-promoting collaboration in relation to presenteeism. Relationships between health-promoting collaboration, well-being and work ability are also in focus, regarding presenteeism as a mediator.Methods: The data comprise the findings of a quantitative survey of 308 employees at a German university of applied sciences. Correlation and mediator analyses were conducted.Results: The results show a significant negative relationship between health-promoting collaboration and presenteeism. Significant positive relationships were found between health-promoting collaboration and both well-being and work ability. Presenteeism was identified as a mediator of these relationships.Conclusion: The relevance of health-promoting collaboration in reducing presenteeism was demonstrated and various starting points for practice were proposed. Future studies should investigate further this newly developed concept in relation to presenteeism. (shrink)

A number of philosophers of medicine have attempted to provide analyses of health and disease in which the role that values play in those concepts is restricted. There are three ways in which values can be restricted in the concepts of health and disease. They can be: (i) eliminated, (ii) tamed or (iii) corralled. These three approaches correspond, respectively, to the work of Boorse, Lennox, and Wakefield. The concern of each of these authors is that if unrestricted values (...) are allowed to infect our concepts of health and disease, then anything could be construed as healthy or diseased. They believe that, if at all possible, such a result should be avoided. Unfortunately, as I argue, this result is unavoidable and such attempts to limit values in these concepts are destined to fail. I argue for this position by showing how each of these three attempts to provide value-restricted analyses of health and disease fail as analyses of the concepts of health and disease and that they fail because of their attempts to restrict the role of values in their accounts. I also show how, despite their best efforts, each of these analyses are, themselves, value-driven and value-laden. This leads to the conclusion that values infect our concepts of health and disease at all levels. (shrink)

This article presents a critique of the health promotion policy of Japan, which is based on an examination of the social importance of and justification for health promotion. This is done to suggest the proper direction that the future Japanese policy could take, and to question the adequacy of the term of ‘health promotion’. We find the ‘social progress’ characterization of the ‘Second Term of National Health Promotion Movement in the Twenty-First Century - Health Japan (...) 21 ’ to be problematic. While there are clear restraints found in terms of social costs related to the policy, the aims toward social justice provided by the policy are not clear. Considering the social importance and justification of health promotion, and the present conditions seen in Japan, we believe that it is necessary clearly to position health promotion as a form of social justice. Having said this, the term ‘health promotion’ is in itself misleading and can belie the range of activities required to action these policies. Therefore, we propose considering the selection of a different and more appropriate term for health promotion that concretely defines policies that actively work toward definitive health equity. (shrink)

The paper contrasts Lennart Nordenfelt’s normative theory of health with the naturalists’ point of view, especially in the version developed by Christopher Boorse. In the first part it defends Boorse’s analysis of disease against the charge that it falls short of its own standards by not being descriptive. The second part of the paper sets out to analyse the positive concept of health and introduces a distinction between a positive definition of health (‘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)

Bryan Norton proposes a "convergence hypothesis'* stating that anthropocentrists and nonanthropocentrists can arrive at common environmental policy goals if certain constraints are applied. Within his theory he does not, however, address the consideration ofnonconsequentualist issues, and, therefore, does not provide an argument for the convergence between consequentualist and nonconsequentualist ethical positions. In the case of biotechnology, nonconsequentualist issues can dominate the debate in both the fields of environmental ethics and bioethics. I argue that, the convergence hypothesis must be rejected when (...) tested against the case of biotechnology, and this limitation of convergence applies to any theory of reconciliation within the "health" concept because the achievement and preservation of "health "emphasizes a consequentualist outlook. I conclude that an inclusive ethics for ecosystem and human health should be explicit about this limitation. (shrink)

Ensuring well-being ahead of positive psychology aims at the treatment of individuals with psychological problems. Positive psychology contributes to the improvement of traumatic processes. But there is more to the field of study of positive psychology than that. In studies in this field, it has become important for individuals to be empowered with their own internal resources and to feel good with their values. The aim of this study is to determine the relationships between the concepts of (...) psychological well-being and consent. The main purpose of the concept of psychological well-being is to support the individual with its own values in a psychologically healthy life. These values strengthen individuals and contribute to mental health by helping regulate people's cognition, emotions and behaviours. Religion is full of values for a happy and peaceful life for the believers. Religious values have the potential to empower people, enhance their cognition, and provide psychological well-being. The concept of consent is contained many meanings such as; Accepting the result after making an effort to get what they want in life, being resilience against negative life events, being hopeful, being satisfied with the life he/she lives, to find inner peace, having good moral qualities and good morals. It has been determined that components such as acceptance of emotions arising from negative experiences, a meaningful life, life satisfaction, psychological resilience related to the concept of psychological well-being are included in the concept of consent among the religious concepts. In this paper, positive psychology and "consent", a religious concept, have been examined and suggested for positive psychology practices for individuals with faith in order to empower them with their own values. (shrink)

Sustainability, and the related concept of climate change, is an emerging domain within nursing and nurse education. Climate change has been posited as a serious global health threat requiring action by health professionals and action at international level. Anåker & Elf undertook a concept analysis of sustainability in nursing based on Walker and Avant's framework. Their main conclusions seem to be that while defining attributes and cases can be established, there is not enough research into sustainability (...) in the nursing literature. This paper seeks to develop their argument to argue that sustainability in nursing can be better understood by accessing non‐nursing and grey literature and, for example, the literature in the developing web‐based ‘paraversity’. Without this understanding, and application in nursing scholarship, nurses will have a rather narrow understanding of sustainability and its suggested links with social and health inequalities and the dynamics underpinning unsustainable neoliberalist political economy. This understanding is based on the social and political determinants of health approach and the emerging domain of planetary health. However, this is a major challenge as it requires a critical reflection on what counts as nursing knowledge, a reflection which might reject sustainability and political economy as irrelevant to much of nursing practice. (shrink)

