The Quality of Life.

by Martha Nussbaum; Amartya Sen

Review by: James P. Sterba
Ethics, Vol. 105, No. 1 (Oct., 1994), pp. 198-201
Published by: The University of Chicago Press
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198 Ethics October1994
threats," as suggested by James Sterba, David Lewis, and Anthony Kenny, is
particularly acute. After a lengthy weighing of pros and cons, Lee settles for
the most minimal form of minimum deterrence.
Given the abstract form of Lee's presentation, the recommendation for
minimum deterrence must stand as a recommendation not for the United
States alone but for nation-states in general. It seems to follow, then, from
Lee's argument that all 138 presently existing states should set about devel-
oping their own minimum nuclear deterrents. Strategists like Gallois have so
recommended, but the utilitarian case against a world of nuclear states is
overwhelming. Perhaps Lee's conflict between morality and prudence can only
be transcended by some scheme for internationalizing nuclear weapons, but
none is pursued in Lee's text.
Most of Lee's discussions involve two nuclear powers confronting each other
over an extended period of time. Will this be the primary form of nuclear
confrontation in the post-Cold War epoch? Perhaps. But then again, the pri-
mary form might be between nuclear powers and nonnuclear powers (like the
United States and Iraq) or between nuclear powers (like India and Pakistan) that
do not have the resources to choose complex counterforce schemes and therefore
do not need Lee's sophisticated arguments against them.
Were Lee's book put into a time vault and retrieved in a hundred years,
it might be eagerly studied by Chinese and Japanese strategists seeking escape
from the wearying maneuvers of a newborn nuclear arms race. But it might
be viewed, after a hundred years, as a troubling and elegant reminder of a
world well lost.

DOUGLAS P. LACKEY
Baruch College and the GraduateCenter, CUNY

Nussbaum, Martha, and Sen, Amartya, eds. The Quality of Life.

New York: Clarendon Press, 1993. Pp. 453. $19.95 (paper).

This volume is an attempt to examine arguments for and against a variety of

different accounts of how to measure the quality of life. The articles in it
derive from a conference that took place at the WILDER in Helsinki in July
1988. The conference was an attempt to bring philosophers and economists
together to discuss this important topic, although the philosophers who are
included in this volume outnumber the economists by about two to one. The
volume contains articles by, among others, Julia Annas, Sissela Bok, G. A.
Cohen, Robert Erikson, Martha Nussbaum, Onora O'Neill, Derik Parfit, Hil-
ary Putnam, Ruth Anna Putnam, John Roemer, Thomas Scanlon, Amartya
Sen, Charles Taylor, and Michael Walzer, with some articles serving as com-
mentaries on other articles. The volume is divided into four sections.
In section 1, Cohen and Sen evaluate the capability approach to assessing
quality of life. Cohen clearly and succinctly summarizes much of the debate
in "left-egalitarian thinking" concerning what it is that people should have
equal shares of. In so doing, he comes close to endorsing Sen's capability
approach, but he claims that Sen's account suffers from "a severe expositional

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 Book Reviews 199
obscurity." According to Cohen, Sen wants to assess the quality of life in
terms of something in between primary goods and welfare-what Sen calls
"functionings" and Cohen calls "midfare" (because it is in between primary
goods and welfare). Sen's mistake, according to Cohen, is to definitionally
connect functionings or midfare with capabilities since at least some of the
functionings and midfare that we think contribute to the qualify of life do
not link up with any (active) capability that persons have. Cohen claims that
we see this most clearly when a baby is being nourished or when we are being
warmed by the rays of the sun. In such cases, no capability is being exercised
at all.
In response, Sen points out that some of the capabilities we have are not
created by us, for example, the capability to have a malaria-free life. But the
issue here is not whether capabilities are created by us but whether they are
such that they are all exercised by us, and in Cohen's examples babies and
anyone who is being warmed by the sun do not appear to be exercising any
capabilities at all. A more adequate response would be to point out that even
in these cases, a capability is still being realized, if not exercised, and so
provided that this sense of capability is included, it is still appropriate to
describe Sen's approach to assessing quality of life as a capability approach.
Nevertheless, while recognizing the merit of these and other articles in-
cluded in this section, one suspects that the goal of "examining arguments
for and against a variety of different accounts of how to measure quality of
life" (p. 2) might be better served if some representatives of the welfare or
primary-goods perspectives were included here. One also wonders how one
can hope to make much headway toward achieving this goal if only the views
of left-egalitiarians on the quality of life are discussed or represented. I suspect
that I can fairly make this point being a left-egalitarian myself. (I now under-
stand from Martha Nussbaum that there was an attempt to secure a wider
spectrum of views, but some people did not defend the views they were ex-
pected to defend, and other people who were invited chose not to attend.)
Section 2 begins with Hilary Putnam's interesting, extended critique of
Bernard Williams's distinction between truth in science and truth in ethics,
which elevates truth in science over truth in ethics. Against Williams, Putnam
argues that truth in ethics and truth in science are virtually on a par. Here it
would have been interesting to see Williams's response to Putnam's critique.
(Again, Nussbaum informs me that Williams was invited but was unable to
attend.) However, this section does include an article by Charles Taylor in
which he tries to distinguish arguments in science from arguments in ethics
but then maintains that this still allows for considerable scope for ad hominem
arguments in ethics.
This section also includes an important article by Michael Walzer which
attempts to show how his social construction view of morality is in fact compati-
ble with the universal condemnation of sexist objectification. Walzer argues
that sexist objectification is incompatible with-moral agency and, hence, cannot
be the result of what he means by "social construction."
The two other principal papers in this section return to the discussions
of what constitutes the quality of life. Thomas Scanlon argues persuasively
against the adequacy of desire as a measure of the quality of life, arguing
instead for exploration of an approach based on a critical scrutiny of a "sub-

