This is the brisk summary I made of the reading for this week’s Mental Health Reading Group at UCLan, digging back to try to understand the recovery model after reading the Kim Hopper paper last time.
1 Introduction
Capability = the alternative things a person is able to do:
an ability to achieve various valuable ‘functionings’ as a part of living.
Contrasts with, eg.,
Personal utility: such as happiness or desire satisfaction.
Opulence: wealth
Negative freedoms
Equality of resources
Personal utility: such as happiness or desire satisfaction.
Opulence: wealth
Negative freedoms
Equality of resources
This paper is supposed to be a clearer account of the whole
approach.
2 Functionings,
capabilities and values
Functionings = the various things a person manages to do.
Some are basic / animal (being nourished). Others more complex (self-respect).
But variation in value attached to the latter. Hence the whole approach owes an
account of which functionings (and hence capabilities as ability to function) matter.
3 Value objects and
evaluative spaces
Despite this, it is useful to say what is valued (in this
case capabilities and functionings) even prior to ranking them. This already contrasts
with other approaches (eg welfarism) and does not attach intrinsic value to the
means of living. Though freedom will
play a role.
4 Capability and
freedom
The freedom live different kinds of life is reflected in a person’s set of capabilities.
Should freedom be assessed independently of what a subject values (ie the range
of things to value from which she can choose)? No: assessment of freedom
depends on what one can choose between. (Also adding bad extra options does not
increase freedom.)
5 Value purposes and
distinct exercises
How to assess capabilities? In accord with a subject’s
wellbeing? Or their broader ‘agency’ goals (which may not just be there
wellbeing) ie all that they have reason to aim at? Their achievements in
either, or their freedoms? Fourfold matrix. Re state intervention, wellbeing,
rather than agency gaols may be more important. For adults, freedom may be more
relevant to the state than achievement.
6 Wellbeing, agency
and living standards
Wellbeing achievement: concerns intrinsic functionings (so
doing good may be a source of wellbeing by affecting the person’s own being).
Vary from basic to complex. A subject’s being is constituted by their
functionings. Agency achievement is broader (and also broader than the person’s
own functioning). Living standard is narrower.
7 Why capability not
achievement?
Functioning achievement is a point (a vector?) of all the
distinction functionings. Capability is a set of points that could be selected.
If related, why pick latter?
1) May be interested in wellbeing freedom.
2) Freedom itself may be important for wellbeing achievement. (So removing even only the less valued alternatives may reduce wellbeing.) A ‘refined’ account of actual functioning may also take account of freedom (eg fasting <> starving).
1) May be interested in wellbeing freedom.
2) Freedom itself may be important for wellbeing achievement. (So removing even only the less valued alternatives may reduce wellbeing.) A ‘refined’ account of actual functioning may also take account of freedom (eg fasting <> starving).
8 Basic capability
and poverty
Basic capabilities are abilities to satisfy basic
functionings and addresses a problem with equality of commodities such as food
(given eg different metabolisms). No clear correlation between income and basic
capabilities. Also income not desired intrinsically. But locally and
derivatively basic incomes can be defined.
9 Midfare,
functionings and capability
Cohen: capability combines 2 elements: ability to do basic
things but also ‘midfare’ ie states of a subject produced by goods which
explains the values of utility levels eg. state of nutrition rather than food
supply. Midfare <> capability.
Sen: midfare = functionings not capability. Capability is
then the better measure (cf section 7) because of the connection to freedom in
even achieving wellbeing.
10 The Aristotelian
connections and contrasts
Nussbaum: Aristotle’s politics of dustribution of goods
starts with the question of the function of man and a life lived as a set of
activities. Cf capabilities.
But: for Aristotle, there is only one list of functionings
that constitute human good. Not incompatible with but not implied by Sen’s
view. Though commodity requirements vary between cultures, the valued capabilities
vary less but Sen is reluctant to commit to an objectivist picture of human
nature.
11 Incompleteness and
substance
Capabilities approach is a gappy general framework and
allows different weights to attach to functionings and hence capabilities. So
why leave it like this? Aim is agreement on framework before seeking agreement
on specific values (or... on the metaphysics of value). But even so, it has
different consequences from rivals (eg valuing utility, or primary goods
intrinsically).
Aside from some details of the account – such as how and why freedom could appear at two levels: a ground level functioning as part of well-being achievement but also at a higher level as a set of capabilities – discussion mainly focused on some issues Sen leaves open. For a recovery approach to mental healthcare, should the focus be well being or agency goals (all the things a subject can wish for)? And to what extent should we, and can we, expect agreement on what basic capabilities should be? Like the discussion of Hopper, this suggested a tension between a patient-centred approach stressing patient autonomy and a paternalistic account attempting to articulate what should count towards wellbeing.
PS: I first begin to include Sen in writing here.
Aside from some details of the account – such as how and why freedom could appear at two levels: a ground level functioning as part of well-being achievement but also at a higher level as a set of capabilities – discussion mainly focused on some issues Sen leaves open. For a recovery approach to mental healthcare, should the focus be well being or agency goals (all the things a subject can wish for)? And to what extent should we, and can we, expect agreement on what basic capabilities should be? Like the discussion of Hopper, this suggested a tension between a patient-centred approach stressing patient autonomy and a paternalistic account attempting to articulate what should count towards wellbeing.
PS: I first begin to include Sen in writing here.
