Source
Veit (2025), LIT-098 (Croatian Journal of Philosophy 25(73)), read in full in NOTE-097 from the PhilSci-Archive preprint. The published version was not read, and page numbers are the preprint’s.
What was actually shown
The target. Kukla (2014) defines a condition as a health condition “if and only if, given our resources and situation, it would be best for our collective wellbeing if it were medicalized” (quoted p. 11). Veit classes this as moral conceptual engineering: the same four-stage activity as naturalist conceptual engineering, but with moral, political and social assessment at the first stage (pp. 6–7).
The first horn (pp. 13–14). Kukla offers her neutrality about justice as a strength. Veit calls it “a blatant weakness” (p. 14). In his thought experiment a conservative majority uses the definition to medicalise “an unwillingess to bear the child of one’s rapist”, a same-sex love (the text says “opposite sex”, apparently a slip) and opposition to the dominant religion. The definition would then license what it was built to condemn. It could fail even its own goal of collective wellbeing, unless there is moral consensus.
The second horn (pp. 14–16). Suppose justice were agreed. The definition still counts as health conditions “all and only those things that are perceived to be something social justice should address” (p. 15). Medical tools are refined for whatever they are pointed at, so medicine co-evolves into justice promotion, and “health would simply become justice” (p. 15). Holding medicine fixed is the only escape, and the fixing has to come from naturalist or constructivist resources (p. 16). So “pure normativism can be ‘pure’ in name only” (p. 16).
The remedy (pp. 16–17). Pluralism, with “at least three alternative accounts”. Health needs only an empirical link to wellbeing and autonomy, not a conceptual one, in order to matter morally (p. 17). Justice may still properly inform medical decisions.
What could have come out otherwise. A definition by justice could have been shown to fix a stable extension without outside help. The paper argues that it cannot. It tests nothing.
What this does not say
- That justice has no place in medicine. Veit endorses Kukla’s aim of preventing medicalised oppression and keeps justice as an input to medical decisions. What he rejects is building it into the concept.
- That the second horn’s premise is true. That medical tools grow toward whatever justice demands is asserted, with no historical case (NOTE-097, C3: weak–moderate). The account stands or falls with it.
- That every normativist account fails. A normativist account with a specified theory of justice escapes the first horn by construction. Veit grants that the first horn bites only “unless there is complete moral consensus” (p. 17), which makes it a pragmatic objection.
- That Veit concedes Kukla an escape. The seeded skim said he concedes medicine can be taken as independently fixed (p. 17). The full text makes no such concession. Holding medicine fixed is the route his second horn closes (NOTE-097, corrections).
- That conceptual engineering beats conceptual analysis here. The paper announces that switch and does not argue it (p. 6).
Connections
- The pattern is general: a category defined only by the desirability of acting on it loses its extension. NOTE-097 notes that it could be turned against defining, say, “harmful content” by what it would be good to moderate. The paper does not make that application.
- The reading names a related case of reshaping a mental-health concept for its social effects, which the record holds but could not read.