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200 Ethics October1994
stantial list" of elements that make life valuable. Scanlon appears to be endors-
ing a primary-goods analysis of the quality of life ofjust the sort that is rejected
by Cohen and Sen, but, unfortunately, he does not respond to the most central
reasons they give for rejecting such an account. In the end, Scanlon may wish
to argue that while a substantial list of primary goods fails as an analysis of
the quality of life, it can still prove useful when we are trying to achieve a
political consensus.
In her principal contribution to this section, Martha Nussbaum seeks to
defend a refurbished Aristotelian account of the quality of life in terms of
basic human functions that are claimed to have validity for all human beings.
As it turns out, her Aristotelian list of functions tends to converge with propos-
als of Sen and other contributors to this volume. In a later contribution to
this volume, she also argues for the superiority of an Aristotelian over a
Kantian conception of morality, but her argument there seems to depend on a
comparison of a refurbished Aristotelian account to a less refurbished Kantian
account. If contemporary defenders of both types of views are allowed to do
their best refurbishings, it is difficult for me at least to see what sort of practical
differences between the accounts will remain.
In section 3, the shortest in the volume, there are two principal contribu-
tions under the heading "Women's Lives and Gender Justice." In the first,
Julia Annas argues that judgments about the injustice where sex roles are
concerned are systematically backward-looking in that "it is only those who
no longer have to live with a particular sex-linked restriction who can rationally
reject the claim that it was needed to answer a natural difference" (p. 295;
emphasis added). As her commentator, Margarita Valdes, aptly points out,
however, this raises a problem concerning how we can rationallyreject any
sex-linked restrictions in the societies in which we live. Valdes thinks, and I
agree, that we already have sufficient past and present evidence to reject any
such sex-linked restrictions, but Annas contends that it is a virtue of her
account that it is still an open question whether human nature could provide
a grounding for two ideal norms for the lives of men and women.
In her contribution to this section, Onora O'Neill argues that principles
of justice are those principles that can be genuinely consented to by any
plurality of potentially interacting beings, and she relates questions about
gender justice to questions about justice across international boundaries. It
would seem that O'Neill's Kantian account of justice could be usefully con-
nected to the Aristotelian capability account favored by Nussbaum, Sen, and
other contributors to this volume, because in order to determine what princi-
ples people could genuinely consent to, we do need some account of who
those people are and what would be a good life for them. In this way, it seems
possible to draw together the Aristotelian and Kantian accounts discussed in
this volume.
There is much more to this volume than I have been able to summarize
or comment on. For example, section 4 is devoted to policy assessments in
health care and certain issues of welfare economics. But I hope I have said
enough to indicate how important this volume is and how much there is to
learn from it. It is a volume of articles at the cutting edge of current research.
One last point. This is an unusual volume in that most of the contributors
are quite sensitive to feminist issues in assessing the quality of life. I only wish

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 Book Reviews 201
that future volumes devoted to this topic would also be as sensitive to questions
concerning nonhuman life as well as human life, such as the question of
whether respect for the quality of nonhuman life should morally constrain
the means we use for advancing the quality of human life. Accordingly, I was
happy to learn from Nussbaum that a proposal with this more inclusive agenda
has recently been submitted to WILDER.

JAMES P. STERBA
Universityof Notre Dame

McLaughlin, Andrew. Regarding Nature: Industrialismand Deep Ecology.

Albany: State University of New York Press, 1993. Pp. 280. $49.50 (cloth);
$16.95 (paper).

George Brown, Jr., Democrat from California, the influential chair in the U.S.
Congress of the Science, Space, and Technology Committee, addressed the 1993
annual American Academy of Science and Technology Policy Colloquium:
Global leadership in science and technology has not translated into lead-
ership in infant health, life expectancy, rates of literacy, equality of
opportunity, productivity of workers, or efficiency of resource consump-
tion. Neither has it overcome failing education systems, decaying cities,
environmental degradation, unaffordable health care, and the largest
national debt in history.... Basic human needs-elemental needs-are
intrinsically different from other material needs because they can be
satisfied. Other needs appear to be insatiable, as the consumption pat-
terns of the United States clearly demonstrate.. . . Once basic human
needs are met, satisfaction with our lives cannot be said to depend on
the amount of things we acquire, use, and consume.... More technology-
based economic growth is not necessary to satisfy humanity's elemental
needs, nor does more growth quench our thirst for consumption. In
terms of the social contract, we justify more growth because it is suppos-
edly the most efficient way to spread economic opportunity and social
well-being. I am suggesting that this reasoning is simplistic and often
specious. [Science (May 7, 1993), p. 735]
George Brown does not consider himself a deep ecologist, but his warning is
virtually an abstract of Andrew McLaughlin's extended critique here. Brown
is high-level evidence that McLaughlin is prophetic: the hitherto universally
accepted paradigm for human well-being is rapidly facing a crisis. "The expan-
sion of industrialism is honored as 'economic growth,' a process demanded by
politicians and populace as the only road to 'prosperity"' (p. 197). But, despite
the many benefits of a science-and-technology-driven industrialism, we are
now realizing that it has become a kind of cancerous growth, with industry
promoting ever-escalating desires in ever-escalating populations that cannot
be satisfied.
Nor, continues McLaughlin, if they could be satisfied, would people find
the outcome satisfactory. In fact, in the recent experience of prosperity in
the developed countries, people are not any happier when they are more
consumptive. The trouble is that "the human good is conceived as an increase

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