Taking the title of his book from Isaiah Berlin's famous essay distinguishing a negative concept of liberty connoting lack of interference by others from a positive concept involving participation in the political realm, Samuel Fleischacker explores a third definition of liberty that lies between the first two. In Fleischacker's view, Kant and Adam Smith think of liberty as a matter of acting on our capacity for judgment, thereby differing both from those who tie it to the satisfaction (...) of our desires and those who translate it as action in accordance with reason or "will." Integrating the thought of Kant and Smith, and developing his own stand through readings of the Critique of Judgment and The Wealth of Nations, Fleischacker shows how different acting on one's best judgment is from acting on one's desires--how, in particular, good judgment, as opposed to mere desire, can flourish only in favorable social and political conditions. At the same time, exercising judgment is something every individual must do for him- or herself, hence not something that philosophers and politicians who reason better than the rest of us can do in our stead. For this reason advocates of a liberty based on judgment are likely to be more concerned than are libertarians to make sure that government provides people with conditions for the use of their liberty--for example, excellent standards of education, health care, and unemployment insurance--while at the same time promoting a less paternalistic view of government than most of the movements associated for the past thirty years with the political left. (shrink)

The emergence of key concepts in Reinhart Koselleck’s sense has been much discussed in conceptual history, but mainly for the eighteenth and nineteenth centuries. The article documents a post–World War II emergence of the concept of health, from relative anonymity to becoming a key concept, comparable to concepts such as politics, democracy, and culture. While previous research has emphasized conceptual mobility, this article focuses on conceptual aggregation, where the concept of health assembles and assimilates meanings, (...) becoming essential to discourse. This is explained with reference to the development of the welfare state and the political use of a positive, expanded health concept. The article utilizes a collocation analysis of Norwegian digitized newspapers 1950–2010, culled from the uniquely extensive database of the Norwegian National Library. (shrink)

In this paper we focus on some new normativist positions and compare them with traditional ones. In so doing, we claim that if normative judgments are involved in determining whether a condition is a disease only in the sense identified by new normativisms, then disease is normative only in a weak sense, which must be distinguished from the strong sense advocated by traditional normativisms. Specifically, we argue that weak and strong normativity are different to the point that one ‘normativist’ label (...) ceases to be appropriate for the whole range of positions. If values and norms are not explicit components of the concept of disease, but only intervene in other explanatory roles, then the concept of disease is no more value-laden than many other scientific concepts, or even any other scientific concept. We call the newly identified position “value-conscious naturalism” about disease, and point to some of its theoretical and practical advantages. (shrink)

This dissertation serves as a monograph on the moral and social implications of a utilitarian-based system of health care which recognizes and takes rights seriously. Though the design and claims are stated primarily in terms of utilitarianism, admittedly, there are elements of communitarian, deontological, and rights theories which have been incorporated. ;Such a commingling of theoretical elements, under the claim of being utilitarian, may seem ambiguous, however, it is my contention that such inclusions only serve to enhance the plausible (...) nature of this sphere-specific form of utilitarianism and the adjudication of rights. Additionally, though there are other components of theories included, the basis of utilitarianism still serves as the foundation by which all other actions, decisions, and values are judged. ;While it is true that utilitarianism offers a standard for all areas of life, the idea of examining a sphere or environment of utility, in this case, the utility associated with the sphere of health care, allows for the good to be clearly defined. One primary weakness of classical utilitarianism is that it ignores, or at least does not do full justice to, the notion of personal responsibility or sense of obligation. If the only duty or requirement is to produce some obscure sense of the "greatest good" or the "greatest happiness," the question of how the good is identified and who is to have the good remains unanswered by the traditional utilitarian construct. ;The classical view of utilitarianism is too broad in its scope of defining "the greatest good" or realm of value. But to narrow the area of value to a particular sphere or environment allows for the utility and associated rights in question to be identified, the value measured, and the success more easily interpreted. ;While maintaining the general premise of utilitarianism, that is, "the greatest good for the greatest number," the notion is not from some nebulous concept or subjective position about life or feelings in general. This sphere-specific position also acknowledges and defines the "rights" of the individual within the particular sphere being considered, in this case, the sphere of health care. (shrink)

This paper argues that the medical conception of health as absence of disease is a value-free theoretical notion. Its main elements are biological function and statistical normality, in contrast to various other ideas prominent in the literature on health. Apart from universal environmental injuries, diseases are internal states that depress a functional ability below species-typical levels. Health as freedom from disease is then statistical normality of function, i.e., the ability to perform all typical physiological functions with at (...) least typical efficiency. This conception of health is as value-free as statements of biological function. The view that health is essentially value-laden, held by most writers on the topic, seems to have one of two sources: an assumption that health judgments must be practical judgments about the treatment of patients, or a commitment to "positive" health beyond the absence of disease. I suggest that the assumption is mistaken, the commitment possibly misdescribed. (shrink)

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

Herbert Fingarette [1] argues that alcoholism is not a disease and that the alleged alcoholic under certain circumstances has the power to control his or her drinking disorders. I shall analyze Fingarette's argument and show that his position rests on some logical and conceptual confusions.In analyzing Fingarette's argument for the self-control theory of drinking disorders I conclude that it is problematic for the following reasons: (1) his argument assumes that the identification of a single cause of alcoholism is a necessary (...) condition of its being a disease; (2) unless it is already assumed (a priori) that persons with drinking disorders possess freedom and self-control to the extent that Fingarette assumes they do, then such persons are likely to suffer from apathy or defeatism regarding their condition; (3) even if Fingarette is correct in his criticism of certain health care programs for those with drinking disorders, it does not follow from this that certain theories about the possible causes of such disorders are false; (4) Fingarette's claim that those with drinking disorders are morally responsible for their actions that result from their disorders is problematic, that is, unless it can be shown that such persons act freely; and (5) Fingarette attempts to support the self-control theory of alcoholism by refuting a straw man conception of the disease model of alcoholism. (shrink)

