Biomedical Engineering Reference
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whose behalf the contract is made, but excludes animals. Hobbes considers a
state form with a sovereign who has been handed over all powers as the only
attractive form of contract, enforcing security by imposing fear of punish-
ment. Anywhere outside the realm of such sovereigns is characterized by a
state of war (e.g., in international relations) (Nussbaum 2006, pp. 46-48).
John Locke's theory of the social contract contains several ideas used in
Nussbaum's capability approach. In the natural state, people are free, equal,
and independent. They are free in the sense that nobody rules over another
person and that each has the right to govern oneself. They are equal in the
sense that nobody has the right to rule over another person and that any
jurisdiction is mutual. They are independent in the sense that all people
have the right to further their own interests, without hierarchical relations.
People have similar physical and mental capabilities that are connected to
moral rights. Equal capabilities are sufficient grounds for a general status
of each person to be considered a goal in oneself, rather than as a means
to another end. Such equal capabilities also are a necessary precondition,
because animals, lacking the same capabilities, can be used as means to an
end according to Locke. Nussbaum does not include this in her theory. Locke
distinguishes binding moral obligations in his natural state, including the
obligation to maintain oneself and others, not to take another's life, and to
abstain from damaging another's freedom, health, or property. The principle
of moral equality leads to the obligation to charity and good will. A social
contract is not a precondition for moral reciprocity. Humans also have a nat-
ural dignity because they are created by God. They are entitled to a digni-
fied life, but are also needful and not able to realize such a life on one's own.
They have a natural tendency to look for community and fraternity with
others in political communities. Locke combines elements of a natural law
theory that are similar to Grotius' ideas. However, Locke has also formulated
the founding idea for the social contract. Even though the natural state is
not necessarily a state of war, nothing outside a political society can prevent
this natural state from falling into a state of war. Mutual benefit is the main
goal for which the contracting parties agree to accept the authority of laws
and institutions. Nussbaum builds upon the natural law elements in Locke's
work and criticizes the social contract ideas (Nussbaum 2006, pp. 48-51).
David Hume (1739-1740, 1751, 1777) describes the circumstances under which
justice is possible and necessary, inspiring Rawls. Hume bases his vision on jus-
tice on convention rather than contract thinking. Mutual benefit is again the key
to the emergence and continuation of justice. According to Hume, justice is only
possible in cases of a limited but not extreme lack of resources, where people
are simultaneously selfish and competitive, and charitable to some extent, yet
capable to impose limits to their behavior. He considers this to be the human
situation in reality. Egoism is not all-powerful, but kindness is unbalanced and
partisan, mostly in favor of one's own family and less favorable to more remote
relations. Justice is a convention whose usefulness depends on the physical
and psychological circumstances, including a global equality of capabilities
