Biomedical Engineering Reference
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between people. Hume excludes animals, people with severe mental or physi-
cal disabilities, and women from justice because they do not have more or less
the same capabilities as healthy men in the society in which they live. Humane
treatment of these outsiders would not be based on justice but on charity and
hence would be unreliable (Nussbaum 2006, pp. 51-55).
In his essay “Über den Gemeinspruch Das mag in der Theorie richtig sein,
taugt aber nicht für die Praxis” (1793) and in “Metaphysik der Sitten” (1797),
Kant makes a combination of moral philosophy and social contract thinking.
Nussbaum is interested in the tension inherent in his work, because Kant's
moral philosophical notion that people must always be treated as goal in
oneself and never as a means to an end is a core element of Rawls' theory of
justice. Kant's theory of the social contract is essentially the same as Locke's.
The natural state is characterized by natural, egalitarian freedom. The social
contract is closed when people opt for a state of distributive legal justice.
The contract is needed because justified claims are uncertain in the natural
state. It is not only beneficial but also morally right for all persons to join
the contract. In Kant's view, the free, equal, and independent contracting
parties are the same citizens whose lives are governed by the contract. He
distinguishes active and passive, dependent citizens. Only active citizens are
included in the contract and have political rights. Passive citizens are subor-
dinate to the state, but still have certain prepolitical human rights, includ-
ing freedom and equality. By requiring that contracting parties should be
approximately equal, Kant creates two classes of citizens. Some passive citi-
zens may become active citizens, but this does not apply to women and the
disabled (Nussbaum 2006, pp. 55-57).
Nussbaum insists on developing a broader concept of justice than assumed
by the social contract thinkers, but does not explain why she thinks “justice”
is more applicable to questions of dealing with the disabled, poor people
in developing countries, and nonhuman animals than concepts like “char-
ity.” Her capability approach is a political theory about basic rights, not an
all-encompassing moral theory, and not even a complete political theory
(Nussbaum 2006, p. 139). She assumes that the capabilities or basic rights
are already enclosed in the notion of human dignity and humane life. Her
theory converges with ethical contract thinking but does not assume mutual
benefit as driver for cooperation. Instead, benefits and goals of cooperation
are morally and socially inspired, and justice and participation are aims with
an intrinsic value. People are connected by altruistic bonds as well as by
mutual benefit. Whereas contract thinking is a procedural theory, the capa-
bility approach is aimed at results.
Nussbaum applies a political concept of the person as proposed by Aristotle:
the human being is a political animal, and strives for a social form of the
good, sharing complex goals with others on many levels. Her concept of dig-
nity is Aristotelian (rationality and animal nature are a whole), not Kantian
(humanity is opposed to animal nature; rationality is opposed to needs
shared by humans and animals). Nussbaum requires a theory of “the good”