The goal of this programmatic paper is to highlight a close connection between the core problem in the philosophy of medicine, i.e. the concept of health, and the core problem of the philosophy of mind, i.e. the concept of consciousness. I show when we look at these phenomena together, taking the evolutionary perspective of modern state-based behavioural and life-history theory used as the teleonomic tool to Darwinize the agent- and subject-side of organisms, we will be in a (...) better position to make sense of them both as natural phenomena. (shrink)

BackgroundThe positive component of Mental Health Literacy refers to a person’s awareness of how to achieve and maintain good mental health. Although explored recently, the term still lacks a clear definition among healthcare practitioners.AimTo identify the attributes and characteristics of PMeHL, as well as its theoretical and practical applications.MethodsLiterature search and review, covering the last 21 years, followed by concept analysis according to the steps described by Walker and Avant approach.ResultsPositive component of Mental Health Literacy (...) is considered one component of MHL, integrating positive mental health. The concept’s attributes include: competence in problem-solving and self-actualization; personal satisfaction; autonomy; relatedness and interpersonal relationship skills; self-control; and prosocial attitude. Four case scenarios were used to clarify the antecedents and consequences of PMeHL.ConclusionPositive component of Mental Health Literacy is considered a component of MHL, which deserves attention throughout the lifespan, in different contexts and intervention levels. Considering PMeHL as a multi-faceted and dynamic construct will help understand the mechanisms that improve mental health and promote healthy behaviors. Priority should be given to robust primary research focused on nursing interventions that enhance and sustain PMeHL in people and families. (shrink)

The article examines the patient-doctor relationship, relying on Michel Foucault’s concept of the clinical gaze. We argue that during the last decades, a profound transformation of the social nature of medicine took place, one that Foucault’s understanding of the clinical gaze cannot adequately account for. First, the article offers an elaboration of the three-node network of clinical gaze, the clinic, and nosology to explain the positioning of the doctor and the patient within the specific social ontology generated by the (...) rise of medicine. We then discuss intensive but irresolute developments brought by technological advancements, especially the X-ray tube. Finally, we argue that in the contemporary clinic, equipped with a plethora of sophisticated devices, the position of the doctor endured the most radical transformation in comparison with Foucault’s proponent of the clinical gaze at the dawn of modern medicine. (shrink)

Scientific advances in health care have been disproportionately distributed across social strata. Disease burden is also disproportionately distributed, with marginalized groups having the highest risk of poor health outcomes. Social determinants are thought to influence health care delivery and the management of chronic diseases among marginalized groups, but the current conceptualization of social determinants lacks a critical focus on the experiences of people within their environment. The purpose of this article was to integrate the literature on marginalization (...) and situate the concept in the framework of social determinants of health. We demonstrate that social position links marginalization and social determinants of health. This perspective provides a critical lens to assess the societal power dynamics that influence the construction of the socio‐environmental factors affecting health. Linking marginalization with social determinants of health can improve our understanding of the inequities in health care delivery and the disparities in chronic disease burden among vulnerable groups. (shrink)

Employee health is not only positively related to the employee well-being and family happiness, but also impacts organizations, and society as a whole. We searched the health-promoting leadership literature in the following databases: Web of Science, ProQuest, EBSCO, and a Chinese local database. Based on this research, we clarify the concept of health-promoting leadership, propose a definition of health-promoting leadership, and examine measurement scales for this type of leadership. We also suggest a research framework for (...) health-promoting leadership, demonstrating its potential outcomes at both the individual level and the organizational level ; the mechanisms for its development based on conservation of resources theory, the job demands–resources model, social learning theory, and social exchange theory; and antecedents. Finally, we identify six potential research areas: Research level, performance, the impacts of health-promoting leaders on themselves, moderators, research methods, and intervention effects on health-promoting leadership. (shrink)

In Western medicine the interpretation prevails that mental illness is a psychological and/or biological disorder. Most important concepts in health psychology, such as sense of coherence, self‐efficacy, hope, or dispositional optimism are all very cognition and individual centered. In this individualized perspective, mental illness is constructed in such a way that it can be treated in a dyadic doctor–patient or therapist–patient relationship with the help of drugs or therapeutic techniques. In this article, I would like to develop a contrasting (...) social construction of mental illness. In Umbanda and Candomblé temples in Brazil, what is interpreted in the Western model as illness is understood as a “spiritual problem.” Here, the individual is constructed in relationship to the community, and individual health and healing is footed in moral‐spiritual orders. In presenting the details of my investigation, I will apply Grawe’s common factors as a foil for developing the link between mental illness and its social context. (shrink)

Eli Feiring has developed a concept of forward-looking responsibility in healthcare. On this account, what matters morally in the allocation of scarce healthcare resources is not people's past behaviours but rather their commitment to take on lifestyles that will increase the benefit acquired from received treatment. According to Feiring, this is to be preferred over the backward-looking concept of responsibility often associated with luck egalitarianism. The article critically scrutinises Feiring's position. It begins by spelling out the wider implications (...) of Feiring's view. Against this background, it shows that (i) Feiring's distinction between backward-looking and forward-looking responsibility is incompatible with the Scanlonian notion of responsibility she apparently endorses; (ii) her favoured forward-looking notion of responsibility is subject to the objections levelled against the luck egalitarian view (whatever the strength of such objections). (shrink)

Dr Hillel Steiner in this reply to Elizabeth Telfer takes each of her arguments for different arrangements of a health service and examines them--'four positions which can be located on a linear ideological spectrum'--and adds a fifth which could have the effect of 'turning the alleged linear spectrum into a circle'. Underlying both Elizabeth Telfer's article and Dr Steiner's reply, the base is inescapably a 'political' one, but cannot be abandoned in favour of purely philosophical concepts. Whatever the attitude (...) of mind of the reader of these two papers to the provision of a health service, the stimulus to more careful assessments of our own National Health Service and its problems can only be good. (shrink)

Undoubtedly, technology continues to permeate the world at an unprecedented pace. The discipline of nursing is not alien to this phenomenon as nurses continue to employ various technological objects and applications in clinical practice, education, administration and research. Despite the centrality of technology in nursing, it has not been recognised as a metaparadigm domain of interest in the discipline of nursing. Thus, this paper sought to examine if technology truly reflected a metaparadigm domain using the four requirements posited by Fawcett. (...) Using these requirements, we examined the onto‐epistemology of technology in relation to nursing and conclude that technology potentially represents a distinct domain that intersects with nursing (particularly, from the humanities perspective). Also, technology encompasses some phenomena of interest to the discipline of nursing, demonstrates perspective‐neutrality, and is international in scope and substance albeit with some nuances which do not fit well with nursing onto‐epistemology. Put together, it is highlighted that technology intersects with the existing metaparadigm domains (person, health, environment and nursing) which positions it as a potential phenomenon of interest to the discipline of nursing requiring further work to articulate its position and role. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:“Though This Be Madness, Yet There Is Method in ’T”A Positive Account of MadnessValentina Cardella, PhD (bio)What does it mean to be mad? How can we define mental disorder? The question is still widely discussed among psychiatrists and philosophers, and what exactly distinguishes sanity and insanity remains unclear. Despite this lack of clarity, the common conceptualization of madness is that mental disorders are impairments in rationality: people with (...) mental disorders are generally believed to have impairments in reasoning and logic (Bermúdez, 2001; Edwards, 1981; Harvey, Watkins, Mansell, & Shafran, 2004).Yet, the result of this conception is that we fail to understand madness. We do not understand how, for example, schizophrenic patients can be more logical than healthy people in some reasoning tasks (Mellet et al., 2006; Owen, Cutting, & David, 2007), or delusional patients can be perfectly rational in defending their ideas (Cardella, 2020), or depressive people can be more realistic than non-clinical subjects (Moore & Fresco, 2012). In contrast, if we consider rationality as the core feature of sanity, we fail to understand sanity, too, because normal people exhibit many kinds of biases and heuristics, and thus irrationality is widespread in the general population (Bortolotti, 2020; Johnson-Laird, 2006; Evans, 2002; Kahneman, Tversky, & Slovic, 1982).In his paper, Garson focuses on Late Modern theorists of madness (Locke, Kant, Wigan, and Heinroth) to reframe the problem and provide a positive account of mental disorder. These authors contrast madness to idiocy, rather than sanity, and therefore their conception of madness is very different: “while idiocy is marked by the diminished, or even abolished, functioning of the reasoning power, madness is marked by its perverse functioning. The mad person “has” reason, but deploys it in a perverse, improper, or unseemly manner” (Garson, 2023, p. 286).In his reading of Late Modern authors, Garson provides a new ontology of mental disorder, that goes beyond an absence of reason, and has also political and social implications. Furthermore, he reminds us that every scientific discipline has its philosophical assumptions. In defining madness, [End Page 305] we cannot help but choose a contrasting class, and each choice will have very different consequences. Even if psychiatry is a medical discipline, which aims to endorse a neutral view of mental disorder, it is impossible for it to be unbiased and impartial. All the more so, for it has to deal with human suffering and fragility.But, in this article, there is one crucial question that remains unanswered. In his analysis of Late Modern theorization of madness, Garson comes to the conclusion that madness is marked by a perverse deployment of reason. Yet, who decides when reason is deployed in a perverse manner? While the lack of rationality is something that we can detect easily enough, the task of defining precisely what is an ‘improper’ or ‘perverse’ use of reason is much harder. In other words, it seems to me that, in replacing the ‘lack of rationality’ paradigm with ‘the perverse rationality paradigm,’ the question of what is madness still remains open, and, most important, some normative aspects remain necessary. To recognize when rationality is improperly used, we have to adopt an evaluative stance, which defines what a proper use of reason would be.Valentina [email protected] University of MessinaValentina Cardella Valentina Cardella is Associate Professor of Philosophy of Language at the University of Messina, Italy. Her research interests encompass cognitive sciences, philosophy of language, and psychopathology.The author reports no conflicts of interest.Commentary submitted on June 13, 2023Accepted on June 13, 2023ReferencesBermúdez, J. L. (2001). Normativity and rationality in delusional psychiatric disorders. Mind and Language 16, 457–93. Google ScholarBortolotti, L. (2020). The epistemic innocence of irrational beliefs. Oxford: Oxford University Press. Google ScholarCardella, V. (2020). Rationality in mental disorders: too little or too much? European Journal of Analytic Philosophy 16 (2), 13–36. Google ScholarEdwards, R. B. (1997). Mental health as rational autonomy. In Edwards, R. B. (ed.), Ethics of psychiatry: Insanity, rational autonomy, and mental health care. New York: Prometheus Books. Google ScholarEvans, J. (2002). Logic and human reasoning: an assessment of the deduction paradigm. Psychological Bulletin 128... (shrink)

This paper attempts to philosophically articulate empirical evidence on the positive effects of illness within the wider context of a discussion of the positive aspects of vulnerability. The conventional understanding holds that to be vulnerable is to be open to harms and wrongs; it is to be fragile, defenseless, and of compromised autonomy. In this paper, we challenge the assumption that vulnerability consists of nothing but powerlessness and dependence on others. This paper attempts to: (1) outline the theoretical (...) conceptualisation of the positive aspects of coping with illness, while simultaneously showing how these findings provide empirical support for some classical philosophical ideas; (2) influence a change in the manners in which the ill are usually perceived (as weak, dependent, robbed of a good life) and (3) point to the importance of modernising the prevalent biomedical conception of illness with the subjective dimension of health. Biomedical understanding of illness focuses on the vulnerable experience of the sufferer, suggesting the importance of philosophical additions. (shrink)

Both practitioners and scholars are increasingly interested in the idea of the human-centered organization. This term first appeared in the late 1950s and has gained attention in the last ten years. Awareness of the need for human-centeredness grew during the COVID-19 pandemic, in which many organizational leaders were compelled to focus on employee health, safety, and well-being. In this paper, we review and synthesize the rather fragmented scholarly and practitioner literature on human-centered organization (HCO) to develop an integrated definition (...) and framework. The 26 sources reviewed in depth indicate that the HCO construct is primarily utilized in two ways. First, human-centered design scholars and practitioners conceive of HCOs as employing human-centered design practices. The second discourse involves the humanistic management and culture literature, which conceives of HCOs as embodying humanistic values and cultures. After reviewing these separate discourses, we synthesize them in an integrated definition as well as framework of HCO. The framework starts from humanistic values such as dignity, well-being, and justice, which are pivotal in creating organizational practices characterized by a common good purpose, positive human experiences on the job, team structures to coordinate work, and participatory tools and approaches. (shrink)

Recent research in epidemiology has identified a number of factors beyond access to medical care that contribute to health disparities. Among the so-called socioeconomic determinants of health are income, education, and the distribution of social capital. One factor that has been overlooked in this discussion is the effect that stigmatization can have on health. In this paper, I identify two ways that social stigma can create health disparities: directly by impacting health-care seeking behaviour and indirectly (...) through the internalization of negative interpersonal judgments. I then argue that social arrangements that foster self-respect can reduce the impact of stigmatization on health disparities. I conclude by showing how John Rawls' conception of justice can be used to address the intersection of stigma, health, and self-respect, in contrast to critics of his position, who have seen him as excessively focused on the allocation of material goods. (shrink)

In this article, we suggest that the evidence regarding the social determinants of health calls for a deep re‐thinking of our understanding of distributive justice. Focusing on John Rawls's theory of distributive justice in particular, we argue that a full reckoning with the social determinants of health requires a re‐working of Rawls's principles of justice. We argue first that the social bases of health – a Rawlsian conception of the social determinants of health – should be (...) considered a social primary good. We argue second that including the social bases of health as a social primary good would lead the parties to the original position to choose an additional principle of justice and assign it lexical priority over Rawls's second principle. According to this principle, inequalities in people's share of the social bases of health are to be arranged so as to improve the health status of those least advantaged on the social health gradient. -/- . (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)

There are positive views towards use of science and technology in all Asian countries, and positive views towards use of enhancement in China, India and Thailand. After considering of the widespread use of cosmetic surgery and other body enhancements in Asian countries, and the generally positive views towards letting individuals make choices about improvement of themselves, the paper concludes that we can expect other enhancements to also be adopted rapidly in Asia. There will be future ethical dilemmas (...) emerging from this with concepts of preservation of nature, flow with nature, and definitions of human-ness, along with concepts of harmony and social justice. Japan is less willing to engage in genetic enhancement compared to China, India and Thailand, despite widespread cosmetic surgery across Asia. (shrink)

Traditional health sciences (including nursing) paradigms, conceptual models, and theories have relied heavily upon notions of the ‘person’ or ‘patient’ that are deeply rooted in humanistic principles. Our intention here, as a collective academic assemblage, is to question taken‐for‐granted definitions and assumptions of the ‘person’ from a critical posthumanist perspective. To do so, the cinematic works of filmmaker David Cronenberg offer a radical perspective to revisit our understanding of the ‘person’ in nursing and beyond. Cronenberg's work explores bodily transformation (...) and mutation, with the body as a fragile and malleable vessel. Cronenberg's work allows us to interrogate the body in all its complexity, contingency, and hybridity and provides avenues of rupture within current understandings of ‘the person’. Reinventing the definition of what it means to be human, critical posthumanism offers opportunities to both critique humanist theories and build affirmative futurities. Also drawing on the work of Deleuze and Guattari, specifically, their concept of becoming, we propose a critical posthumanist alternative to the conceptualization of the person in the health sciences, that of the becoming‐mutant, so frequently explored in Cronenberg's films. Such a conceptualization permits the inclusion of various technological interventions of the contemporary subject: The postperson. This position offers the health science disciplines a radical reconceptualization of the conceptual and theoretical approaches, extending beyond those trapped within the quagmire of humanistic principles. (shrink)

This book is aimed at providing the reader with a systematic overview of the concepts of health and disease as utilized in various areas of the health sciences. It attempts to provide some historical background to modern models of health and disease. Special attention is given to controversial topics such as the notion of "mental health." the volume contains a number of new papers on health and disease by physicians, philosophers and others.

This article defends the public funding of abortion in the Canadian health care system in light of objections by opponents of abortion that the procedure should be denied public funding. Abortion opponents point out that women terminate their pregnancies most often for social reasons, that the Canadian health care system only requires funding for medically necessary procedures, and that abortion for social reasons is not medically necessary care. I offer two lines of response. First, I briefly present an (...) argument that characterizes abortion sought for social reasons as medically necessary care, directly contesting the anti-abortion position. Second, and more substantially, I present a justice argument that shows that even if abortion is not regarded as medically necessary care, the reasons that typically motivate women to seek abortion are sufficiently weighty from the moral perspective that it would be unjust to deny them public funding. I finish by drawing the more general conclusion that health care funding decisions should be guided by a broader concept of necessary care, rather than by a narrow concept of specifically medical necessity. A broad concept of necessary care has been debated in health care policy in the Netherlands, and I suggest that such a concept would be a more just and defensible guide for funding decisions than the concept of medical necessity. (shrink)

Background Concepts of health have been widely discussed in the philosophy and ethics of medicine. Parallel to these theoretical debates, numerous empirical research projects have focused on subjective concepts of health and shown their significance for individuals and society at various levels. Only a few studies have so far investigated the concepts of health of non-professionals and professionals involved in long-term home care and discussed these empirical perspectives regarding moral responsibilities. Objectives To identify the subjective concepts of (...) the health of non-professionals (care recipients, informal caregivers) and professionals (registered nurses) involved in long-term home care and to discuss them against the background of existing normative guidelines addressing non-professionals and professionals’ responsibilities and rights concerning health. Research design A qualitative design was chosen to explore subjective concepts of health. Data were collected by semi-structured interviews; content analysis was applied according to Mayring. Participants and research context Twenty-eight interviews were conducted with non-professionals and professionals in long-term home care arrangements in Northern Germany. Ethical considerations Ethics approval was obtained from the Institutional Review Board at the University Medicine Greifswald (BB123/16). Findings Non-professionals and professionals consider health as a capability that enables them to participate in social activities and live their own lives according to their preferences. The former regard health particularly as a feeling and an attitude, the latter as the absence of disease with a focus on mental and emotional well-being. Both groups highlight the unsurpassable value of health and the personal responsibility for it. Discussion Normative guidelines applicable to practice in long-term home care discuss responsibilities and rights unevenly and raise several problems regarding non-professionals and professionals’ subjective concepts of health. Conclusion Individuals’ concepts of health are relevant for the subsequent interpretation of rights and responsibilities and should, thus, be reflected upon to address health-related needs effectively. (shrink)

The aim of this study is to develop a valid and reliable measurement tool for determining students' spiritual health and life orientation. For this purpose, the Spiritual Health and Life-Orientation Measure (SHALOM) inventory developed by Fisher (2010) is adapted to Turkish. The adaptation study was carried out on 1591 high school students in three study groups studying in Ankara and Muş. The original English measure consisting of four dimensions and twenty items was translated into Turkish, factor analysis, validity (...) and reliability tests were conducted on the sampling data. As a result of the study, the Turkish-adapted inventory consists of four dimensions (personal, social, environmental and transcendental) which resemble the original inventory. In addition, internal consistency coefficients of the inventory dimensions were in perfect harmony with the original inventory and served the purpose of the scale. In Conclusion The Turkish adaptation of the SHALOM Inventory can be used in different disciplines of psychology, educational sciences, and social sciences. Summary: The concept of religion, which is an important dynamic and carrier of the social field, has gone into a double distinction since the second half of the 18th century; the concept of spirituality has begun to be refined from the concept of religion. The concepts of religion and spirituality are very difficult to define; While the concept of religion focuses ideology and rules of belief, spirituality centers on individual experiences and interrelationships that extend religion. For this reason, different spirituality and religion definitions are made from different perspectives and different spirituality scales were developed within this framework. However, the results of these studies differ significantly from each other; this means that spirituality was defined and conceptualized based on the scale that was used. Early period studies on spirituality mostly focus on religion, health, psychology and work life. In these studies, after defining the concept of spirituality; the relationship between the concept and health, religion, psychology and business life or necessity for human life is discussed. In the West, until the 1950s, the concepts of religion and spirituality were used interrelated. However, today these two concepts are almost completely separated from each other.Literature consists of numerous inventory development studies to measure spirituality. The fact that the inventory works based on different conceptual foundations makes it difficult to draw a general, meaningful and consistent conclusion about spiritual health and life orientation. Furthermore, spirituality measurements reflecting the religion and values ​​of a particular culture cannot be comprehensive or universal. At this point, Fisher criticizes the measurement tools developed for the purpose of measuring spirituality: in terms of "mixing religion and spirituality", "relying on the world of values", "not taking into account cultural differences", "and questioning only the mystical/spiritual experience". As a result, it can be said that no measurement developed in the conceptual structure of the West does not take into account the cultural flexibility and accept its spiritual values as universal or prevalent.The SHALOM inventory developed by Fisher, which adapted to the Turkish culture in present study, is based on four basic (individual, social, environmental and transcendent) areas that constitute the world of interpersonal relationship. In this study, spirituality, as in Fisher's work, emphasizes the interaction with certain concepts of different intensities that are considered as independent from religion and above religions. In this context, the concept of spirituality communicates with one's personal space, social position, nature, and transcendental power. This adaptation study will provide useful information and comments on the students' spiritual health levels. This is the most important motive behind the idea of adapting the SHALOM inventory developed by Fisher to the Turkish culture. In addition, by adapting the SHALOM inventory, which is emphasized to have cultural flexibility and adapted to different languages, a new and different measurement tool will be available to understand the nature of the concept of spirituality.This research was carried out to adapt the inventory of Spiritual Health and Life Orientation scale developed for students to Turkish culture. This inventory adaptation study was performed with the data collected from three working groups in Ankara and Muş provinces and 1591 high school students. The first study group was carried out with 414, the second study group with 788, and the third group with 389 high school students. While the data collected from 414 students were used for Exploratory Factor Analysis (AFA) analysis, data collected from 788 students were used for Confirmatory Factor Analysis (CFA). In addition, 389 students were used to determine the criterion validity of the inventory. The original language of the SHALOM inventory, which is intended to be adapted into Turkish, is English, and translation studies are conducted separately by three linguistic experts who know the grammar and semantic characteristics of both languages. After the translation studies, the scale was applied to the sampling group and AFA was performed on the sample data. The AFA results showed that a factor roof resembling the original inventory was formed. Determining factors are given appropriate names (personal, enviromental, social and transcendental) by taking into consideration the theoretical names and the dimension names in the original form of the SHALOM. The structure was confirmed by DFA, and as a result of the DFA, X2/sd (1.72) ratio and IFI (0.96) fit indicator was found to be the appropiate fit for the model tested. As a result, it is understood that the Spiritual Health and Life Orientation Inventory consists of four dimensions as in the original inventory, the internal consistency coefficients of the inventory dimensions are in harmony with the original inventory and serve the purpose of the scale. In conclusion the Turkish adaptation of the SHALOM Inventory can be used in different disciplines of psychology, educational sciences, and social sciences. Spirituality should not only be defined within the framework of Western theories, but the nature and likelihood of the spirituality predicted by Islam should be discussed. Moreover, the types and dimensions of Islamic spirituality should be determined by taking into account the cultural subjectivity of an Islamic character. In the study of spirituality, the human model which modernity presents universally should not be accepted as the only truth. It should be tried to develop human models that come from Islamic culture and history and which are specific to us and define us. This should be taken into account not only in mental health / religious studies, but also in psychology of religion in general. In addition, culture-specificity should be given importance, and the experience gained from the cultural accumulation developed by the Turkish civilization with the Islamic doctrine should lead to the studies of spirituality. In this respect, this study aims to adapt the value and spiritual orientation of a different culture to Turkish culture, but it is problematic to construct the concept with Western values. Although Western values are similar to Islamic values and principles, it is envisaged that it may be difficult to measure the concept of spirituality in practice. (shrink)

Professionals within the mental health services face many ethical dilemmas and challenging situations regarding the use of coercion. The purpose of this study was to evaluate the significance of participating in systematic ethics reflection groups focusing on ethical challenges related to coercion. In 2013 and 2014, 20 focus group interviews with 127 participants were conducted. The interviews were tape recorded and transcribed verbatim. The analysis is inspired by the concept of ‘bricolage’ which means our approach was inductive. Most (...) participants report positive experiences with participating in ethics reflection groups: A systematic and well-structured approach to discuss ethical challenges, increased consciousness of formal and informal coercion, a possibility to challenge problematic concepts, attitudes and practices, improved professional competence and confidence, greater trust within the team, more constructive disagreement and room for internal critique, less judgmental reactions and more reasoned approaches, and identification of potential for improvement and alternative courses of action. On several wards, the participation of psychiatrists and psychologists in the reflection groups was missing. The impact of the perceived lack of safety in reflection groups should not be underestimated. Sometimes the method for ethics reflection was utilised in a rigid way. Direct involvement of patients and family was missing. This focus group study indicates the potential of ethics reflection groups to create a moral space in the workplace that promotes critical, reflective and collaborative moral deliberations. Future research, with other designs and methodologies, is needed to further investigate the impact of ethics reflection groups on improving health care practices. (shrink)

Would a “medicalization” of love be a “good” or “bad” form of medicalization? In discussing this question, Earp, Sandberg, and Savulescu primarily focus on the potential positive and negative consequences of turning love into a medical issue. But it can also be asked whether there is something intrinsically regrettable about medicalizing love. It is argued here that the medicalization of love can be seen as an “evaluative category mistake”: it treats a core human value as if it were mainly (...) a means to other ends . It is also argued that Earp et al’s closing argument can be seen as involving another evaluative category mistake: it treats an object of desire and practical interest as if it mainly were an object of scientific contemplation and theoretical interest. It is concluded that, to relate love to health and well-being in a more satisfying way, we should construe the latter two in broader ways, whereby love is itself a component or element of human flourishing. (shrink)

Linkage arguments, which defend a controversial right by showing that it is indispensable or highly useful to an uncontroversial right, are sometimes used to defend the right to health care. This article evaluates such arguments when used to defend RHC. Three common errors in using linkage arguments are neglecting levels of implementation, expanding the scope of the supported right beyond its uncontroversial domain, and giving too much credit to the supporting right for outcomes in its area. A familiar linkage (...) argument for RHC focuses on its contributions to the right to life. Among the problems with this argument are that it requires a positive conception of the right to life that is not uncontroversial and that it only justifies the subset of RHC that seeks to prevent loss of life. A linkage argument for RHC with better prospects claims that a well-realized right to health care enhances the realization of a number of uncontroversial rights. (shrink)

Applying equity to health care is difficult and it is especially challenging when applied to cases that involve urgent military medicine care under resource scarcity. Part of the difficulty centers on the concept of equity itself. It is not clear what the best concept of equity applicable to medical care would be, or that there should be only one, or the same ones, across all levels of military health care. Despite the fact that equity is a (...) key concern in health care, particularly in the age of the COVID-19 pandemic, it may be that there is no single theory of justice that would be most justified for military physicians to use. This paper examines whether a hybrid position of equity might be both theoretically robust and applicable in practice. After briefly introducing the discussion, we outline four major philosophical definitions of equity – (1) Egalitarianism, (2) Prioritarianism, (3) Desertism, and (4) Sufficientism. We then report empirical findings suggesting that a practice-based hybrid concept of equity is used by physicians within the practice of micro-allocation. Our findings will shed lights on ethical justifications and reasoning which should guide medical rules for military and humanitarian health care providers. (shrink)

Bengt Brülde in his article ``The Goals of Medicine. Towards a Unified Theory'' has proposed a normative theory of the goals of medicine within which the concept of quality of life plays a crucial role. In Brülde's analysis, however, the very concept of medicine is deliberately left quite vague and it is therefore difficult to see how the goals of medicine are related to the goals of closely allied enterprises such as health promotion and social welfare. In (...) this reply I therefore propose an analysis of these related conceptual areas. I do this mainly in two respects. Following the nomenclature in a previously published article I propose a systematic conceptual framework for all varieties of health enhancement and distinguish different notions of medicine within this framework. A consequence of this analysis is, for instance, that the means and also the immediate goals of medicine in its broadest sense are more diversified than the means and immediate goals of medicine in its narrowest sense. From this position I expand the topic further by comparing medicine and health enhancement with social welfare and try to trace the basic features between – as well as the common properties of – these different enterprises. (shrink)

In their response to ‘Public interest in health data research: laying out the conceptual groundwork’, Grewal and Newson critique us for inattention to the law and putting forward an impracticably broad conceptual understanding of public interest. While we agree more work is needed to generate a workable framework for Institutional Review Boards/Research Ethics Committees, we would contend that this should be grounded on a broad conception of public interest. This broadness facilitates regulatory agility, and is already reflected by some (...) current frameworks such as that found in the guidelines approved under Australia’s Privacy Act. It remains unclear which elements of our broad account Grewal and Newson would reject, or indeed where the substantive disagreement with our position lies. (shrink)

Philosophical discussions of health and disease have traditionally been dominated by a debate between normativists, who hold that health is an inescapably value-laded concept and naturalists, such as Christopher Boorse, who believe that it is possible to derive a purely descriptive or theoretical definition of health based upon biological function. In this paper I defend a distinctive view which traces its origins in Aristotle's naturalistic ethics. An Arisotelian would agree with Boorse that health and disease (...) are ubiquitous features of the natural world and thus not mere projections of human interests and values. She would differ from him in rejecting the idea that value is a non-natural quality. I conclude my discussion with some comments of the normative character of living systems. (shrink)

How are the contemporary conceptions of the living body and health related to numerical systems? Addressing the contemporary practice of quantification of bodies and health, such a question is bound to arise. As a discipline historically positioned amidst natural sciences, technology, and art, medicine has always been sensitive to theories and apparatuses able to quantify and reshape the living body, as well as to the practical possibility of operating on it. This is why, in the era where telecommunication, (...) algorithmic information technology, and data-driven decision making are reaching their apex, new forms of medical practice, and new alliances between medicine and technology are emerging as a direct consequence of the evolution of technology. This is what was particularly aimed at by the International Congress "The Quantification of Bodies. Organism, Health, and Representation", which took place at the University of Coimbra on 28-29 November 2019, organized by the IEF - Institute for Philosophical Studies. The present book collects some of the papers presented there, selected according to their interdisciplinary approach and/or to their more informative nature, suitable even for non-specialist readers. A collection that reflects, in a fragment, many of the potentialities opened by this new field of studies. (shrink)

Product-harm crises can trigger product recalls or product discards, which is very likely to cause secondary pollution to the environment. Also, these crises may harm customers’ health and threaten firms’ survival. To foster low-carbon economy and green development in such complex systems, this paper studies the internal mechanism of the product crisis and its impact on the firm value. It proposes a two-stage model to avoid the endogeneity of product-harm crises. In the first stage, this paper assesses the effect (...) of firms’ leverage on their capacity to produce higher quality products. In the second stage, this paper conducts the impact of these crises on stock prices. Then, it depicts the financial effects of product-harm crises over time, and analyzes the differences of such effects based on brand equity. Results show that book leverage can positively impact firms’ capacity to produce high-quality products. In addition, the market’s response to product-harm crises is significant at 1% level, and with the increase in severity, the market reaction is more prominent. Furthermore, its negative effect is persistent for a firm experiencing a severe crisis. Luckily, brand equity can mitigate this negative impact. These findings provide some ways to improve product performance and firm value in the green context. (shrink)

The author proceeds from empirical basis to show how far the two Rawls's principles of justice can be implemented in Africa. Positions not only of Rawls but also of other philosophers are presented, reconstructed and commented. They are also opposed with critiques and other theories, so that the appropriate position for Africa can be explained. The author comes to the conclusion that the fundamental liberties are still in the making in Africa. A long colonial past and Aparthied have deprived Africa (...) from its blossoming. However, a groping democracy of full hope is pointing ahead. So that freedom and democracy gain more room the author suggests the establishment of federalism based on ethnic groups. To speak of democracy and freedom without a substantial economic support seems illusive. In order to improve the lot of the least advantaged the author proposes betterment of education and health. (shrink)

This paper defends a distinctly liberal approach to public health ethics and replies to possible objections. In particular, I look at a set of recent proposals aiming to revise and expand liberalism in light of public health's rationale and epidemiological findings. I argue that they fail to provide a sociologically informed version of liberalism. Instead, they rest on an implicit normative premise about the value of health, which I show to be invalid. I then make explicit the (...) unobvious, republican background of these proposals. Finally, I expand on the liberal understanding of freedom as non-interference and show its advantages over the republican alternative of freedom as non-domination within the context of public health. The views of freedom I discuss in the paper do not overlap with the classical distinction between negative and positive freedom. In addition, my account differentiates the concepts of freedom and autonomy and does not rule out substantive accounts of the latter. Nor does it confine political liberalism to an essentially procedural form. (shrink)

Mobile health services have been widely used in medical services and health management through mobile devices and multiple channels, such as smartphones, wearable equipment, healthcare applications, and medical platforms. However, the number of the users who are currently receiving the mHealth services is small. In China, more than 70% of internet users have never used mHealth services. Such imbalanced situation could be attributed to users’ traditional concept of medical treatment, psychological factors and privacy concerns. The purpose of (...) this study is to explore the direct and indirect effects of mHealth users’ self-efficacy and privacy concerns on their intention to adopt mHealth services, providing guidelines for mHealth service providers to enhance users’ intention of adoption. A questionnaire was designed by the research team and 386 valid responses were collected from domestic participants in China. Based on the unified theory of acceptance and use of technology model, a research model integrated self-efficacy and privacy concerns was constructed to investigate their effects on users’ intention to adopt mobile mHealth services. The results show that self-efficacy could facilitate users’ intention to adopt mHealth services, and had a significantly positive effect on perceived ubiquity, effort expectancy, performance expectancy and subjective norm. This study verifies the direct and indirect effects of self-efficacy and privacy concerns on users’ intention to adopt mHealth services, providing a different perspective for studying mHealth adoption behavior. The findings could provide guidelines for mHealth service providers to improve their service quality and enhance users’ intention of adoption. (shrink)